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Nabilone is a synthetic cannabinoid with therapeutic use as an antiemetic and as an adjunct analgesic for neuropathic pain. It mimics tetrahydrocannabinol (THC), the primary psychoactive compound found naturally occurring in Cannabis.

In Canada, the United States, the United Kingdom and Mexico, nabilone is marketed as Cesamet. It was approved in 1985 by the U.S. Food and Drug Administration (FDA) for treatment of chemotherapy-induced nausea and vomiting (CINV) that has not responded to conventional antiemetics. Though it was approved by the FDA in 1985, the drug only began marketing in the United States in 2006. In Austria Nabilone is marketed as Canemes and got its approval for CINV in 2013.

Although it doesn't have any indication officially (except in Mexico), nabilone is widely used as an adjunct therapy for chronic pain management. Numerous trials and case studies have demonstrated modest effectiveness for relieving fibromyalgia[3] and multiple sclerosis.

Nabilone is a racemic mixture consisting of the (S,S) and the (R,R) isomers ("trans").

Chemical Nomenclature
Common names Cesamet (r)
Substitutive name Nabilone
Systematic name (6aR,10aR)-rel-1-hydroxy-6,6-dimethyl-3-(2-methyloctan-2-yl)-
Routes of Administration

WARNING: Always start with lower doses due to differences between individual body weight, tolerance, metabolism, and personal sensitivity. See responsible use section.

Threshold < 0.25 - 0.50 mg
Light 1 mg
Common 1.5 - 2 mg
Strong 3 - 4 mg
Heavy > 6 mg
[[ {{{OralROA_TimelineFile}}} | center | {{{OralROA_TimelineWidth}}} ]]
Total 6 - 8 hours
Onset 60 minutes
Peak 40-60 hours
Offset x hours

DISCLAIMER: PW's dosage information is gathered from users and resources for educational purposes only. It is not a recommendation and should be verified with other sources for accuracy.

Medical uses Nabilone has shown modest effectiveness in relieving fibromyalgia. A 2011 systematic review of cannabinoids for chronic pain determined there was evidence of safety and modest efficacy for some conditions.

The main settings that have seen published clinical trials of nabilone include movement disorders such as parkinsonism, chronic pain, dystonia and spasticity neurological disorders, multiple sclerosis, and the nausea of cancer chemotherapy. Nabilone is also effective in the treatment of inflammatory bowel disease, especially ulcerative colitis. Medical cannabis patients report that nabilone is more similar in effect to cannabidiol (CBD) than tetrahydrocannabinol (THC), indicating that it has more of a therapeutic effect on the body than a "high" effect on the mind.

A study comparing nabilone with metoclopramide, conducted before the development of modern 5-HT3 antagonist anti-emetics such as ondansetron, revealed that patients taking cisplatin chemotherapy preferred metoclopramide, while patients taking carboplatin preferred nabilone to control nausea and vomiting.

Nabilone is also occasionally used for the adjuvant treatment of severe anxiety.

Nabilone is sometimes used for nightmares in PTSD, but there have not been studies longer than nine weeks, so effects of longer term use are not known. Nabilone has also been used for medication overuse headache.

