humulene and Muscle-Spasticity

As far as 80% of people diagnosed with multiple sclerosis (MS) experience disabling symptoms in the course of the disease, such as spasticity and neuropathic pain. As first-line symptomatic therapy is associated with important adverse reactions, cannabinoids have become increasingly popular among patients with MS. This review intends to provide an overview of the evidence of the role of cannabinoids in treating symptoms related to MS and to encourage further research on this matter.. To date, the evidence supporting the role of cannabis and its derivatives in alleviating the MS-related symptoms comes only from studies on experimental models of demyelination. To the best of our knowledge, relatively few clinical trials inquired about the therapeutic effects of cannabinoids on patients with MS, with variable results.. We conducted a literature search through PubMed and Google Scholar from the beginning until 2022. We included articles in English describing the latest findings regarding the endocannabinoid system, the pharmacology of cannabinoids, and their therapeutic purpose in MS.. Evidence from preclinical studies showed that cannabinoids can limit the demyelination process, promote remyelination, and have anti-inflammatory properties by reducing immune cell infiltration of the central nervous system in mice with experimental autoimmune encephalomyelitis. Moreover, it has been established that experimental autoimmune encephalomyelitis mice treated with cannabinoids experienced a significant reduction of symptoms and slowing of the disease progression. Given the complexity of human immune and nervous systems, cannabinoids did not have the anticipated effects on human subjects. However, data obtained from clinical trials showed some beneficial results of cannabinoids as a single or as add-on therapy in reducing the spasticity and pain related to MS.. Considering their various mechanisms of action and good tolerability, cannabinoids remain an interesting therapy for spasticity and chronic pain related to MS.

Topics: Animals; Cannabinoid Receptor Agonists; Cannabinoids; Cannabis; Encephalomyelitis, Autoimmune, Experimental; Humans; Mice; Models, Theoretical; Multiple Sclerosis; Muscle Spasticity; Neuralgia

Cannabis products are being increasingly liberalized all over the world and there is a huge interest in cannabis-based medicine.. Presentation of current studies on the efficacy of different cannabis-based medicine for the treatment of various diseases CURRENT DATA: In German pharmaceutical legislation, nabiximols is approved for the treatment of moderate to severe therapy-resistant spasticity in multiple sclerosis and nabilone is approved for the treatment of therapy-resistant chemotherapy-associated nausea and vomiting. In case of therapy failure cannabinoids, as part of an individual therapeutic attempt, may be considered for the treatment of chronic pain (neuropathic pain, cancer pain, non-neuropathic noncancer pain), cachexia in human immunodeficiency virus as well as for Dravet and Lennox-Gastaut syndrome. From the authors' perspective there is not enough evidence for the use in chemotherapy-associated nausea and vomiting and chronic non-neuropathic pain.. Currently, a wide use of cannabinoids does not seem probable in the near future. Further studies involving more patients and evaluating long-term effects are necessary.

Topics: Cannabinoids; Cannabis; Chronic Pain; Humans; Muscle Spasticity; Nausea; Vomiting

Biological activity of cannabinoids is caused by binding to two cannabinoid receptors CB1 and CB2. Psychoactive is not only tetrahydrocannabinol (THC) but also: cannabidiol, cannabigerol or cannabichromen. Formerly, the usefulness of hemp was assessed in the relation to temporary appeasement of the symptoms of some ailments as nausea or vomiting. Present discoveries indicates that cannabis-based drugs has shown ability to alleviate of autoimmunological disorders such as: Multiple sclerosis (MS), Rheumatoid arthritis (RA) or inflammatory bowel disease. Another studies indicates that cannabinoids play role in treatment of neurological disorders like Alzheimer disease or Amyotrophic lateral sclerosis (ALS) or even can reduce spreading of tumor cells. Cannabinoids stand out high safety profile considering acute toxicity, it is low possibility of deadly overdosing and side-effects are comprise in range of tolerated side-effects of other medications. In some countries marinol and nabilone are used as anti vomiting and nausea drug. First cannabis-based drug containg naturally occurring cannabinoids is Sativex. Sativex is delivered in an mucosal spray for patients suffering from spasticity in MS, pain relevant with cancer and neuropathic pain of various origin. Despite the relatively low acute toxicity of cannabinoids they should be avoid in patients with psychotic disorders, pregnant or breastfeeding woman. Cannabinoids prolong a time of reaction and decrease power of concentration that's why driving any vehicles is forbidden. Cannabis side-effects varies and depend from several factors like administrated dose, rout of administration and present state of mind. After sudden break from long-lasting use, withdrawal symptoms can appear, although they entirely disappear after a week or two.

