The NIH has granted Temple University researchers $1.5 million to test a laboratory-made version of cannabinoids for slowing the progress of multiple sclerosis. Cannabinoids are found in nature in the marijuana plant. Researchers believe that this class of chemicals can create immune suppression, which just might help in multiple sclerosis. Much like steroids (but with fewer side effects and much more selectively), cannabinoids can "switch off" a portion of the immune response and bring down inflammation and "hyperactivity" of immune cells, possibly preventing (or slowing) some of the damage caused to the myelin by immune cells. It does this by interacting with the receptors on specific immune cells.
Temple researchers have synthesized a compound that has this calming effect on the immune system without any of the psychoactive effects that are associated with marijuana. This four-year research project begins this summer. If successful, this could be a lovely addition to potential MS treatments (though I say this with caution, as preliminary research is just now being done).
Research findings on cannabis and MS
Numerous case studies, surveys and double-blind studies have reported improvement in patients treated with cannabinoids for symptoms including spasticity, chronic pain, tremor, sexual dysfunction, bowel and bladder dysfunctions, vision dimness, dysfunctions of walking and balance (ataxia), and memory loss.12-20 Cannabinoids have been shown in animal models to measurably lessen MS symptoms and may also halt the progression of the disease.21
A recent British survey of MS patients found that 43 percent of respondents used cannabis therapeutically. Among them, nearly three quarters said that cannabis mitigated their spasms, and more than half said it alleviated their pain. A survey published in August 2003 in the Canadian Journal of Neurological Sciences reported that 96 percent of Canadian MS patients believe that cannabis is therapeutically useful for treating the disease. Of those who admitted using cannabis medicinally, the majority found it to be beneficial, particularly in the treatment of chronic pain, spasticity, and depression.22 The accompanying editorial states, “This is an exciting time for cannabinoid research. There is a growing amount of data to suggest that cannabis (marijuana) can alleviate symptoms like muscle spasticity and pain in patients with MS.23
The published results of a number of GW Pharmaceuticals Phase III studies show that pain relief from the cannabis preparation Sativex® was significantly superior to placebo, and there were subjective improvements in spasm frequency, bladder control, spasticity, and sleep. The authors of one such trial concluded that “the results of this study suggest that Sativex® is an effective treatment for spasticity associated with MS.” In April 2005, GW announced that it had received approval to distribute Sativex in Canada for the symptomatic relief of neuropathic pain in adults with Multiple Sclerosis.24
A U.K. study published recently in the journal Lancet looked at 630 multiple sclerosis patients after 15 weeks of orally delivered treatment. Fifty-seven percent of the patients taking a whole cannabis extract said their pain had eased, compared with 50% who took capsules containing THC and 37% who were given placebo capsules. Patients also reported improved sleep and fewer or less intense muscle spasms and stiffness. Those who could walk were significantly more mobile as measured by a walking test. The investigators also noted there were fewer relapses in the treatment groups; however, the study was not designed to investigate impact on relapses.25 An accompanying editorial suggests that current data supporting the benefit of cannabinoid treatment of spasticity in MS is now as strong as for any available pharmaceutical agent.26
Research on the distribution of cannabinoid receptors in the brain suggests that they may play a role in movement control. Only recently have scientists found an animal model for MS, called experimental allergic encephalomyelitits (EAE), allowing testing for symptom suppression. Recent pre-clinical reports found that cannabinoids lessened both tremor and spasticity in mice suffering from EAE.27
In addition to studying the potential role of marijuana and its derivatives in the treatment of MS-related symptoms, scientists are exploring the potential of cannabinoids to inhibit neurodegeneration. A 2003 study that the American MS Society calls “interesting and potentially exciting” demonstrated that cannabinoids were able to slow the disease process in mice by offering neuroprotection against EAE.28 After analyzing the findings, authors at London’s Institute of Neurology concluded, “In addition to symptom management, cannabis may also slow down the neurodegenerative processes that ultimately lead to chronic disability in multiple sclerosis and probably other diseases.29
Research Citations
12. Dixon WE (1899). The pharmacology of Cannabis indica. BMJ, ii: 1354-1357.
13. Petro DJ et al (1981). Treatment of Human Spasticity with Delta-9-Tetrahydrocannabinol. Journal of Clinical Pharmacology, 21: 413-416. http: //www.druglibrary.org/schaffer/hemp/medical/spast1.htm
14. Petro DJ (1980). Marihuana as a therapeutic agent for muscle spasm and spasticity. Psychosomatics, 21: 81-85.
15. Petro DJ (2002). Cannabis in multiple sclerosis: Women’s health concerns. Journal of Cannabis Therapeutics, 2(3-4):161-175.
16. Musty RE, Consroe P. (2002) Spastic disorders. In: Grotenhermen F, Russo EB, editors. Cannabis and cannabinoids: Pharmacology, toxicology, and therapeutic potential. Binghamton, NY. Haworth Press. p. 195-204.
