In a very small double blind placebo controlled clinical trial with palmitoylethanolamide no effects could be found on pain and spasticity. The trial was sadly enough in less than 70 patients. There was no dose finding in this study, a second flaw. Most probably PEA needs to be given in a dose around 2000 mg/day for positive effects in such a severe disorder.
It is a missed opportunity to spent so much effort in a trial with few patients and no dose finding in such an important indication.
For treating spinal cord pain and pain in other central nervous disorders a dose of above 2000 mg/day is recommendable.
Andresen SR, Bing J, Hansen RM, Biering-Sørensen F, Johannesen IL, Hagen EM, Rice AS, Nielsen JF, Bach FW, Finnerup NB. Ultramicronized palmitoylethanolamide in spinal cord injury neuropathic pain: A randomized, double-blind, placebo-controlled trial. Pain. 2016 May 25. [Epub ahead of print]