Topics: Arthritis, Rheumatoid; Cannabidiol; Cannabinoids; Cannabis; Contraindications; Dronabinol; Drug Combinations; Humans; Inflammatory Bowel Diseases; Multiple Sclerosis; Muscle Spasticity; Nausea; Nervous System Diseases; Pain; Plant Extracts; Vomiting

Marijuana has been used medically since antiquity. In recent years there has been a resurgence of interest in medical applications of various cannabis preparations. These drugs have been cited in the medical literature as potential secondary treatment agents for severe pain, muscle spasticity, anorexia, nausea, sleep disturbances, and numerous other uses. This article reviews the research literature related to medical applications of various forms of cannabis. Benefits related to medical use of cannabinoids are examined and a number of potential risks associated with cannabis use, both medical and recreational, are considered. There is a clearly identified need for further research to isolate significant benefits from the medical application of cannabinoids and to establish dosage levels, appropriate delivery mechanisms and formulations, and to determine what role, if any, cannabinoids might play in legitimate medical applications. It is also imperative to determine if reported dangers pose a significant health risks to users.

Topics: Cannabinoids; Cannabis; Clinical Trials as Topic; Dronabinol; Humans; Marijuana Abuse; Muscle Spasticity; Nausea; Pain; Quality of Life; United States

Cannabis-based medications have been a topic of intense study since the endogenous cannabinoid system was discovered two decades ago. In 2011, for the first time, a cannabis extract was approved for clinical use in Germany.. Selective literature review.. Cannabis-based medications exert their effects mainly through the activation of cannabinoid receptors (CB1 and CB2). More than 100 controlled clinical trials of cannabinoids or whole-plant preparations for various indications have been conducted since 1975. The findings of these trials have led to the approval of cannabis-based medicines (dronabinol, nabilone, and a cannabis extract [THC:CBD=1:1]) in several countries. In Germany, a cannabis extract was approved in 2011 for the treatment of moderate to severe refractory spasticity in multiple sclerosis. It is commonly used off label for the treatment of anorexia, nausea, and neuropathic pain. Patients can also apply for government permission to buy medicinal cannabis flowers for self-treatment under medical supervision. The most common side effects of cannabinoids are tiredness and dizziness (in more than 10% of patients), psychological effects, and dry mouth. Tolerance to these side effects nearly always develops within a short time. Withdrawal symptoms are hardly ever a problem in the therapeutic setting.. There is now clear evidence that cannabinoids are useful for the treatment of various medical conditions.

Topics: Anorexia; Cannabinoids; Cannabis; Chronic Pain; Evidence-Based Medicine; Humans; Muscle Spasticity; Nausea; Vomiting

Cannabis therapy has been considered an effective treatment for spasticity, although clinical reports of symptom reduction in multiple sclerosis (MS) describe mixed outcomes. Recently introduced therapies of combined Delta9-tetrahydrocannabinol (THC) and cannabidiol (CBD) extracts have potential for symptom relief with the possibility of reducing intoxication and other side effects. Although several past reviews have suggested that cannabinoid therapy provides a therapeutic benefit for symptoms of MS, none have presented a methodical investigation of newer cannabinoid treatments in MS-related spasticity. The purpose of the present review was to systematically evaluate the effectiveness of combined THC and CBD extracts on MS-related spasticity in order to increase understanding of the treatment's potential effectiveness, safety and limitations.. We reviewed MEDLINE/PubMed, Ovid, and CENTRAL electronic databases for relevant studies using randomized controlled trials. Studies were included only if a combination of THC and CBD extracts was used, and if pre- and post-treatment assessments of spasticity were reported.. Six studies were systematically reviewed for treatment dosage and duration, objective and subjective measures of spasticity, and reports of adverse events. Although there was variation in the outcome measures reported in these studies, a trend of reduced spasticity in treated patients was noted. Adverse events were reported in each study, however combined TCH and CBD extracts were generally considered to be well-tolerated.. We found evidence that combined THC and CBD extracts may provide therapeutic benefit for MS spasticity symptoms. Although some objective measures of spasticity noted improvement trends, there were no changes found to be significant in post-treatment assessments. However, subjective assessment of symptom relief did often show significant improvement post-treatment. Differences in assessment measures, reports of adverse events, and dosage levels are discussed.

