Is your doctor following current research at all and are they willing to try this on you as an off-label use? Or do they believe that you shouldn't bother about spasticity like Dr. William M. Landau suggests. And you'd have to go to Europe to get it because we have absolute f*cking idiots in
Congress about marijuana.
An objectively measured sign of spasticity in multiple sclerosis (MS)
patients was relieved with Sativex, the oromucosal cannabinoid spray,
in a small randomized trial reported here.
Mean scores on the
modified Ashworth scale, which measures resistance to muscular
stretching, for lower limb spasticity improved by 18.2% (SD 33.7%) in
patients treated with Sativex for 4 weeks, compared with a 6.7%
improvement (SD 26.6%
) in patients using a placebo spray (
P=0.029 for the between-group difference), according to Letizia Leocani, MD, PhD, of University Hospital San Raffaele in Milan.
Previous
studies had shown that Sativex, which combines tetrahydrocannabinol and
cannabidiol in equal parts, improved MS patients' self-reported
symptoms of spasticity. But
a systematic review and practice guideline released earlier this year by the American Academy of Neurology indicated that the product is "probably ineffective" for objective spasticity measures.
Hence, the current study -- presented at the
European Committee for Treatment and Research in Multiple Sclerosis,
held jointly this year with its North American counterpart --
provides new support for Sativex as a useful treatment for MS
spasticity, an important manifestation that contributes to disability.
It
randomized 43 patients to a 2-week titration period followed by 2 weeks
of treatment at stable doses with either placebo or Sativex. Following a
2-week washout period, patients then crossed over to a second 4-week
cycle with the other treatment.
Exclusion criteria were other
medical or psychiatric illnesses that might interfere with treatment or
symptomatology, contraindications to transcranial magnetic stimulation,
or THC urine test results indicating previous cannabis use.
Patients
must have had progressive MS for at least 1 year and modified Ashworth
scores at screening of greater than 1 in at least one limb.
Mean
patient age in the study was 48 (SD 7) and mean score on the Expanded
Disability Status Scale was 5.7 (SD 0.9, range 3.5 to 6.5).
In
addition to modified Ashworth score, patients were evaluated with timed
10-meter walks and neurophysiological measures including motor evoked
potentials, intracortical inhibition/facilitation, and the so-called H/M
ratio (maximal Hoffmann reflex versus the maximal motor response of the
soleus muscle).
A responder analysis showed that, among those
achieving at least 20% improvement in modified Ashworth scores, half of
participants showed such responses only when receiving Sativex. The
remainder were divided among patients responding to both the active drug
and placebo and those who only responded to placebo.
Importantly,
however, Sativex did not produce significant improvements on outcomes
other than the modified Ashworth score. In addition to the objective
measures, these included patient-reported pain, sleep, and fatigue.
Leocani
said these results indicated that additional research is needed on "the
relevance of other spinal and supraspinal mechanisms involved in the
physiopathology of spasticity."
Sativex is not approved in the U.S.; it is available in several European countries for relief of MS spasticity.