Marijuana, taken in pill or spray form, helps ease certain multiple sclerosis symptoms, while about a dozen other alternative remedies offer no benefit, according to a report by U.S. neurologists.
Not enough research exists to say if smoking the drug helps in MS, according to the report.
The pill or oral spray form of marijuana may help reduce stiffness and involuntary spasms, pain from those symptoms and frequent urination, though it doesn’t help reduce tremors, the study published today in the journal Neurology found. The results form the basis of new guidelines from the American Academy of Neurology on use of alternative therapies in MS.
The guidelines are the first by the academy to say which complementary treatments appear to work the best and which don’t for patients with multiple sclerosis, said lead author Vijayshree Yadav, an assistant professor in neurology at Oregon Health & Science University in Portland. Many MS patients use alternative therapies along with standard drugs to treat their symptoms.
“It appears there’s little evidence for most complementary and alternative medicine therapies to treat MS,” Yadav said in a telephone interview. “This opens up an entire avenue for research. It provides the impetus for researchers to design studies so that the gap in knowledge could be addressed.”
The researchers searched the medical literature on alternative medicine studies going back to 1970. The recommendations were based on findings from 115 articles. Of those only 10 were considered to have the highest level of significance, Yadav said.
Though most of the alternative treatments aren’t studied enough to be recommended on their benefits, that doesn’t mean they don’t work, said John Corboy, a professor of neurology at the University of Colorado School of Medicine in Aurora, who wasn’t an author of today’s guidelines.
“What I tell patients is if you’re using something and you feel better and there’s not any theoretical or real reason to think it’s hurting you and it’s not costing you a lot of money, then there’s certainly no reason not to do it,” he said in a telephone interview. “If, however, it’s expensive and, worse yet, has data arguing against it or if you use it as an alternative and not as a complementary approach, then you’re causing yourself harm.”
Some of Corboy’s patients use marijuana candies or cooked into brownies as an alternative to smoking to help ease their symptoms. While a pill provides a set amount of marijuana, the other delivery methods may not. Corboy said these products may work best at night when the side effects are less dangerous.
One prescription pill containing a synthetic cannabinoid that’s approved in the U.S. is Marinol, sold by AbbVie Inc. based in North Chicago, Illinois, for uses including treating nausea and vomiting associated with chemotherapy. The spray form of marijuana, called Sativex isn’t available in the U.S. GW Pharmaceuticals Plc, based in the U.K., makes Sativex.
Researchers found that long-term safety of medical marijuana in the pill or spray form is unknown since most studies lasted only six to 15 weeks. Side effects can include seizures, dizziness and thinking and memory problems.
Howard Lee Weiner, chief of the Division of Multiple Sclerosis at Brigham and Women’s Hospital in Boston, said the plant form of marijuana may work just as well as the spray or pill, although more studies are needed.
“We have to take complementary and alternative medicines seriously,” he said today in a telephone interview. “There are some that can help patients. You want to stay away from things that are dangerous, that are harmful or that are expensive.”
In the U.S., 20 states and the District of Columbia have laws that allow doctors to authorize use of cannabis therapy for illnesses ranging from pain and nausea to spasticity, or stiffness and spasms and movement disorders, according to Norml, a marijuana-reform organization. On top of that, Colorado and Washington allow for the legal production, sale and consumption of marijuana for non-medical purposes.
Today’s study also found that ginkgo biloba may help reduce tiredness but not thinking and memory issues. Magnetic therapy, where a patient lies on a mat with electronic magnetic feeds, may also help reduce tiredness while not providing a benefit for a patient’s depression. Reflexology may also work as well.
Bee sting therapy and a low-fat diet with fish oil used as complementary therapies don’t appear to benefit symptoms and bee stings may cause deadly allergic reactions and infections, the researchers said.