Topics: Cannabis; Humans; Multiple Sclerosis; Muscle Spasticity; Phytotherapy; Plant Extracts

For centuries extracts from the Cannabis sativa plant have been used for recreational use and as remedies. Anecdotal reports from patients with multiple sclerosis (MS) experiencing relief of their spasticity and pain after smoking marihuana have prompted discussions about a potential therapeutic application of cannabis preparations in MS. Only recently the first large, multicenter, double-blind, placebo controlled study was conducted evaluating the use of cannabinoids for treatment of spasticity and other symptoms related to MS. Based on this trial and previous uncontrolled observations together with insights from basic research and animal experiments there is reasonable evidence for the therapeutical employment of cannabinoids in the treatment of MS related symptoms. Furthermore, data are arising that cannabinoids have immunomodulatory and neuroprotective properties. However, results from clinical trials do not allow the recommendation for the general use of cannabinoids in MS. This article summarizes the present knowledge of clinical and experimental research regarding the therapeutic potential of cannabinoids for the treatment of MS.

Topics: Cannabinoids; Cannabis; Humans; Immunologic Factors; Multiple Sclerosis; Muscle Spasticity; Neuroprotective Agents; Pain; Phytotherapy

Topics: Cannabis; Humans; Multiple Sclerosis; Muscle Spasticity; Plants, Medicinal; Randomized Controlled Trials as Topic

Growing basic research in recent years led to the discovery of the endocannabinoid system with a central role in neurobiology. New evidence suggests a therapeutic potential of cannabinoids in cancer chemotherapy-induced nausea and vomiting as well as in pain, spasticity and other symptoms in multiple sclerosis and movement disorders. Results of large randomized clinical trials of oral and sublingual Cannabis extracts will be known soon and there will be definitive answers to whether Cannabis has any therapeutic potential. Although the immediate future may lie in plant-based medicines, new targets for cannabinoid therapy focuses on the development of endocannabinoid degradation inhibitors which may offer site selectivity not afforded by cannabinoid receptor agonists.

Topics: Cannabinoid Receptor Modulators; Cannabinoids; Cannabis; Dronabinol; Endocannabinoids; Humans; Multiple Sclerosis; Muscle Spasticity; Pain; Phytotherapy; Plant Extracts; Receptors, Cannabinoid

Marijuana contains over 60 different types of cannabinoids, which are its medicinally active ingredients. Cannabinoids have the capacity for neuromodulation--through direct, receptor-based mechanisms--at many levels within the nervous system, providing therapeutic properties that may be applicable to the treatment of neurologic disorders. These include antioxidation, neuroprotection, analgesia, anti-inflammation, immunomodulation, modulation of glial cells, and tumor growth regulation. This article reviews the current and emerging research on the physiologic mechanisms of endogenous and exogenous cannabinoids and their applications in the management of neurologic disease.

Topics: Analgesia; Cannabis; Humans; Legislation, Drug; Muscle Spasticity; Nervous System Diseases; Neuroglia; Neuroprotective Agents; Pain; Phytotherapy; Plant Preparations

--In 1996, the Netherlands Health Council issued a negative recommendation regarding the use of medication on the basis of cannabis (marihuana). However, interest in medicinal cannabis has certainly not waned since. --The neurological diseases for which cannabis could presently be used therapeutically are: multiple sclerosis, chronic (neuropathic) pain and the syndrome of Gilles de la Tourette. --Since September 2003, the Dutch Ministry of Health, Welfare and Sport delivers medicinal cannabis to Dutch pharmacies, so that now for the first time, medicinal cannabis can be given to patients on a prescription basis within the framework of the Opium Law. The result of this is that doctors and patients now assume that this is a medication for which the efficacy and safety have been established. --The question arises whether new scientific data have become available since 1996 that provide scientific support for the current Governmental policy. --In a recent clinical trial that has aroused much discussion, patients with multiple sclerosis and problematic spasticity were treated with oral cannabis or a placebo. There was no significant effect of treatment on the primary outcome measure, i.e. objectively determined spasticity. Nevertheless, it was concluded that the mobility was improved and that the pain was subjectively decreased. --Until now, convincing scientific evidence that cannabinoids are effective in neurological conditions is still lacking. --However, it is also not possible to conclude definitely that cannabinoids are ineffective; still, this is no basis for official stimulation of their use.

Topics: Cannabis; Humans; Muscle Spasticity; Nervous System Diseases; Pain; Phytotherapy; Plant Extracts; Safety; Treatment Outcome

Topics: Anorexia; Cachexia; Cannabinoids; Cannabis; Epilepsy; Hiccup; Humans; Migraine Disorders; Muscle Spasticity; Nausea; Pain; Palliative Care; Randomized Controlled Trials as Topic; Seizures; Vomiting

This review highlights the pharmacology, pharmacokinetics, pharmacological actions, therapeutic uses and adverse effects of cannabinoids. The effect of cannabinoids on anaesthesia is mentioned briefly. Important advances have taken place in cannabinoid research over the last few years and have led to the discovery of novel ligands. The possible clinical applications of these ligands and the direction of future research are discussed.

