• Pain: Limited. A Cochrane review of two small nabilone trials found no convincing benefit. Newer studies and patient surveys are more positive but lower quality .

• Sleep: Limited. One small trial found nabilone improved sleep more than amitriptyline.

Compared with standard treatment: Exercise, sleep habits, and medicines such as duloxetine have stronger evidence.

Good to know: People with fibromyalgia are often sensitive to side effects. Start with the conservative approach.

What to ask for: A low-dose THC-containing product at bedtime, the approach studied with nabilone. Start with the conservative approach.