Marijuana Makes Multiple Sclerosis Patients Less Stiff

People with multiple sclerosis experience a variety of life-altering symptoms, and among them are muscle stiffness, pain, and muscle spasms. Results of a new study found that marijuana (cannabis) extract capsules are effective in relieving a variety of symptoms, including stiff muscles and others that reduce quality of life.

For the 250,000 to 350,000 people in the United States and about 2.5 million worldwide, multiple sclerosis causes life-changing and often debilitating symptoms as the body's immune system destroys the protective coating that covers their nerves. This nerve damage, which is not reversible, leads to problems that include pain, muscle spasms, weakness or numbness in one or more limbs, partial or complete loss of vision, fatigue, dizziness, and more.

In the new study, the MUSEC (MUltiple Sclerosis and Extract of Cannabis), which was conducted at the University of Plymouth in the UK, experts explored the use of marijuana extract capsules and their ability to relieve muscle stiffness. Alleviation of muscle stiffness can allow patients with multiple sclerosis to experience improved mobility, flexibility, independence, and quality of life.

While some previous studies have shown that smoking marijuana can relieve muscle spasms in multiple sclerosis, taking cannabis extracts has not proven to be as promising. Results of this new randomized, double-blind study, however, were different.

A total of 279 individuals from 22 centers in the UK with stable multiple sclerosis participated in the study. Subjects were randomly assigned to take either placebo capsules (135 patients) or cannabis sativa extract capsules (144 patients) standardized to contain 0.8 to 1.8 mg of cannabidiol and tetrahydrocannabinol (THC), which was gradually increased from 5 mg to a maximum of 25 mg over the first two weeks of the 12-week trial.

THC is the main psychoactive component of cannabis and has been shown to have pain-relieving effects as well as an ability to reduce fatigue and stimulate the appetite. Cannabidiol is a cannabinoid found in cannabis and has been used to relieve inflammation, nausea, and anxiety, along with showing anti-cancer benefits.

At the end of the three month trial, results based on patient reporting and expert analysis were as follows:

• Muscle stiffness declined in 29 percent of patients who took the marijuana capsules compared with 16 percent of those who took placebo
• Patients who were not already taking anti-spasticity medications experienced the largest benefit from taking marijuana: 38 percent response versus 16 percent with placebo
• Improvement in muscle spasms was reported by 31 percent of marijuana users versus only 13 percent of those on placebo
• Sleep quality improved in 34 percent of marijuana users versus 19 percent of placebo users
• Bodily pain relief at week 12 was 28 percent among those who took marijuana compared with 19 percent of those on placebo
• Pain ratings improved significantly by the end of the study, dropping 1.2 points (marijuana group) versus 0.3 points (placebo)

Participants who took marijuana did experience some side effects, including balance problems, dizziness, dry mouth, nausea, diarrhea, fatigue, urinary tract infection, and confusion. The authors pointed out, however, that the biggest difference in side effect rates happened during the two weeks when the THC dose was increased.

Previous research on marijuana and MS
Previous research by some of the same investigators was reported in May 2012 by the University of Plymouth. The eight-year study set out to determine if THC in capsule form could reduce the progression of multiple sclerosis.

The findings from that study were less promising than those of the newest one. According to John Zajicek, professor of clinical neuroscience at Plymouth, their research revealed "little evidence to suggest that THC has a long term impact on the slowing of progressive MS."

In a 2009 review study of marijuana, investigators evaluated data from six trials (five of which were double-blind, randomized, and placebo-controlled) and reported that a combination of THC and cannabidiol could significantly reduce muscle spasms in patients with multiple sclerosis. The authors also noted that the combination of THC and cannabidiol can limit psychotropic effects.

Why new marijuana and MS study is important
Overall, the authors noted that "the study met its primary objective to demonstrate the superiority of cannabis extract over placebo in the treatment of muscle stiffness in MS." The study is also important because it adds valuable input to the growing literature on medical marijuana and how it may benefit people with multiple sclerosis.

SOURCES:
Lakhan SE, Rowland M. Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review. BMC Neurology 2009 Dec 4; 9:59
Multiple Sclerosis National Research Institute
Peninsula College of Medicine and Dentistry
Zajicek JP et al. Multiple sclerosis and extract of cannabis: results of the MUSEC trial. Journal of Neurology Neurosurgery and Psychiatry 2012; 83:1125-32

Image: Wikimedia Commons

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