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Review
. 2009 Dec 4;9:59.
doi: 10.1186/1471-2377-9-59.

Whole Plant Cannabis Extracts in the Treatment of Spasticity in Multiple Sclerosis: A Systematic Review

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Free PMC article
Review

Whole Plant Cannabis Extracts in the Treatment of Spasticity in Multiple Sclerosis: A Systematic Review

Shaheen E Lakhan et al. BMC Neurol. .
Free PMC article

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Figures

Figure 1
Figure 1
Flow diagram of included studies.

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References

    1. Beard S, Hunn A, Wight J. Treatments for spasticity and pain in multiple sclerosis: a systematic review. Health Tech Assess. 2003;7:1–111. - PubMed
    1. Shakespeare D, Boggild M, Young CA. Anti-spasticity agents for multiple sclerosis. Cochrane Database of Syst Rev. 2003. p. CD001332. - PubMed
    1. Williamson EM, Evans FJ. Cannabinoids in clinical practice. Drugs. 2000;60:1303–1314. doi: 10.2165/00003495-200060060-00005. - DOI - PubMed
    1. Smith PF. Medicinal cannabis extracts for the treatment of multiple sclerosis. Curr Opin Invest Drugs. 2004;5:727–730. - PubMed
    1. Clark AJ, Ware MA, Yazer E, Murray TJ, Lynch ME. Patterns of cannabis use among patients with multiple sclerosis. Neurology. 2004;62:2098–2100. - PubMed
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