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AAN Guideline: Oral Cannabis May Help Ease MS Symptoms, Uncertainty Over Other Therapies — Physician’s First Watch

Medical News |
March 25, 2014

AAN Guideline: Oral Cannabis May Help Ease MS Symptoms, Uncertainty Over Other Therapies

By Amy Orciari Herman

Clinicians may offer oral cannabis extract, tetrahydrocannabinol, or cannabinoid spray to patients with multiple sclerosis to ease patient-reported spasticity and pain (excluding central neuropathic pain), according to new guidelines on alternative therapies for MS from the American Academy of Neurology. Clinicians should counsel patients, however, that cannabis is likely ineffective at improving objective measures of spasticity.

Other conclusions based on an evidence review in Neurology include:

  • Cannabis spray may be offered to reduce urinary frequency.

  • Data are inadequate to recommend for or against smoking cannabis.

  • Magnetic therapy is probably effective for reducing fatigue and ineffective for treating depression.

  • Gingko biloba does not improve cognition.

  • A low-fat diet with omega-3 supplementation is probably ineffective for limiting relapses, disability, fatigue, or MRI lesions.

Reader Comments (4)

Jose GROS-AYMERICH, MD Physician, Oncology, INSS -Retired

I'd say that some of the reported beneficial effects of Cannabis and Cannabis active elements in MS may be mediated by its actions on immune system, several published works address the issue of Cannabis and immunity.
Another herbal product, 'Anapsos', an extract from a Central American fern, 'Calaguala', registered for Psoriasis and Atopic Dermatitis in Spain, was proposed having immune regulatory effects, and positive effects in a rodent model of Autoimmune Myelitis, some data may exist about Anapsos use in MS Fatigue and in Alzheimer's Dementia.
Is this a therapeutic way deserving extensive and thorough research, or it's just anecdotal?
Thanks. Salut †

Dr Michael Murray MB ChB, FRCA,FFICM Physician, Critical Care Medicine, Glasgow

I think to say there is insufficent evidence against smoking cannabis is frankly ridiculous. There is no evidence that it is effective, the dose cannot be controlled , there is potential for addiction, cancer, addiction, abuse and the " benefits" will be practically all subjective. The entire concept of " medical" cannabis is simply disputed by mosy physicians and the majority of "medical" cannabis users are white lower income males 30- 40 with a history of substance abuse. This shows that it is not consistent with disease epidemiology. The USA is specific in the developed world due to the lack of universal health care and inappropriate drug sentencing to result in the non commital comment that the smoking dried up plants in the 21st century is a useful treatment cannot be categorically denied

Howard Black Other Healthcare Professional, Palliative Medicine, Eastern Illinois Univ.

Thanks for the service.

Elizabeth Hatcher MD PhD Physician, Psychiatry, Solo office practice

It's useful to see headlines & short summaries of information & new findings/treatments of direct relevance to the patients I see in clinical practice.

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