#CMSC2018 – Pharmacist Discusses Advances, Challenges in Cannabinoids Research to Treat MS

#CMSC2018 – Pharmacist Discusses Advances, Challenges in Cannabinoids Research to Treat MS

Several studies have demonstrated the therapeutic potential of cannabis and its derivate products to manage the symptoms of multiple sclerosis (MS) and other neurodegenerative diseases. But there is still much to be done to enhance their use and accessibility to patients who may benefit from these therapies, according to a recent presentation by Matthew Makelky, PharmD.

Makelky, a researcher at the University of Colorado, reviewed the current status and advances made in cannabinoids use for MS at the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC) in Nashville, Tennessee, May 30-June 2. The presentation was titled “Hashing it out: Cannabis for Multiple Sclerosis.”

The use of marijuana for medical purposes is currently legal in 29 states in the U.S. Only nine of those states also allow recreational marijuana use. With the trend toward legalizing cannabis, additional pressure lies on clinicians who prescribe it to ensure proper use and administration.

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Cannabis contains more than 100 pharmacologically active compounds (cannabinoids), with the most studied compounds being the tetrahydrocannabinol (THC) and cannabidiol (CBD). Both have been evaluated for their potential to modulate spasticity associated with MS, as well as to manage seizures, inflammation, pain, anxiety, and other conditions.

Theoretically, CBD holds greater therapeutic potential than THC, since the first does not have the psychoactive properties that accompany THC use. Still, this compound is linked to some adverse side effects, such as drowsiness, decreased appetite, diarrhea, fatigue, and convulsion.

The THC compound is the one responsible for the “high” experience people feel when consuming cannabis, and is linked to increased neurological risk. THC has been associated with altered brain development and cognitive impairment when used in early adolescence, but also to an increased risk of chronic psychosis disorders.

According to the American Academy of Neurology, the use of oral cannabis extract (OCE) and synthetic THC improved spasticity-related symptoms and pain in patients with MS.

In contrast, AAN considers there is limited or insufficient evidence demonstrating the effectiveness of oromucosal cannabinoid spray, such as Sativex (nabiximols), or smoked cannabis for these indications.

As for treating MS-related urinary symptoms and tremor, none of the tested forms of cannabinoids have shown compelling evidence of effectiveness, according to Makelky.

There are some cannabinoid-based drugs already available on the market and others are under development. Because of the different effects of each cannabinoid compound, finding suitable dosages and methods of administration, as well as optimal frequency of use, may be both challenging and risky.

Also, cannabinoids may chemically react with other prescribed drugs — increasing or reducing their effects — which adds another layer of potential hazard that should be discussed between patients and clinicians.

In summary, cannabis-derived compounds hold potential to treat MS and “to help specific disease states,” Makelky said. Still, there is a lot to learn about “the complex metabolism and interaction profiles” of these compounds, he added.

35 comments

  1. Joe Ryan says:

    While I appreciate that more studies need to be done all I can say is CBD oils have had a tremendous effect for me. My attitude, physical feeling have improved more than I can quantify or put into words. I will deal with the supposed side effects. The daily impact it has had for me far outreaches and expectations I had.

    Joe

    • Allis says:

      CBD has also been helpful for me. I sleep better, overall experience less pain, and it helps my anxiety. I just generally feel better with it than without it.

    • Sue says:

      Thank you. I have a meeting on the 13th to hopefully get CBD oil (prescribed here in Canada) so nice to hear it has been helpful.
      Sue

    • Scott Johnson says:

      CBD is legal in my area and I do not want to wait another 5-10 years for more testing…I have had MS 25 years and had flair up after flair up while waiting on clinical trial after clinical trial.

    • Helen Mc Donnell says:

      I was told I had ms over 8 yrs ago. I only tried cbd oil tonight as I’m only starting! I have spasms an pains in my legs I’m losing the feelings in both hands. My walkin is letting me dwn I lost about 85% walkin.will I give the oil a chance or does anyone no anything stronger or better,I’d try anything at this stage! Tnx H.

      • Chelsea Ellis says:

        Hey Ms Helen my name is Chelsea I’ve had MS since I was 13 I’m 28 now my MS is getting harder an harder I can walk but just for q short period of time jus want to know what do u do jus want some advice PLEASE an thank u an I pray u get betta

  2. Glenda says:

    Thanks for your input, Joe. I think the pendulum has swung and clinicians are more worried about the “Opoid Crisis” or “street drug” use than a patient’s wellbeing. There HAS to something, somewhere to alleviate some of the debilitating effects of MS. Everyone has forgotten that the “high” mentioned above only is associated with the first few doses of any drug without increasing the dosage. I’m glad you’ve found some relief!

    • Beth Boggs says:

      I completely understand your feelings regarding marijuana. However, the CBD oil that can be purchased is from the HEMP plant, not the cannabis/marijuana plant. It does not have any odor & it does not have any THC, so there isn’t any “high”.

  3. Edith Cheney says:

    Shocking that AAN would say synthetic THC is helpful for spasticity and pain. Where I live that is called Spice and is responsible for many hospitalizations and deaths when smoked by young kids.

