Article

Cannabis use in patients with multiple sclerosis

London School of Hygiene and Tropical Medicine, Londinium, England, United Kingdom
Multiple Sclerosis (Impact Factor: 4.86). 11/2006; 12(5):646-51. DOI: 10.1177/1352458506070947
Source: PubMed

ABSTRACT Little is known about the extent and patterns of cannabis use in people with multiple sclerosis (MS).
MS patients attending neurology outpatient clinics at two hospitals in London and one in Kent, UK completed a questionnaire.
Questionnaires were completed by 254/337 (75%) MS patients. Forty-three per cent had used cannabis at some stage (ever users). Of these, 68% (75/110) had used cannabis to alleviate symptoms of MS (MS-related cannabis use). Forty-six (18%) had used cannabis in the last month (current users), of whom 12% (31/254) had used it for symptom relief. Being married or having a long-term partner, tobacco smokers and increasing disability were independent risk factors for MS-related cannabis use. Compared to patients who could walk unaided, cannabis use was more likely in those who were chair-bound (adjusted OR 2.47; 1.10-5.56) or only able to walk with an aid (adjusted OR 1.56; 0.90-3.60). Pain and spasms were common reasons for cannabis use. Seventy-one per cent of individuals who had never used cannabis said they would try the drug if it were available on prescription.
A large proportion of MS patients had tried cannabis for symptom control, however current use was small. A subgroup with greater disability appears to derive some symptomatic benefit.

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Available from: Kim Wolff, Nov 27, 2014
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    • "With the advent of the internet, use of CAM can be widely publicised and adopted even before scientific evidence can support or refute the claims of efficacy. Indeed PwMS perceived benefit from taking cannabis for the control of sleep disturbances, pain and spasticity (Consroe et al. 1997; Clark et al. 2004; Chong et al. 2006). This was subsequently supported by biology, experimental and clinical class I evidence in humans to support the role of cannabinoid control of spasticity and pain in PwMS (Baker et al. 2000, 2012; Novotna et al. 2011; Zajicek et al. 2012; Langford et al. 2013). "
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    ABSTRACT: Multiple sclerosis (MS) is the major immune-mediated, demyelinating, neurodegenerative disease of the central nervous system. Compounds within cannabis, notably Δ9-tetrahydrocannabinol (Δ9-THC) can limit the inappropriate neurotransmissions that cause MS-related problems and medicinal cannabis is now licenced for the treatment of MS symptoms. However, the biology indicates that the endocannabinoid system may offer the potential to control other aspects of disease. Although there is limited evidence that the cannabinoids from cannabis are having significant immunosuppressive activities that will influence relapsing autoimmunity, we and others can experimentally demonstrate that they may limit neurodegeneration that drives progressive disability. Here we show that synthetic cannabidiol can slow down the accumulation of disability from the inflammatory penumbra during relapsing experimental autoimmune encephalomyelitis (EAE) in ABH mice, possibly via blockade of voltage-gated sodium channels. In addition, whilst non-sedating doses of Δ9-THC do not inhibit relapsing autoimmunity, they dose-dependently inhibit the accumulation of disability during EAE. They also appear to slow down clinical progression during MS in humans. Although a 3 year, phase III clinical trial did not detect a beneficial effect of oral Δ9-THC in progressive MS, a planned subgroup analysis of people with less disability who progressed more rapidly, demonstrated a significant slowing of progression by oral Δ9-THC compared to placebo. Whilst this may support the experimental and biological evidence for a neuroprotective effect by the endocannabinoid system in MS, it remains to be established whether this will be formally demonstrated in further trials of Δ9-THC/cannabis in progressive MS.
    Journal of Neuroimmune Pharmacology 12/2014; 10(2). DOI:10.1007/s11481-014-9575-8 · 3.17 Impact Factor
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    • "To our knowledge, this survey represents the largest systematic study of patient experiences with CBMs conducted to date. Although other, and sometimes larger, surveys have been reported, they did not compare patients' experiences with multiple CBM products or administrations forms, or they were restricted to a single country and/or focused on a single medical condition (Hazekamp 2013; Corless 2009; O'Connell 2007; Chong 2006; Ware 2005; Prentiss 2004; Page 2003; Ware 2003; Braitstein 2001; Ogborne 2000). The majority of subjects in our study were current users who had a health professional involved in the management of their illness, and were using CBMs for at least several years. "
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    ABSTRACT: Cannabinoids, including tetrahydrocannabinol and cannabidiol, are the most important active constituents of the cannabis plant. Over recent years, cannabinoid-based medicines (CBMs) have become increasingly available to patients in many countries, both as pharmaceutical products and as herbal cannabis (marijuana). While there seems to be a demand for multiple cannabinoid-based therapeutic products, specifically for symptomatic amelioration in chronic diseases, therapeutic effects of different CBMs have only been directly compared in a few clinical studies. The survey presented here was performed by the International Association for Cannabinoid Medicines (IACM), and is meant to contribute to the understanding of cannabinoid-based medicine by asking patients who used cannabis or cannabinoids detailed questions about their experiences with different methods of intake. The survey was completed by 953 participants from 31 countries, making this the largest international survey on a wide variety of users of cannabinoid-based medicine performed so far. In general, herbal non-pharmaceutical CBMs received higher appreciation scores by participants than pharmaceutical products containing cannabinoids. However, the number of patients who reported experience with pharmaceutical products was low, limiting conclusions on preferences. Nevertheless, the reported data may be useful for further development of safe and effective medications based on cannabis and single cannabinoids.
    Journal of psychoactive drugs 07/2013; 45(3):199-210. DOI:10.1080/02791072.2013.805976 · 1.10 Impact Factor
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    • "In one survey in the UK, 75 patients with MS were questioned, of which 49 experienced chronic pain. Of these patients, 83.7% had tried cannabis to help treat their condition, and 75.6% reported that it provided some relief for their pain (Chong et al., 2006). In an earlier survey that targeted patients with MS that self-medicated with cannabis, some 95% of respondents reported that cannabis improved chronic pain to their extremities, spasticity, and some other symptoms such as bladder and bowel dysfunction (Consroe et al., 1997). "
    Neuropathic Pain, 03/2012; , ISBN: 978-953-51-0452-0
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