Marijuana for MS -- Does it Help or Do Users Just Mind Less?

Does marijuana reduce the debilitating physical symptoms of
multiple sclerosis (MS) ... or does it just help patients
care a little less about them? If you or a loved one
suffers from MS, this could be a very important question.

It's widely accepted that marijuana has some therapeutic
value for MS-related symptoms, including for painful muscle
spasticity. In fact, clinical studies have demonstrated
that when two of marijuana's active ingredients,
9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are
isolated and then combined into a drug, they can reduce
muscle spasticity with only minor psychotropic effects.
Sativex, a pharmaceutical formulation of marijuana that is
approved for neuropathic pain in MS patients in Canada but
not in the US, contains both ingredients.

Yet for many, the intoxicating effects of marijuana's
ingredients are troubling.

With the hope of making a case for FDA approval here,
researchers at the Global Neuroscience Initiative
Foundation in Los Angeles selected six recent randomized
controlled trials involving a total of 481 patients with MS
who took oral preparations of combination THC and CBD
extracts. The findings are interesting -- according to the
admittedly subjective reports of the patients, the extracts
relieved spasticity... but when several objective measures
of spasticity (including a mobility index and patients'
"walk time") were examined, no significant i mprovements
were evident. And, though the combination dose was thought
to keep people from getting high, patients in each of the
six trials experienced adverse effects in the form of
intoxication and sedation. The study was published last
December in the online journal BMC Neurology.

Good Stuff or Not?

So -- is marijuana helpful for MS patients? The answer,
according to Moses Rodriguez, MD, a neurologist at the Mayo
Clinic College of Medicine in Rochester, Minnesota, and a
nationally recognized MS expert, is yes and no. Dr.
Rodriguez told me that although many MS patients (including
some of his own) report that marijuana is effective in
alleviating spasticity, he said that there are no standards
regulating how it should be used and "the data proving its
efficacy is weak and its side effects are worrisome."

One challenge, he explained, is that scientists still don't
understand why marijuana helps. "We know that it works on
receptors in the brain, but marijuana does not have a
direct effect on the muscles, so it is difficult to break
away the drug's general well-being effects from its
anti-spasticity effects," he said. He also pointed out that
little is known about marijuana's systemic and long-term
effects on MS patients, which is of potential concern.
Therefore, Dr. Rodriguez remains "very cautious" about
recommending marijuana to his patients, "especially when
other agents are available on the market that can
effectively control spasticity, such as baclofen and
tizanidine," he said. (Note: There is also little data on
long-term effects of these drugs and they, too, have side
effects.) The National Multiple Sclerosis Society takes a
similar stance -- it does not recommend medical marijuana,
citing "insufficient evidence of a clea r benefit compared
with existing therapies and issues of side effects,
systemic effects and long-term effects."

Dr. Rodriguez believes that there may come a day when new
marijuana agents will be manufactured that offer the
anti-spasticity effects without the side effects. Until
then, he recommends staying with FDA-approved drugs for
MS-related spasticity.


Source(s):
Moses Rodriguez, MD, a neurologist at Mayo Clinic in
Rochester, Minnesota, professor of immunology and neurology
at the Mayo Clinic College of Medicine.

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