Subjective effects The effects listed below are based upon the subjective effects index and personal experiences of PsychonautWiki contributors. The listed effects will rarely (if ever) occur all at once, but heavier dosages will increase the chances and are more likely to induce a full range of effects. Physical effects Effect::Spontaneous tactile sensations - The "body high" of cannabis is extremely variable in both its style and intensity. It depends entirely on the individual strain of plant and does not manifest itself consistently. In general, however, it can be described as a pleasurable, warm, soft, and all-encompassing tingling sensation. It maintains a consistent presence that quickly rises with the onset and hits its limit once the peak has been reached before immediately dissipating. Effect::Sedation - Although certain strains of cannabis present mild encouraged stimulation at low to moderate doses, for the most part, the effects on the user's energy levels are primarily sedating. This encourages one to relax but can, however, be suppressed by simply forcing oneself to engage in physical activities. Effect::Motor control loss - This substance causes a partial to moderate suppression of motor control which intensifies proportional to dose, but rarely results in a complete inability to walk and perform basic movements. Effect::Appetite enhancement - The feeling of increased appetite following the use of cannabis has been documented for hundreds of years and is known colloquially as "the munchies" in popular American and United Kingdom culture. Clinical studies and survey data have found that cannabis increases food enjoyment and interest in food. This is thought to be due to the way in which endocannabinoids in the hypothalamus activate cannabinoid receptors that are responsible for maintaining food intake.[3] Effect::Nausea suppression - Nabilone is effective for suppressing nausea induced by both general illness and substances. It is considered an effective treatment for chemotherapy-induced nausea and vomiting (CINV) and is a reasonable option in those who do not improve following preferential treatment. Effect::Vasodilation - THC decreases blood pressure which dilates the blood vessels and increases blood flow throughout the body. The arteries in the eyeball expand from the decreased blood pressure. Studies in the 1970s showed marijuana, when smoked or eaten, effectively lowers intraocular pressure by about 25%, as much as standard medications.[6] These enlarged arteries often produce a bloodshot red eye effect. It is precisely this effect on the human eye that makes cannabis an effective medicine for glaucoma.[7] Effect::Pain relief - This substance has been reported as useful for treating certain headaches and chronic pain, including pain caused by neuropathy and possibly fibromyalgia and rheumatoid arthritis.[8][9] Effect::Perception of increased weight or Perception of decreased weight - Depending on the specific strain of cannabis, one can find themselves with a body which can feel either physically heavier or lighter than it usually would in a style that is entirely dependent upon dose. Effect::Changes in gravity - At extremely high doses, many users report a feeling of being pulled backwards across vast distances at powerful speeds. This sensation progressively increases in intensity and eventually becomes unbearable if one leans backwards or lies down; however, it disappears altogether once the user sits up or leans forward. Effect::Dehydration- This is known colloquially as "cotton mouth" in popular American and United Kingdom culture. Effect::Seizure suppression - There are many anecdotal reports of the successful treatment of seizures in epilespy with the use of low THC/high CBD marijuana. However, there is not enough scientific evidence to draw conclusions about its safety or efficacy.

Cognitive effects Effect::Emotion enhancement - The most prominent cognitive component of the cannabis experience is the way in which it enhances the emotions one is already feeling proportional to dose. This can result in euphoria, extreme laughter, and increased immersion within tasks and activities or it can result in anxiety and paranoia depending on the user's current state of mind. Effect::Paranoia - All cannabinoids are capable of inducing paranoia at high doses or with chronic administration. Effect::Dream suppression - It is commonly reported that regular cannabis use before sleep results in a complete absence of dreams. A day or two of abstaining from cannabis results in an intensification of dreams for a short period of time. Effect::Laughter Effect::Thought connectivity Effect::Thought deceleration Effect::Immersion enhancement Effect::Conceptual thinking Effect::Mindfulness Effect::Information processing suppression Effect::Anxiety or Effect::Anxiety suppression Effect::Memory suppression - Nabilone as Cannabis is known to suppress short-term memory due to inhibition of glutamate neurotransmission in the hippocampus. This effect primarily effects short-term memory, making ego death or long-term memory suppression very unlikely. Effect::Time distortion - Nabilone as Cannabis has been commonly reported to alter one's sense of time. The distortion that occurs is generally mild, and is most commonly reported to be in the the form of time expansion. Effect::Derealization Effect::Depersonalization Effect::Novelty enhancement Effect::Suggestibility enhancement Effect::Creativity enhancement

Visual effects Effect::Colour enhancement Acuity suppression - Nabilone as THC is known to decrease intraocular pressure. This can sometimes result in blurry vision for some people. Effect::Geometry - Nabilone as Cannabis is capable of inconsistently inducing mild psychedelic geometry at extremely high doses within many users. Within many users who also regularly use psychedelics, however, it is capable of inducing these consistently in a visual style which seems to be an averaged out depiction of all the psychedelics one has used within the past. These rarely extend beyond level 4 and are considered to be mild, fine, small and zoomed out (but often well-defined). Effect::Brightness alteration - THC has been shown to modulate the activity of cone cells in the eye. This can cause an increased sensitivity to light, causing ones vision to appear brighter than normal.

Auditory effects Enhancements Multi-sensory effects Effect::Synaesthesia

Combinational effects Psychedelics - When used in combination with psychedelics, cannabis is capable of intensifying and extending the duration of both the visual and cognitive effects with extreme efficiency. This should be used with caution if one is not experienced with psychedelics. Dissociatives - When used in combination with dissociatives, the geometry, euphoria, dissociation and hallucinatory effects are often greatly enhanced. Alcohol - When used in combination with alcohol, cannabis often creates feelings of extreme nausea, dizziness and changes in gravity. It is recommended that people smoke before drinking and not the other way around unless they are extremely cautious.

Experience reports

There are currently no anecdotal reports which describe the effects of this compound within our experience index. Additional experience reports can be found here:

External links