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Published March 24 in the journal Neurology, the guidelines cover a wide range of complementary and alternative medicines typically used when conventional treatments fail. Among the few that appear to work, the authors say medical marijuana shows the strongest potential.
According to the authors, moderate evidence exists showing medical marijuana can ease common symptoms of multiple sclerosis, including pain, frequent urination and muscle spasticity.
Side effects are minor and treatments are “generally well tolerated,” they write.
However, most of the evidence comes from studies involving cannabis-based pills and oral sprays. Not enough clinical data is available to determine whether smoking marijuana is helpful for MS, note the authors.
Dr. Timothy Coetzee, Chief Research Officer of the National MS Society, who was not involved with the review, believes the guidelines are important for medical marijuana policy decisions.
“I think it really emphasizes our approach to support the rights of people with MS to work with their doctors, recognizing that they need to do this in the context of the legal regulations of the state they’re in,” he says.
Pills containing marijuana’s active ingredient, such as Marinol and Cesamet, have been approved by the FDA and can be prescribed for off-label use in MS.
Sativex, an oral spray made from whole cannabis extract, is not available in the U.S., but is approved in 24 other countries, including Canada and the UK, for the treatment of MS-related spasticity.
In a study published last month in the journal European Neurology, German neurologist Dr. Peter Flachenecker concluded that Sativex may be “an effective and well-tolerated treatment option for resistant multiple sclerosis spasticity.”