Topics: Anesthesia; Cannabinoids; Cannabis; Drug Interactions; Humans; Muscle Spasticity; Pain; Phytotherapy; Plant Extracts

Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several conditions for which there may be therapeutic benefit from marijuana use and that merit further research. Marijuana should be held to the same evaluation standards of safety and efficacy as other drugs (a major flaw in Proposition 215) but should not have to be proved better than current medications for its use to be adopted. The therapeutic window for marijuana and THC between desired effect and unpleasant side effects is narrow and is a major reason for discontinuing use. Although the inhaled route of administration has the benefit of allowing patients to self-titrate the dose, the smoking of crude plant material is problematic. The NIH panel recommended that a high priority be given to the development of a controlled inhaled form of THC. The presence of a naturally occurring cannabinoid-receptor system in the brain suggests that research on selective analogues of THC may be useful to enhance its therapeutic effects and minimize adverse effects.

Topics: Analgesics; Animals; Antineoplastic Agents; Cachexia; California; Cannabis; Drug Approval; Glaucoma; Humans; Muscle Spasticity; Nausea; Phytotherapy; Self Medication; Vomiting

The use of crude marijuana for herbal medicinal applications is now being widely discussed in both the medical and lay literature. Ballot initiatives in California and Arizona have recently made crude marijuana accessible to patients under certain circumstances. As medicinal applications of pure forms of delta-9-tetrahydrocannabinol (THC) and crude marijuana are being considered, the most promising uses of any form of THC are to counteract the nausea associated with cancer chemotherapy and to stimulate appetite. We evaluated the relevant research published between 1975 and 1996 on the medical applications, physical complications, and legal precedents for the use of pure THC or crude marijuana. Our review focused on the medical use of THC derivatives for nausea associated with cancer chemotherapy, glaucoma, stimulation of appetite, and spinal cord spasticity. Despite the toxicity of THC delivered in any form, evidence supports the selective use of pure THC preparations to treat nausea associated with cancer chemotherapy and to stimulate appetite. The evidence does not support the reclassification of crude marijuana as a prescribable medicine.

Topics: Appetite Stimulants; Cannabis; Dronabinol; Glaucoma; Humans; Multiple Sclerosis; Muscle Spasticity; Nausea; Neoplasms

Spasticity is a common and poorly controlled symptom of multiple sclerosis. Our objective was to determine the short-term effect of smoked cannabis on this symptom.. We conducted a placebo-controlled, crossover trial involving adult patients with multiple sclerosis and spasticity. We recruited participants from a regional clinic or by referral from specialists. We randomly assigned participants to either the intervention (smoked cannabis, once daily for three days) or control (identical placebo cigarettes, once daily for three days). Each participant was assessed daily before and after treatment. After a washout interval of 11 days, participants crossed over to the opposite group. Our primary outcome was change in spasticity as measured by patient score on the modified Ashworth scale. Our secondary outcomes included patients' perception of pain (as measured using a visual analogue scale), a timed walk and changes in cognitive function (as measured by patient performance on the Paced Auditory Serial Addition Test), in addition to ratings of fatigue.. Thirty-seven participants were randomized at the start of the study, 30 of whom completed the trial. Treatment with smoked cannabis resulted in a reduction in patient scores on the modified Ashworth scale by an average of 2.74 points more than placebo (p < 0.0001). In addition, treatment reduced pain scores on a visual analogue scale by an average of 5.28 points more than placebo (p = 0.008). Scores for the timed walk did not differ significantly between treatment and placebo (p = 0.2). Scores on the Paced Auditory Serial Addition Test decreased by 8.67 points more with treatment than with placebo (p = 0.003). No serious adverse events occurred during the trial.. Smoked cannabis was superior to placebo in symptom and pain reduction in participants with treatment-resistant spasticity. Future studies should examine whether different doses can result in similar beneficial effects with less cognitive impact.

