Chest pain doesn’t necessarily come from the heart. An estimated 200,000 Americans each year experience non-cardiac chest pain, which in addition to pain can involve painful swallowing, discomfort and anxiety. Non-cardiac chest pain can be frightening for patients and result in visits to the emergency room because the painful symptoms, while often originating in the esophagus, can mimic a heart attack. Current treatment — which includes pain modulators such as selective serotonin reuptake inhibitors (SSRI) — has a partial 40 to 50 percent response rate in alleviating symptoms.
New research authored by Temple University Hospital gastroenterologist Ron Schey, MD, FACG, suggests a novel approach to treating non-cardiac chest pain due to esophageal hypersensitivity. The treatment involves a drug called dronabinol, a cannabinoid receptor activator that has traditionally been used to treat nausea and vomiting in HIV patients and for cancer patients undergoing chemotherapy,
In a pilot study involving 13 patients with non-cardiac chest pain, Dr. Schey and his research team found that patients who were given 5 mg of dronabinol twice daily for four weeks fared better than patients who took a placebo, or dummy pill. Those getting dronabinol experienced improved pain tolerance and decreased frequency and intensity of chest pain. In addition, no significant adverse effects were reported.
“This novel study has promising findings in future treatment for these patients,” said Dr. Schey, Associate Professor of Medicine at Temple University School of Medicine, who conducted the research while on staff at the University of Iowa Hospitals and Clinic, and analyzed the data at Temple along with Zubair Malik, MD, a first-year fellow in Temple’s Division of Gastroenterology.