Multiple Sclerosis and Cannabinoids

Multiple sclerosis is a condition that affects the central nervous system (brain, optic nerve and spinal cord) impacting the vision, hearing, memory, balance, speech, and mobility of its victims.

Symptoms of MS include:

• Numbness
• Cognitive impairment
• Blurred vision
• Urinary urgency and incontinence
• Muscle spasms
• Dizziness
• Depression
• Fatigue
• Sexual dysfunction
• Speech problems
• Tremors

The diagnosis of MS will be carried out through specific tests and the treatment will focus in a speedy recovery from attacks, slow the progress of the disease and improve its symptoms. There is growing amount of evidence that cannabinoids improve tremors, pain, spasticity and nocturia (urinary frequency at night). THC and nabilone improved the symptoms mentioned and seems to activate CB1 and CB2 receptors.

The role of cannabinoids in Multiple Sclerosis is becoming more comprehensible, especially in symptoms of muscle stiffness and spasticity, as well as neuropathic pain, sleep and bladder disturbances. Tremors and nystagmus have not improved significantly but it will require further studies. There are no serious safety concerns and a slow prolonged period of titration improves tolerability.

Cannabinoids in Multiple Sclerosis (CAMS) study was performed in 630 patients with stable MS and muscle spasticity. Patients felt that THC was useful in treating their disease. Cannabinoids for MS spasticity (and symptoms of other diseases) have been in use in Canada and Europe for a number of years, in the form of Sativex, an oral spray made from extracts of marijuana plants. There have been synthetic drugs modeled after marijuana, including Marinol, but Sativex is the first to be extracted from the natural marijuana plant. Sativex is made by GW Pharma and is available in Europe and Canada. It is a CBD:THC 1:1 and is extracted from the marijuana plant, therefore is not synthetic (as Marinol) so its illegal in the USA while Marinol is legal , covered by insurance and sold in pharmacies.

Somehow, I must say, I am not surprised…
Fernando Fandino-Sende, MD