Topics: Adult; Cannabis; Cognition; Cross-Over Studies; Fatigue; Female; Humans; Male; Marijuana Smoking; Middle Aged; Multiple Sclerosis; Muscle Spasticity; Musculoskeletal Pain; Phytotherapy; Plant Preparations; Treatment Outcome; Walking

The objective was to determine whether a cannabis-based medicinal extract (CBME) benefits a range of symptoms due to multiple sclerosis (MS). A parallel group, double-blind, randomized, placebo-controlled study was undertaken in three centres, recruiting 160 outpatients with MS experiencing significant problems from at least one of the following: spasticity, spasms, bladder problems, tremor or pain. The interventions were oromucosal sprays of matched placebo, or whole plant CBME containing equal amounts of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) at a dose of 2.5-120 mg of each daily, in divided doses. The primary outcome measure was a Visual Analogue Scale (VAS) score for each patient's most troublesome symptom. Additional measures included VAS scores of other symptoms, and measures of disability, cognition, mood, sleep and fatigue. Following CBME the primary symptom score reduced from mean (SE) 74.36 (11.1) to 48.89 (22.0) following CBME and from 74.31 (12.5) to 54.79 (26.3) following placebo [ns]. Spasticity VAS scores were significantly reduced by CBME (Sativex) in comparison with placebo (P =0.001). There were no significant adverse effects on cognition or mood and intoxication was generally mild.

Topics: Aerosols; Cannabidiol; Cannabis; Disability Evaluation; Dose-Response Relationship, Drug; Double-Blind Method; Dronabinol; Humans; Mouth Mucosa; Multiple Sclerosis; Muscle Spasticity; Pain; Pain Measurement; Plant Extracts; Tremor; Urinary Bladder Diseases

To determine whether plant-derived cannabis medicinal extracts (CME) can alleviate neurogenic symptoms unresponsive to standard treatment, and to quantify adverse effects.. A consecutive series of double-blind, randomized, placebo-controlled single-patient cross-over trials with two-week treatment periods.. Patients attended as outpatients, but took the CME at home.. Twenty-four patients with multiple sclerosis (18), spinal cord injury (4), brachial plexus damage (1), and limb amputation due to neurofibromatosis (1).. Whole-plant extracts of delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), 1:1 CBD:THC, or matched placebo were self-administered by sublingual spray at doses determined by titration against symptom relief or unwanted effects within the range of 2.5-120 mg/24 hours. Measures used: Patients recorded symptom, well-being and intoxication scores on a daily basis using visual analogue scales. At the end of each two-week period an observer rated severity and frequency of symptoms on numerical rating scales, administered standard measures of disability (Barthel Index), mood and cognition, and recorded adverse events.. Pain relief associated with both THC and CBD was significantly superior to placebo. Impaired bladder control, muscle spasms and spasticity were improved by CME in some patients with these symptoms. Three patients had transient hypotension and intoxication with rapid initial dosing of THC-containing CME.. Cannabis medicinal extracts can improve neurogenic symptoms unresponsive to standard treatments. Unwanted effects are predictable and generally well tolerated. Larger scale studies are warranted to confirm these findings.

Topics: Administration, Oral; Analgesics, Non-Narcotic; Cannabidiol; Cannabis; Cross-Over Studies; Double-Blind Method; Dronabinol; Humans; Hypotension; Muscle Spasticity; Nervous System Diseases; Pain; Phytotherapy; Placebos; Plant Preparations; Severity of Illness Index; Spasm; Urination Disorders

The authors conducted a randomized, double-blind, placebo-controlled, twofold crossover study in 16 patients with MS who presented with severe spasticity to investigate safety, tolerability, and efficacy of oral Delta(9)-Tetrahydrocannabinol (THC) and Cannabis sativa plant extract. Both drugs were safe, but adverse events were more common with plant-extract treatment. Compared with placebo, neither THC nor plant-extract treatment reduced spasticity. Both THC and plant-extract treatment worsened the participant's global impression.

Topics: Administration, Oral; Cannabinoids; Cannabis; Cross-Over Studies; Double-Blind Method; Dronabinol; Health Status; Humans; Middle Aged; Multiple Sclerosis; Muscle Spasticity; Muscle Tonus; Pain Measurement; Plant Extracts; Sample Size; Treatment Outcome

Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS) is an early-onset cerebellar ataxia with often presence of peripheral sensorimotor neuropathy and lower limb spasticity. Recently, the presence of pain has been associated with ARSACS in a quarter of the population in relation to spasms and neuropathic pain. However, limited therapeutic options available to patients and the occurrence of persistent symptoms despite treatment with the usual pharmacologic agents have led to exploring cannabis as a potential alternative. The aim of this study was to characterize the profile of cannabis use among patients with ARSACS. Phone interviews were conducted to document current or former cannabis use. Reasons of cannabis use and the characteristics of use were also investigated. Among the 50 study participants, 18% currently used cannabis, 40% reported at least one occurrence of cannabis use and 42% reported having never used cannabis. A greater proportion of patients with regular cannabis use reported chronic pain in comparison to those who never used. Although less frequent than ataxia, spasticity, muscle cramps or muscle spasms, which were independently reported by more than half of the studied sample, chronic pain was notably present in 30% of participants. While our study did not assess the therapeutic effects of cannabis, our results highlight that there is a potential role for cannabis and cannabinoids in the management of multiple ARSACS-associated symptoms and that agents modulating the endocannabinoid system need to be properly investigated.

