FAAH: Fatty acid amide hydrolase (FAAH) inhibitors attenuate persistent pain-related behavior
HIV-sensory neuropathic (HIV-SN) pain may be treatable by cannabinoids, but Cannabis is reluctantly prescribed. Endogenous lipids such as palmitoylethanolamide or fatty acid amide hydrolase (FAAH) inhibitors may offer an alternative approaches to treat neuropathic pain. FAAH inhibitors act via inhibiting the degradation of endocannabinoids and lipid signaling molecules such as 2-AG and anandamide.
In order to evaluate this potential approach in the management of HIV-SN pain, two distinct FAAH inhibitory compounds, URB597 and PF-3845 were tested in a model, and compared with standard antinociceptive gabapentin or vehicle treatment, for the attenuation of tactile allodynia, cold allodynia, and mechanical hyperalgesia. 
Both FAAH inhibitors markedly reduced cold and tactile allodynia with limited anti-hyperalgesic effects.
The effects of both FAAH inhibitors were longer lasting than gabapentin.
Conclusion was that:
these findings support the use of lipid messengers such as palmitoylethanolamide (or 2-AG and anandamide), as well as the inhibition of endocannabinoid degradation as a promising target for management of disabling persistent HIV-SN pain syndromes.
December 2014, prof. dr. Jan M. Keppel Hesselink