    • Kendra davidson says:

      The synthetic thc they are talking about comes from your pharmacy it is called dronabinal it isn’t the street one called spice.

  4. Elizabeth Henehan says:

    I medical marijuana for several months. It may have helped my bladder spasms but nothing else. It costs $300.93 a month. Not worth it. I had a 50T:50C ratio first month. Now I’m on
    1T:20 C.

  5. D says:

    I have tried a1:1 combo in a tincture but the THC set off vertigo. I’m looking to work w/ practitioner to work on the correct ratio for my sensitive system. I could not tolerate oral Baclofen as it too caused Vertigo. Be Well

  6. cynthia says:

    I have been taking the THC 9.12 mg.per ml.with CBD 9.76 mg. per ml. for 6 months. It is an oil that I mix with peanut butter…..it smells and tastes bad…so you have to mix it with something. I take 1 ml. at night. I do not agree with smoking it or using it to ”get high”……but for medical purposes…it is a wonder drug. The trauma clinic that I go to monitors your use carefully ,and even the supplier keeps in touch about its use. I sleep so very much better-and without jumping out of bed 4 or 5 times a night with leg cramps. It also has greatly improved bladder issues….something I have had for many years. I generally feel so much better….and all on a minimal dose. In my opinion, it is much better to take cannabis oil [ controlled by a doctor] than many prescription drugs that have low success rates and major side effects.

  7. Broce says:

    I live in Colorado, and my neurologist and my pain doctor both recommended that I get a medical marijuana license. I use it to help me get to sleep, and stay asleep. I have horrific insomnia, as well as crippling fatigue. I don’t find it does anything for spasticity, except to make me focus on it more (and the same with pain). I don’t take it during the day because I don’t much relish being stuck to the sofa even more than my fatigue requires. It isn’t very expensive – an ounce lasts me at least six months, and that’s usually around $150-200. I am concerned that the AAN seems to be suggesting that synthetic versions are ok, but natural are not. The thing which gives me pause is the amount of money involved. I don’t believe them when they say synthetics are the way to go – I don’t trust their associations with Big Pharma.

    • Yes for a couple of weeks now and I was hoping that it would help with my RA, since I am on so many meds plus infusions every 8 weeks…so far I notice I feel more relaxed and I am sleeping well and soundly.

    • Maryann Wagner says:

      i’m trying it and it seems to help. Some companies offer discount for people on disability or veterans. I find that if you order several months worth, the price is lower. And there are coupons st cbdoilusers.com

    • Nikki says:

      Debra, I’ve been on Tecfidera for 2 years and no relapses. You will prob get flushing ++ but you can tinker with what amounts of food you need to eat before taking it to help there.

    • Jennifer S. says:

      Tecfidera is okay. There is currently some evidence that treating with stronger medications before our MS gets worse seems to help keep us mobile and active. Tecfidera is considered a weaker/first line treatment. The most important thing is that it works. I just ordered CBD oil for my MS — the “hug” along my rib cage has been pretty painful lately. What dose do you use?

    • Gabrielle says:

      I have been on Tecfidera since 2013 and I have only had maybe one relapse a year if that. But my spasms are still there and my vertigo is also I have my numbness on the right side. Other than that I am stable. My neuro states as soon as our states is rdy to go with it he is going to give me the go on the CBD Oil.

  8. Glory Seal says:

    I have only been diagnosed with MS for a little a year and have to baclofen to control the tremors and muscle spasms 3 times a day and pain meds since I started vaping the cbds I only take 1 baclofen a day and that is only a half pill in morning and at night. The great thing about the cbds is you can take more if you need to without waiting the 4-6 hrs to have to with meds and the worse that can happen is you need a nap.

  9. I’ve read in most comments that price and potency are the main issues with CBD oil. I would like to offer you all a solution. We have a number of CBD products that can help with symptoms and treatments, and are also affordable. Take a look!
    theorganicway.ctfocbd.com

  10. Micki says:

    CBD and THC is available in tincture, gummy edibles and liquids. No smoking needed. Various strengths.
    CBD does not require a Medical Marijuana card. Some dispensaries let you in to purchase CBD without a card for entry.
    CBD…about 100-150 mg daily relieves pain. Can take more or less as desired. CBD is not psychoactive like THC. No chance of overdosing. Start small and work up to the daily level you need for relief.
    FYI…THC Indica for sleep…take 5-10-15 mg about 1 1/2 Hrs before you want to sleep. THC Sativa usage is more for the comfortable high and relaxed feel.
    I have cancer and both have helped me along with 1000 mg daily of Tumeric. Check with your docs . Happy Holidays

  11. Ashley knight says:

    Hello,well i hope evey one is having a safe and blessed day. Ok i was told back 2013 that i have m.s. six,months later it changed to r.r.m.s. they perscibed Beta serion. Now their talking about changing the medicine to something stronger but who do i talk to about also wanting to try a canibis treatment because i use canibis almost every day does any one have any idea’s on who i would talk with i would be very greatful?

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