Topics: Analgesics; Ataxia; Cannabis; Cerebellar Ataxia; Humans; Muscle Spasticity; Spinocerebellar Ataxias

Topics: Cannabis; Humans; Medical Marijuana; Multiple Sclerosis; Muscle Spasticity

The use of cannabis as medical therapy to treat chronic pain and spasticity in patients with multiple sclerosis (MS) is increasing. However, the evidence on safety when initiating treatment with medical cannabis oils is limited. The aim of this study was to investigate the safety of sublingual medical cannabis oils in patients with MS.. In this prospective observational safety study 28 patients with MS were treated with medical cannabis oils (THC-rich, CBD-rich and THC+CBD combined products) and were followed during a titration period of four weeks. Patients were evaluated at treatment start (Visit 1) and after four weeks treatment (Visit 2). At each visit neurological examination (Expanded Disability Status Scale - EDSS), ambulation (Timed 25-Foot Walk Test - T25FWT), routine blood tests, plasma cannabinoids, dexterity (9-Hole Peg Test - 9-HPT) and processing speed (Symbol Digit Modalities Test - SDMT) were tested. Adverse events (AEs) and tolerability were reported at Visit 2. Secondary, efficacy of medical cannabis on pain, spasticity and sleep disturbances were measured by numeric rating scale (NRS-11) each day during the 4-week treatment period.. During treatment with cannabis preparations containing 10-25 mg/mL THC, the most common AEs were dry mouth, drowsiness, dizziness and nausea of mild to moderate degree. Two patients experienced pronounced symptoms with excessive dreaming and drowsiness, respectively, which led to treatment stop during the titration. Three serious adverse events (SAE) were reported but were not associated with the treatment. Mean doses of THC and CBD were 4.0 mg and 7.0 mg, respectively, and primarily administered as a once-daily evening dose. Furthermore, pain decreased from a median NRS score of 7 to 4, (p = 0.01), spasticity decreased from a median NRS score of 6 to 2.5 (p = 0.01) and sleep disturbances decreased from a median NRS score of 7 to 3 (p < 0.001). No impairment in disability, ambulation, dexterity or processing speed was observed.. Treatment with medical cannabis oils was safe and well tolerated, and resulted in a reduction in pain intensity, spasticity and sleep disturbances in MS patients. This suggests that medical cannabis oils can be used safely, especially at relatively low doses and with slow titration, as an alternative to treat MS-related symptoms when conventional therapy is inadequate.

Topics: Cannabidiol; Cannabis; Dronabinol; Humans; Medical Marijuana; Multiple Sclerosis; Muscle Spasticity; Oils

Topics: Cannabis; Epilepsy; Hallucinogens; Humans; Medical Marijuana; Muscle Spasticity; Myalgia

Growing evidence supports that cannabinoids relieve MS-related spasticity but little is known about cannabis use among people with MS (PwMS) and spasticity.. To characterize cannabis use among PwMS and spasticity.. As part of baseline data collection for a spasticity intervention trial in Oregon, PwMS and self-reported spasticity answered questions about cannabis use.. 54% reported ever using cannabis and 36% currently use. 79% use multiple routes of administration, 58% use at least daily. 79% find cannabis helpful for spasticity and 26% use cannabis and prescribed oral antispasticity medications.. Many PwMS and spasticity use cannabis and report it helps their spasticity.

Topics: Adult; Aged; Aged, 80 and over; Cannabinoid Receptor Modulators; Cannabis; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Muscle Spasticity; Plant Preparations; Self-Management; Treatment Outcome

Topics: Cannabinoids; Cannabis; Child; Humans; Muscle Spasticity; Neurology

Topics: Cannabinoids; Cannabis; Humans; Medical Marijuana; Multiple Sclerosis; Muscle Spasticity; Nausea; Neuralgia; Vomiting

Topics: Cannabinoids; Cannabis; Humans; Multiple Sclerosis; Muscle Spasticity; Needs Assessment