17. Clifford D (1983). Tetrahydrocannabinol for Tremors in Multiple Sclerosis. Annals of Neurology, 13: 669-671.
18. Ungerleider J et al (198Cool. Delta-9-THC in the treatment of Spasticity Associated with Multiple Sclerosis. Advances in Alcohol and Substance Abuse, 7: 39-50.
19. Meinck H et al (1989). Effects of cannabinoids on spasticity and ataxia in multiple sclerosis. Journal of Neurology, 226: 120-122. http://www.druglibrary.org/schaffer/hemp/medical/ms1.htm
20. Consroe P et al (1997). The Perceived Effects of Smoked Cannabis on Patients with Multiple Sclerosis. European Neurology, 38: 44-48.
21. Growing L et al (1998 ). Therapeutic use of cannabis: clarifying the debate. Drug and Alcohol Review, 17: 445-452.
22. Baker D et al (2000). Cannabinoids control spasticity and tremor in a multiple sclerosis model. Nature, 404: 84-87.
23. Page SA et al (2003). Cannabis use as described by people with multiple sclerosis. Can J Neurol Sci; 30:201-205.
24. Killestein J, Polman CH. (2003). Cannabis Use in Multiple Sclerosis: Excited Interest. Can. J. Neurol. Sci.; 30: 181-182
25. From the GW Pharmaceuticals website, accessed on May 16th, 2006. http://www.gwpharm.com/research_phase_iii.asp
26. Zajicek J et al (2003). Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. Lancet, Nov 8;362(9395): 1517-26.
27. Metz L, Page S (2003). Oral cannabinoids for spasticity in multiple sclerosis: will attitude continue to limit use? Lancet, 362(9395):1513.
28. Achiron A et al (2000). Dexanabinol (HU-211) effect on experimental autoimmune encephalomyelitis: implications for the treatment of acute relapses of multiple sclerosis. Journal of Neuroimmunology, 102: 26-31.
29. Pryce G et al (2003). Cannabinoids inhibit neurodegeneration in models of multiple sclerosis. Brain, Jul 22.
30. Ross E (2003). “First major study of medicinal marijuana indicates it could help in multiple sclerosis”. Associated Press, Thursday, November 6.
31. Beard S, Hunn A, Wight J. (2003). Treatments for spasticity and pain in multiple sclerosis: a systematic review. Health Technol Assess. 7(40):iii, ix-x, 1-111.
32. Hazekamp A et al (2006). Evaluation of a vaporizing device (Volcano(R)) for the pulmonary administration of tetrahydrocannabinol. J Pharm Sci 95 (6) Apr 24: 1308-1317.
33. Musty R, Rossi R. (2001). Effects of smoked cannabis and oral delta-9-tetrahydrocannabinol on nausea and emesis after cancer chemotherapy: a review of state clinical trials. Journal of Cannabis Therapeutics. 1: 29-56.
Almirall Prodesfarma, Spain, and GW Pharmaceuticals in the UK, USA and Canada produce Sativex®, a cannabinoid-based drug
Almirall Prodesfarma, Spain, and GW Pharmaceuticals, UK, USA and Canada produce Sativex® a cannabinoid-based oromucosal spray for treatment of MS.
God, I forgot what I was going to ask.
Oh yeah, and what drug exactly did the Temple group get 1.5 M$ to investigate?
Peter, the chemical (from what I can tell) is “a compound (O-1996) synthesized by scientists at the Medical College of Virginia and the company Organix.” It is a synthetic form of one of the chemicals found in marijuana.
I have commented many times on Dr. Stachowiak’s blog regarding the legalization of marijuana. Thank you Dr. for presenting this exciting information. In this research, millions of dollars will be spent exploring the synthesis of the plant. Right now, growers have already created strains of plants that do not produce a psychoactive effect. If marijuana were decriminalized, the plant could be available immediately at a reasonable price , part of which would be a tax that all states would benefit from. But, why take the simple route?
Cannabis has over 60 cannabinoids in the plant. Researchers don’t know all the functions of the cannabinoids and therefore they don’t know which cannabinoids are really working against the disease.
So why we are trying to transform natural plant to the synthethic form?
There seems to be couple of reasons, first of all money. There are also politic reasons why cannabis is forbidden. The medicinal experts are saying that they are going to vanish the side effects of cannabis which includes the “biggest harmful effect” euphoria.
I’m also suffering MS and getting plenty of pleasure from real cannabis medication. Also my EDSS has dropped two points! It really has changed my quality of life. Also the depression has vanished.
Good documentary about medical marijuana: http://www.youtube.com/watch?v=yqWtYyL94IE
I have asked my doctors for two years for something for the pain – no help. I tried a drug prescribed, but no effect. I have had strong pain killer for dental work (vicotin sp?) which didn’t help my legs, but gave me euphoria. I am taking high doses of baclofen for spasms and it seems to be less effective now.
I smoke the smallest possible amount of marijuana to reduce euphoria and no pain, spasms. It works now.