The American Academy of Neurology has become one of the first medical organizations in the U.S. to endorse the use of medical marijuana.
In new guidelines published in the journal Neurology, the Academy said oral cannabis, medical marijuana pills and medical marijuana spray may help ease symptoms of muscle spasticity and frequent urination caused by multiple sclerosis (MS). The group said there was not enough evidence to show whether smoking marijuana was helpful in treating in MS symptoms.
Muscle spasticity is a common symptom of MS causing involuntary spasms, immobility, disturbed sleep and pain.
The Academy, which represents over 27,000 neurologists, also said there was little evidence that other types of complementary or alternative medicine therapies (CAM) were effective in treating MS.
Many MS patients seek relief from their symptoms by turning to nonconventional therapies such as ginkgo biloba, magnetic therapy, bee sting therapy, omega-3 fatty acids, and reflexology – often without their doctor’s knowledge.
“Using different CAM therapies is common in 33 to 80 percent of people with MS, particularly those who are female, have higher education levels and report poorer health,” said guideline lead author Vijayshree Yadav, MD, with Oregon Health & Science University in Portland.
“People with MS should let their doctors know what types of these therapies they are taking, or thinking about taking.”
Multiple sclerosis is a chronic disease which attacks the body’s central nervous system and destroys the myelin sheath that protects nerve cells in the brain. An estimated 400,000 Americans have the disease and more than 2 million worldwide. There is no known cure.
A medical marijuana spray called Sativex is already being sold in Europe, Canada and Mexico to treat MS spasticity, but it is currently not approved for use in the U.S.
Sativex was developed by British-based GW Pharmaceuticals (NASDAQ: GWPH), which plans to begin a Phase 3 clinical trial of Sativex on MS patients in the U.S. in the second half of 2014. Positive results could lead to approval by the Food and Drug Administration.
One study out of Germany that looked at over 300 patients found that Sativex reduced MS spasticity by 20% or more in 4 out of 10 patients who were previously unresponsive to conventional therapies.
However, in a review of nearly two dozen other trials, a British medical journal said there was little evidence supporting the use of Sativex to treat muscle pain and spasticity in MS patients.
In its new guidelines, the American Academy of Neurology said the long term safety of medical marijuana was unknown.
“Medical marijuana in pill or oral spray form may cause side effects, some of which can be serious. Examples are seizures, dizziness, thinking and memory problems as well as psychological problems such as depression. This can be a concern given that some people with MS are at an increased risk for depression or suicide. Both doctors and patients must weigh the possible side effects that medical marijuana in pill or oral spray form can cause,” the Academy said in a statement.
The Academy’s guidelines say ginkgo biloba may help reduce tiredness caused by MS, but not thinking and memory problems. Magnetic therapy may also help reduce tiredness but not depression. Reflexology may help ease symptoms such tingling, numbness and other unusual skin sensations.
The guidelines say bee sting therapy, a low-fat diet with fish oil, and a therapy called the Cari Loder regimen all do not appear to help MS symptoms such as disability, depression and tiredness. Bee stings could cause a life-threatening allergic reaction and dangerous infections.
The Academy said omega-3 fatty acids such as fish oil likely do not reduce relapses, disability, tiredness or brain lesions caused by MS, nor do they improve quality of life in MS patients.