Topics: Cannabidiol; Cannabis; Dronabinol; Drug Combinations; Humans; Multiple Sclerosis; Muscle Spasticity; Parasympatholytics; Plant Extracts

Topics: Adult; Aged; Aged, 80 and over; Cachexia; Cannabinoids; Cannabis; Humans; Middle Aged; Muscle Spasticity; Phytotherapy; Young Adult

Topics: Anorexia; Cannabinoids; Cannabis; Chronic Pain; Humans; Muscle Spasticity; Nausea; Vomiting

Topics: Anorexia; Cannabinoids; Cannabis; Chronic Pain; Humans; Muscle Spasticity; Nausea; Vomiting

Topics: Anorexia; Cannabinoids; Cannabis; Chronic Pain; Humans; Muscle Spasticity; Nausea; Vomiting

Topics: Cannabis; Humans; Multiple Sclerosis; Muscle Spasticity; Phytotherapy

Topics: Cannabidiol; Cannabinoids; Cannabis; Dronabinol; Drug Approval; Drug Combinations; Humans; Multiple Sclerosis; Muscle Spasticity; Parasympatholytics; Plant Extracts

Topics: Cannabidiol; Cannabis; Dronabinol; Drug Approval; Drug Combinations; Germany; Humans; Multiple Sclerosis; Muscle Spasticity; Pain; Palliative Care; Phytotherapy; Plant Extracts; Psychoses, Substance-Induced

In the present work, we report repeated out-of-body experiences (OBEs) in a patient with tetraplegia and severe somatosensory loss due to multiple sclerosis and predominant involvement of the cervical spinal cord. OBEs were experienced on a daily basis and induced by cannabis treatment that was started for severe spasticity with painful cramps and cloni. In order to investigate the link between OBEs and mental own-body imagery, the patient was asked to imagine himself in the position and visual perspective that is generally reported during OBEs, using front- and back-facing schematic human stimuli. Performance was measured before and after cannabis consumption. First, our data reveal that the patient was less accurate for back-facing than front-facing stimuli. This was found before and after cannabis consumption and is the opposite pattern to what is generally observed in healthy participants and in our control subjects (who did not use cannabis). We refer to this as lesion effect and argue that this relative facilitation for stimuli reflecting the position and visual perspective that is generally reported during OBEs might be due to recurrent and spontaneous own-body transformations during the patient's frequent OBEs. Secondly, we found a cannabis effect, namely a performance improvement in the back-facing condition while performance in the front-facing condition remained unchanged, after cannabis administration. We argue that cannabis administration may interfere with own-body imagery when reflecting the actual body position and only when associated with brain damage. Based on these data we propose an extended neurological model for own-body illusions including multisensory and sensorimotor mechanisms, cannabis consumption, and cortical and subcortical processing.

Topics: Body Image; Cannabis; Humans; Imagination; Male; Middle Aged; Multiple Sclerosis; Muscle Spasticity; Neuropsychological Tests; Photic Stimulation; Phytotherapy; Quadriplegia; Self Concept; Visual Perception

To estimate the patterns and prevalence of cannabis use among patients with multiple sclerosis (MS), 220 patients were surveyed in Halifax, Nova Scotia. Seventy-two subjects (36%) reported ever having used cannabis for any purpose; 29 respondents (14%) reported continuing use of cannabis for symptom treatment. Medical cannabis use was associated with male gender, tobacco use, and recreational cannabis use. The symptoms reported by medical cannabis users to be most effectively relieved were stress, sleep, mood, stiffness/spasm, and pain.

Topics: Administration, Oral; Adult; Cannabis; Cross-Sectional Studies; Drug Utilization; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Muscle Spasticity; Nova Scotia; Pain; Patients; Phytotherapy; Plant Preparations; Sleep Wake Disorders; Smoking; Surveys and Questionnaires; Treatment Outcome

Prior to 2002, few clinical data were available to indicate whether cannabis extracts may be beneficial. However, in the last two years, results of several placebo-controlled clinical trials of orally administered compounds have been published, and these cast doubt on the efficacy of delta9-tetrahydrocannabinol (delta9-THC) in objectively reducing spasticity in MS. By contrast, it has been claimed that sublingually administered cannabis extracts that contain approximately equal concentrations of delta9-THC and cannabidiol, a natural cannabinoid that does not act on the CB1 receptor, can produce a statistically and clinically significant reduction in spasticity, although this claim has yet to be thoroughly validated. Nonetheless, results of preclinical trials also lend support to the hypothesis that the endogenous cannabinoid system may be involved in the regulation of spasticity and pain. A better indication of the clinical potential of the different cannabis extracts will have to await the publication of the most recent clinical trial data. This review critically evaluates the most recent evidence available on the potential use of medicinal extracts of cannabis to relieve pain and spasticity in multiple sclerosis.

