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Tuesday, November 25, 2014

MS Spasticity: How Do Pharmaceuticals Stack Up Against Medical Marijuana?

With more states approving the use of medical marijuana, we examine current therapies for spasticity caused by MS and compare them to Sativex, a cannabis derivative in phase III trials that’s been fast-tracked by the FDA.
Written by Jeri Burtchell | Published on November 10, 2014


How Do MS Pharmaceuticals Stack Up Against Medical Marijuana?
Oregon, Alaska, and Washington, D.C., voted in favor of legalizing marijuana last Tuesday, bringing the number of states that have decriminalized the drug or made special provisions for medicinal use to 23 (plus the District of Columbia). For people who suffer from conditions like cancer, Parkinson’s disease, seizures, or multiple sclerosis (MS) this news could bring relief. Medical marijuana is another tool in a doctor’s arsenal to help these patients fight their personal battles.
Research on the use of marijuana to treat symptoms of MS has been limited, but some studies in the past decade have shown that marijuana relieves MS spasticity.

What Is Spasticity?

According to the National MS Society, spasticity refers to muscle spasms and feelings of stiffness. It is a common symptom in people who have MS.
Medical marijuana
When MS damages the nerves that control muscles, it can result in spasticity that impairs movement and causes pain and stiffness. It usually occurs in the legs and can draw them up toward the body with painful cramping or cause spasms in the lower back.
For some patients who have muscle weakness, spasticity can be beneficial to a degree, as it provides them with the stiffness needed to walk. But when it gets out of control and the pain becomes too much to bear, it may be time to consider medication.
Dr. Vijayshree Yadav has studied the use of alternative medicine in MS for many years. In 2011, she wrote, “In a review of six controlled studies evaluating a combination of THC and CBD [the active ingredients in cannabis] for spasticity in MS, it was found that THC–CBD was well tolerated and improved patient self-reports of spasticity.”
Earlier this year, Yadav authored a set of guidelines for the American Academy of Neurology, saying that pill and mouth spray forms of cannabis have shown success in treating spasticity and bladder symptoms in MS patients.

Treatment Options for Spasticity

There are just three medications that have been approved by the U.S. Food and Drug Administration (FDA) specifically to relieve MS spasticity: Zanaflex, Baclofen, and Botox. Many other medications are used off-label to treat spasticity, too. The following sections outline how each of them works, how they are taken, and their possible side effects.
Added to this lineup is an oral spray called Sativex, which contains a derivative of medical marijuana. It is made by GW Pharmaceuticals and is available by prescription in 15 countries to treat MS spasticity. In April of this year, the FDA fast-tracked Sativex in the United States. Currently in phase III trials, it may soon be another FDA-approved choice for people with spasticity to consider.
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