There is enough evidence for clinicians to prescribe cannabis in pill or spray form to ease patient-reported pain and spasticity in multiple sclerosis, according to new guidelines from the American Academy of Neurology.
The guidelines looked at a variety complementary therapies commonly used in MS including cannabis, magnetic therapy, reflexology, gingko biloba, bee sting therapy and fish oils.
The authors found oral cannabis extract, THC and cannabinoid spray alleviated patient-reported spasticity and pain but not central neuropathic pain. However they were unlikely to improve objective measures of spasticity, they said.
However there was not enough evidence to recommend smoking cannabis and the authors also cautioned that all cannabinoids had potential side effects, the most serious being seizures, poor memory or psychological problems such as depression.
Other complementary therapies showing some promise included magnetic therapy and gingko, which may reduce symptoms of fatigue, as well as reflexology which may be effective for paresthesia.
The guidelines concluded that the Cari Loder regimen, bee sting therapy and omega-3 supplementation were all probably ineffective for a range of MS symptoms.
For a number of other complementary therapies such as hypnosis, music therapy, mindfulness or yoga there was insufficient evidence.
Between a third and 80% of people with multiple sclerosis use some form of complementary therapy, the guidelines noted, with the highest prevalence among women, patients with higher education levels and those with poorer health.
Neurology 2014; online
However there was not enough evidence to recommend smoking cannabis and the authors also cautioned that all cannabinoids had potential side effects, the most serious being seizures, poor memory…
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