Topics: Animals; Cannabis; Chronic Disease; Clinical Trials, Phase III as Topic; Dronabinol; Humans; Multiple Sclerosis; Muscle Spasticity; Pain; Phytotherapy; Plant Extracts; Randomized Controlled Trials as Topic

Topics: Administration, Oral; Affect; Appetite; Cannabidiol; Cannabinoids; Cannabis; Clinical Trials, Phase III as Topic; Double-Blind Method; Dronabinol; Humans; Multiple Sclerosis; Muscle Spasticity; Neuralgia; Plant Extracts; Reflex, Abnormal; Safety; Sleep; Switzerland; Treatment Outcome; United Kingdom

The use of smoked marijuana as a therapeutic agent is presently a matter of considerable debate in the United States. Many people suffering from a variety of disorders maintain that it is necessary for their adequate treatment. Yet, the evidence to support claims is insufficient for FDA approval. An interim solution is proposed which would allow patients referred by their physicians to participate in a 6-month program of legal marijuana availability, similar to the 'compassionate IND' program of a number of years ago. A technique similar to that used for post-marketing surveillance is proposed for obtaining quantitative data for a limited number of potential indications. These are: (1) nausea and vomiting associated with cancer chemotherapy or other causes, (2) weight loss associated with debilitating illnesses, (3) spasticity secondary to neurological diseases, and (4) chronic pain syndromes.

Topics: Cannabis; Drug Approval; HIV Wasting Syndrome; Humans; Marijuana Smoking; Muscle Spasticity; Nausea; Pain; Phytotherapy; Referral and Consultation; United States; United States Food and Drug Administration; Vomiting

In 1998, Washington State passed a law, Initiative 692 (I-692), that gives individuals who are charged with possession of marijuana for medical purposes a possible affirmative defense. The law lets these individuals provide a note from their doctor or a copy of their medical records stating they have a condition that may benefit from the use of marijuana. I-692 does not legalize the medical use of marijuana and does not affect Federal law, which makes obtaining, possessing, and growing marijuana illegal. The Washington law limits the amount of marijuana a patient can possess to a 60-day supply and defines the conditions for which medical marijuana may be used. These conditions include HIV, cancer, multiple sclerosis, and epilepsy.

Topics: Cannabis; Epilepsy; Glaucoma; HIV Infections; Humans; Legislation, Drug; Multiple Sclerosis; Muscle Spasticity; Neoplasms; Pain, Intractable; United States

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Chemotherapy, Adjuvant; Drug Approval; Humans; Marijuana Smoking; Muscle Spasticity; Nausea; United States

The chronic motor handicaps of a 30-year-old multiple sclerosis patient acutely improved while he smoked a marihuana cigarette. This effect was quantitatively assessed by means of clinical rating, electromyographic investigation of the leg flexor reflexes and electromagnetic recording of the hand action tremor. It is concluded that cannabinoids may have powerful beneficial effects on both spasticity and ataxia that warrant further evaluation.

Topics: Adult; Ataxia; Cannabinoids; Cannabis; Humans; Male; Multiple Sclerosis; Muscle Spasticity

This article summarizes current knowledge about the medicinal value of cannabis and its principal psychoactive ingredient, delta 9-tetrahydrocannabinol (THC), particularly in the control of nausea and vomiting, in glaucoma, and in reduction of spasticity in multiple sclerosis. The major issues in the controversy about marijuana and medicine, primarily moral and ethical, are discussed.

Topics: Antineoplastic Agents; Anxiety; Bronchial Spasm; Cannabis; Dronabinol; Glaucoma; Humans; Muscle Spasticity; Nausea; Pain; Sleep Initiation and Maintenance Disorders; Vomiting

A study was done to examine the perceived effects of cannabis on spasticity of spinal cord injured persons. Data compiled from 43 questionnaires of spinal cord injured persons suggested the following: 1) spinal cord injured persons reported decreased spasticity with marijuana use; 2) present use of marijuana correlated positively with past use; and 3) the person's reference or peer group contributed significantly to current use. The study suggests the need to examine the relationship between measurable and reported changes in spasticity.

Topics: Adult; Aged; Cannabis; Humans; Marijuana Abuse; Middle Aged; Muscle Spasticity; Socioeconomic Factors; Spinal Cord Injuries; Surveys and Questionnaires

Topics: Adult; Cannabis; Female; Humans; Male; Muscle Spasticity; Spasm