Sativex Relieves Pain in MS Patients, Italian Study Confirms

Sativex Relieves Pain in MS Patients, Italian Study Confirms

Researchers confirmed that Sativex spray is beneficial in alleviating pain in patients with multiple sclerosis (MS), and also improved their pain sensitivity to cold temperatures.

The study reporting the findings, “Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials,” was published in the journal Medicines.

Pain is one of the most debilitating symptoms of MS; it affects 29 to 86 percent of patients. It is associated with disability, distress, and negatively influences their quality of life.

Cannabis sativa plant-based products (cannabinoids) are effective in managing pain and spasticity in MS patients.

Sativex (nabiximols) is a oromucosal spray containing equal amounts of two cannabinoids: delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). The product is marketed by GW Pharmaceuticals.

In the study, researchers in Italy tested the ability of Sativex to alleviate neuropathic (nerve-related) and nociceptive pain (muscle- and soft tissue-related) in MS patients.

Nineteen MS patients (18 to 65 years old) with chronic pain and spasticity participated in the study. All patients received Sativex (mean of 6.9 puffs per day) for one month, and pain levels were assessed before and after treatment.

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Researchers used a numerical rating scale (NRS) to quantify pain in the range of 0 to 10. The higher the NRS, the worse the pain. Pain was further assessed through a neurophysiological technique called laser-evoked potentials (LEP). In LEP, fine lasers are used to apply heat on the skin, and the response of sensory fibers that carry pain information to the brain are recorded.

Pain-related heat and cold response was measured using a psychophysiological technique called quantitative sensory testing (QST). QST assesses the response to painful stimuli (hyperalgesia) and the response to a stimulus that doesn’t invoke pain (allodynia). Patients were asked to indicate when they detected heat/cold, and for how long they could bear the heat/cold to determine pain thresholds.

Researchers compared the results with data from 20 healthy volunteers, sex- and age-matched to the patient group analyzed.

The main finding of the study was that 74% of the patients (14 patients) reported a 20% reduction in pain after Sativex treatment, indicated by a significant reduction in NRS scores (from 6.61 to 3.55 after treatment).

Compared to healthy study participants, MS patients have decreased upper-limb and lower-limb pain response in LEP, suggesting they have a higher loss of pain and temperature sensations in their limbs.  However, no significant change in LEP was observed in patients after Sativex treatment.

Nonetheless, Sativex treatment was found to improve the cold pain threshold in MS patients significantly through the QST test. The perception of abnormal cold temperatures was reduced from 39.5% before treatment to 28.9% after Sativex therapy in the feet, and from 35.5% to 25% in the hands.

Since pain was reduced in response to temperature, the researchers hypothesized that Sativex may work via the transient receptor potential (TRP) channels — the cellular sensors for cold and heat stimuli.

“In summary, our study further corroborates evidence for the effectiveness of Sativex in reducing pain in MS patients. Furthermore, our findings suggest a possible direct effect of cannabinoids on TRP channels by modulating or desensitizing cold-channel functions” the team concluded.

14 comments

  1. Slavka Ivanovic says:

    Please tell me how and where can I order Sativex ? I would like to buy and pay online . If you have any information I would be happyto get it . I am PPMS patient , and Sativex is working best for my condition. Thanks in advance , best regards

    • Elaine Campbell says:

      I was diagnosed in 2003 and never given anything for MS pain. I would like to try this medication. Can you send me information? Thank you.

      • Sepideh ravandi says:

        I have. Been trying edible CBC ,the : the- smoking weed and under the tongue Cbd bout nothing helps with buttock pain that is killing men.can u help

  2. As a chronic sufferer of neuropathic MS related pain which can typically mount to become agonizing if not addressed upon its early warnings, any cannabinoid research is almost as a godsend for any and all of us. But, this stigma is not solely limited to chronic morbid MS complications. There are all sorts of neuropathic incidence due to other injury and anatomical abberrations that crush and stress and severely damage neurons that may even compound our morbidities just through the living process. Just consider those with MS who may also be Lupus and Rheumatoid Arthritis sufferers. My beloved Mom was one.
    Although I’m deeply grateful for the likes of Lyrica, Nalprexone, Neurontin, et al, the breakthrough pain and the morbid anxieties of their anticipations and the side effects of high doses in some cases to administer relief can be daunting and life altering not for the better. It’s quality of life, I think, that we’re mostly after. We’re willing to courageously accept our disabling limitations and alter our lifestyles to adapt and continue to achieve. There is not one uncourageous one among us.
    But the morbidity of chronic pain is the evil that decays our initiative, emotional resilience, and daily tragically demoralizes. When in God’s Name will governments offer compassionate relief with medical cannibus approval? My state of Texas is abysmal and immoral in its lack of compassion dragging its feet for whatever enigmatic political intentions that deter approval. Do they EXPECT us to purchase weed on the street? I’m just incapable of fathoming the stupidity our legislators demonstrate, here. Effective cannibus research abounds as in this example, God bless them all, while legislatures idle by as we unfortunates due to residential political districts agonize. Agonize is the only word I can consider as appropriate. Don’t these political faces with white shirts, ties, and suits get it?

  3. Erik Oxy says:

    I suffer from intense pain in my calves also it seems when I walk 75 feet or so, i hurt even more then I have a rather severe limp , cold weather also effects me more then the heat. Would thus spray help me and can I get it Kansas ?

  4. Hi, I would liketo try Sativex ordered from England. I started taking CBD only for my MS and helps even the gel in my neck. I didn’t use THC yet. Please keep me post of news about cannabis and Sativex. I prefer to use instead prescriptions all the time or reduce the dose of spasms prescription.I have big problem in my neck already pich the spine cord and my MS is Progressive.

  5. Donna says:

    I work in a pharmacy in Scotland, and Sativex is a prescription only medication. Also, it’s classed as a “special” medication because it’s pretty expensive, and therefore getting a GP to prescribe it is pretty tricky if not impossible!!

  6. Lorraine wareham says:

    My husband started taking sativex 9 days ago he’s on 2 sprays in the morning and 5 in the evening so far he’s no better if anything he’s worse I know it can take up to 2 weeks to see some improvement and it’s only a month’s trial but my husband is getting very disheartened as he’s tried for so long to get sativex I suppose he wanted some sort of a miracle, he’s got ppms and is very depressed so I’m praying this next couple of weeks there is some sort of improvement for him, the point that I’m making is for all of you wanting to try sativex just remember it dosent work for everyone 😯

  7. June Turnbull says:

    I am covered in pain and pins and needles and have been told many a time that there is NOTHING for me I’ve tried all the usual stuff but no joy NOW Joy upon joy, both my GP AND Neurologist say they would be happy for me to start taking Sativex and would I let them know how I get on. Now I wait for my GP to come back from holiday to make a start. We seem to be very lucky and are able to pay the private prescription costs. I say it is too much but my husband is saying nothing is too much IF it works. Let’s see.

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