A to Z of MS
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A to Z of MS Cannabis
There has been some research into cannabis based medicines.
The CAMS study, which involved 660 participants around the UK, looked at the effect of cannabis on various symptoms of MS, primarily on spasticity. Results of this study were mixed, with no significant effect on spasticity as measured by the Ashworth scale. However, some improvement was shown on the time taken to complete a 10-metre walk and patient satisfaction scored were positive.
A systematic review published in December 2009 found that five out of six double-blind, randomized controlled trials reported a decrease in spasticity and improved mobility in people with MS taking a combination of the cannabis extracts Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). All of the studies reported some side effects which seemed to be related to the dosage. Generally the treatment was well-tolerated.
The CUPID trial explored whether cannabis might have a role in protecting the brain from damage by multiple sclerosis, a concept called neuroprotection. Initial results from the study were presented in May 2012 and showed that was no difference between participants who took the cannabis based medicine and those on placebo.
The MUSEC trial, which reported in 2012, involved 279 people taking a cannabis based pill or placebo. The trial showed higher proportions of people on the active treatment reporting reductions in muscle stiffness, spasms and pain and improved sleep quality.
Sativex is a cannabis based mouth spray. It is licensed as an add-on treatment for moderate to severe MS spasticity in people who receive inadequate relief from the standard oral anti-spasticity medicines or have experienced unbearable side effects whilst taking these medicines.
Other than its use in medical trials or in the form of Sativex, it is illegal to posess, cultivate or supply cannabis in the UK.
Zajicek J, et al.
Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial.
Lancet. 2003 Nov 8;362(9395):1517-1526.
Lakhan SE, Rowland M.
Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review.
BMC Neurology 2009;9:59
CUPID study press release.
Study shows noevidence to support an effect of main active constituent of cannabis on MS progression.
read online (pdf 25kb)
Zajicek JP, et al.
Multiple sclerosis and extract of cannabis: results of the MUSEC trial.
Journal of Neurology Neurosurgery and Psychiatry 2012 Jul 12. [Epub ahead of print]