This Is MS Multiple Sclerosis Community: Knowledge & Support

Hopefully regulators around the world get their thumbs out and start approving cannabis in whatever form for MS-related pain.



Meta-analysis of cannabis based treatments for neuropathic and multiple sclerosis-related pain.

Curr Med Res Opin. 2007 Jan;23(1):17-24.
Iskedjian M, Bereza B, Gordon A, Piwko C, Einarson TR.
PharmIdeas Research & Consulting Inc., Oakville, ON, Canada; PharmIdeas USA Inc., Charlotte, NC, USA.

OBJECTIVE: Debilitating pain, occurring in 50-70% of multiple sclerosis (MS) patients, is poorly understood and infrequently studied. We summarized efficacy and safety data of cannabinoid-based drugs for neuropathic pain. Data sources: Studies were identified from Medline, Embase, and Cochrane databases; Bayer Healthcare provided additional trials.

STUDY SELECTION: Accepted were randomized, double-blinded placebo-controlled trials of cannabinoid-based treatments for MS-related/neuropathic pain in adults >/= 18 years of age. Data extraction: Two reviewers identified studies and extracted data; a third adjudicated disagreements. Data included baseline and endpoint pain scores on visual analog or 11-point ordinal scales.

DATA SYNTHESIS: Of 18 articles and three randomized controlled trial (RCT) reports identified, 12 articles and two reports were rejected (9 = inappropriate disease or outcome, 1 = duplicate, 1 = review, and 1 = abstract); six accepted articles and one RCT-report involved 298 patients (222 treated, 76 placebo); four examined Sativex (a cannabidiol/delta-9-tetrahydrocannabinol (THC) buccal spray) (observations = 196), five cannabidiol (n = 41), and three dronabinol (n = 91). Homogeneity chi(2) values were non-significant, allowing data combination. Analyses focused on baseline-endpoint score differences. The cannabidiol/THC buccal spray decreased pain 1.7 +/- 0.7 points (p = 0.018), cannabidiol 1.5 +/- 0.7 (p = 0.044), dronabinol 1.5 +/- 0.6 (p = 0.013), and all cannabinoids pooled together 1.6 +/- 0.4 (p < 0.001). Placebo baseline-endpoint scores did not differ (0.8 +/- 0.4 points, p = 0.023). At endpoint, cannabinoids were superior to placebo by 0.8 +/- 0.3 points (p = 0.029). Dizziness was the most commonly observed adverse event in the cannabidiol/THC buccal spray arms (39 +/- 16%), across all cannabinoid treatments (32.5 +/- 16%) as well as in the placebo arms (10 +/- 4%).

CONCLUSION: Cannabinoids including the cannabidiol/THC buccal spray are effective in treating neuropathic pain in MS.

LIMITATIONS: This review was based on a small number of trials and patients. Pain related to MS was assumed to be similar to neuropathic pain.

Pubmed reference

It looks like there are an array of different benefits that one can get from Cannabis. See link.


http://money.cnn.com/2007/01/30/news/international/bc.gw.reut/index.htm?cnn=yes

Meanwhile we see this injustice:
http://www.guardian.co.uk/medicine/story/0,,2000019,00.html

_________________
John
I am what I am

Amen to that dignan. I'm all about whatever works. Hell, half the stuff we can get for pain is dangerous as hell in the wrong amounts and tends to peter out over time. I can say with confidence from my youth that I don't think you can screw up dosing with marijuana. I have also used it occasionally for that pain that makes your clothes hurt your skin. Not a medical description, but those who get it know what I'm talking aobut. It eliminates that pain temporarily better than anything I've ever tried.

I can't wait until they get the MJ riddle figured out. I think we are only scratching the surface of the good things that MJ can potentially do for us.

The Pain Clinic at the London Health Sciences Centre (London, Canada) is so convinced that MJ works for spasms and pain for patients that they are presently conducting a clinical trial with MJ. It is an open label trial and the main end-point of the trial is to study the side effects of patients using MJ vs conventional pain medications.

As the neuro told me...we know it works...we just want to compare the side effects with other medications.

Harry

Harry, I'm glad to hear about that trial. I agree with Loobie, the other pain medication choices all seem to have limited effectiveness for neuropathic pain and they all come with side effects too. Canada has its good points and bad points, like any country, but one of the things I'm happy about is our relatively enlightened attitude about cannabis.

Dignan,

Yes, looking at a drug scientifically rather than politically has its benefits. The neuro told me that they treat MJ just like any other drug and look at what it can do for patients vs the side effects.....just like they do with ANY other drug that is tested or used.

Marg was initially enrolled in the trial but some logistical problems prevented her from participating. She goes to the clinic every 6 months so I'll be talking to the neuro each time and asking how the trial is going.

Harry

RE:Loobie comment from Jan. 31
I have also used it occasionally for that pain that makes your clothes hurt your skin. Not a medical description, but those who get it know what I'm talking aobut.
Is there a medical term for this? I cannot seem to get across to the docs what I am talking about, and you are the first person I've heard of who has this same thing! Work is agonizing some days because of this.

Dont know if its right, but would it be called "Dysesthesias" triggered by touch? or "Paraesthesias"? http://www.msif.org/en/symptoms_treatments/ms_by_topic/pain/

There is also this link which covers a lot of technical names for MS symptoms: http://www.jsumption.com/imssf/modules.php?op=modload&name=News&file=article&sid=35

Blackdog,

I don't know what the term is, but I've always called it neuropathic pain. My neuro. knows what I'm talking about when I describe it as this, but I'm really not sure. For me, it is very prevelant on my back; especially between the shoulder blades and around the spine.

If it works for HIV, why not MS...?

http://www.medpagetoday.com/Neurology/GeneralNeurology/tb/5048

Dom.[/i]

I appreciate that MJ is beneficial in many ways for people with MS. I unfortunately am not one of them. It is very strange. I have sought relief from pain and tremor through smoking MJ. Bummer is that while I get pain relief my tremor and muscle weakness increases significantly. It happens within a couple of minutes of smoking. I get weak and my muscles tremble when I try to flex at all. What kind of effect is that? Not a good one. I was going to start a trial at UCSD Medical on marijuana for MS, but when I saw how it affected me I decided I did not want to screw up the data for the rest who can benefit.

Has anyone else experienced the type of effects I describe? It so sucks.

G

I haven't had the tremors or spasticity that so many other seem to suffer from. Is it painful? What seems to trigger it?
The MJ seems to help so many with the effects of MS.
I attend a local support group here and when I mention pain/extremely sensitive skin/blinding migraines, etc. the others don't seem to get it.
They, on the other hand, cannot stand extreme heat/stress/extended physical activity. These are things that haven't bothered me so far.
I next see my neuro in mid-March and I will be questioning him (again) about the sensitivity to touch, but I will be using new vocabulary.
Maybe that will help.