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Faculty Presentations on Multiple Sclerosis Treatment with Cannabis and Cannabinoids

petro04Multiple Sclerosis & Medical Cannabis, Denis Petro, MD -
Dr. Petro, Consulting Neurologist and drug researcher, looks at history of medical marijuana use in Multiple Sclerosis and spasticity, recent trials using Cannabinoids and Cannabis extracts to treat MS and prospects for approval in the U.S. Presented to the Third National Clinical Conference on Cannabis Therapeutics, 2004 in Charlottesville, VA.

miller04Multiple Sclerosis and Medical Cannabis, with Jim Miller -
Husband of MS patient Cheryl Miller, Jim tells their story of love, suffering and activism, from first learning of marijuana's efficacy to pressuring members of Congress. After Cheryl's passing, Jim and other MS patients formed the Multiple Sclerosis Patients Union - www.mspu.org

guy04Oromuscosal Cannabis-based Medicine, Geoffrey Guy, MD -
"From Plant to Prescription Medicine" - Introduced by Don Wirtshafter, Geoffrey Guy, Founder and Executive Chairman, GW Pharmaceuticals, UK, explains why extracts of Phyto-Cannabinoids THC & CBD need to represent the natural balance of the Cannabis plant. Describing Cannabinoid action as a "Super-Modulator", Dr. Guy discusses clinical trials involving Multiple Sclerosis (MS), spinal cord injury and neuropathic pain.

Cannabis for MS & Spinal Cord Injury, Richard Musty, PhD - At our Second Clinical Conference on Cannabis Therapeutics, 2002, in Portland, OR, Professor Richard Musty, Pyschology, University of Vermont, presents studies confirming that Medical Cannabis (marijuana) reduces symptoms of Multiple Sclerosis and spinal cord injuries.

Suggested Reading:

pdficonBenito C, Romero JP, Tolón RM, Clemente D, Docagne F, Hillard, CJ, Guaza, C & Romero, J. (2007).  Cannabinoid CB1 and CB2 receptors and fatty acid amide hydrolase are specific markers of plaque cell subtypes in human multiple sclerosis.  J Neurosci., 27(9), 2396-402.

pdficonCabral GA & Griffin-Thomas L. (2008). Cannabinoids as Therapeutic Agents for Ablating Neuroinflammatory Disease.  Endocrine, Metabolic & Immune Disorders – Drug Targets. 8:159-172.

pdficonCentonze, D., Finazzi-Agro, A., Bernardi, G., & Maccarrone, M. (2007).  The endocannabinoid system in targeting inflammatory neurodegenerative diseases.  Trends in Pharmacological Science, 28(4) 180-187.

pdficonCollin C, Davies P, Mutiboko  IK & Ratcliffe S. (2007). Randomized controlled trial of cannabis-based medicine in spasticity caused by multiple sclerosis.  European Journal of Neurology, 14(3): 290-6.

pdficonDeutsch SI, Rosse RB, Connor JM, Burket JA, Murphy ME & Fox FJ. (2008). Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol. CNS Spectrum. 13(5): 393-403.

pdficonPalazuelos, J., Davoust, N., Julien, B., Hatterer, E., Aguado, T., Mechoulam, R., Benito, C., Romero, J., Silva, A., Guzmán, M., Nataf, S. & Galve-Roperh, I. (2008). The CB2 cannabinoid receptor controls myeloid progenitor trafficking.  The Journal of Biological Chemistry.  283(19): 13320-13329.

pdficonPryce G, Ahmed Z, Hankey DJ, Jackson SJ, Croxford JL, Pocock JM, Ledent C, Petzold A, Thompson AJ, Giovannoni G, Cuzner ML & Baker D. (2003).  Cannabinoids inhibit neurodegeneration in models of multiple sclerosis.  Brain, 126(10), 2191-202.

Additional Reading:

Brady CM, DasGupta R, Dalton C, Wiseman OJ, Berkley KJ & Fowler CJ. (2004). An open label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis.  Multiple Sclerosis, 10:425-433.

Canada News Wire. (June 20, 2005). Sativex: Novel cannabis derived treatment for MS pain now available in Canada by prescription.

Chong et al (2006). Cannabis use in patients with multiple sclerosis.  Multiple Sclerosis 12: 646-651.

Clark et al (2004). Patterns of cannabis use among patients with multiple sclerosis.  Neurology 62: 2098-2010.

Collin C, Ambler Z & Kent RA. (2006). A randomized controlled study of Sativex in patients with symptoms of spasticity due to multiple sclerosis.  Multiple Sclerosis. 12(S1):S228-9.

Collin C, Tun P, Serpell MG et al. (2005). A cannabis based medicine (Sativex) has sustained efficacy in the treatment of spasticity in multiple sclerosis.  Journal of Neurol Neurosurg Psychiatry, 76(9):1316.

Consroe, P. et al (1997).  The perceived effects of smoked cannabis on patients with multiple sclerosis.  European Journal of Neurology. 38: 44-48.

D’Souza DC, Perry E, MacDougall L, Ammerman Y, Cooper T, Wu Y, Braley G, Gueorguieva R & Krystal JH. (2004). The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis.  Neuropsychopharmacology. 29: 1558-72.

Fujiwara M & Egashira N. (2004). New perspectives in the studies on endocannabinoid and cannabis: abnormal behaviors associate with CB1 cannabinoid receptor and development of therapeutic application. Journal of Pharmacological Sciences. 96: 362-366

Fox P, Bain PG, Glickman S et al. (2004). The effect of cannabis on tremor in patients with multiple sclerosis. Neurology. 62:1105-9.

Giuffrida A, Leweke FM, Gerth CW, Schreiber D, Koethe D,  Faulhaber J, Klosterkötter J & Piomelli D. (2004). Cerebrospinal Anandamide levels are elevated in acute schizophrenia and are inversely correlated with psychotic symptoms.  Neuropsychopharmacology. 29(2):2108-14.

Killestein J et al (2003).  Immunomodulatory effects of orally administered cannabinoids in multiple sclerosis.  Journal of Neuroimmunology.  137: 140-143.

Mechoulam R, & Hanu L. (2001).  The cannabinoids: an overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection.  Pain Res Manag., 6(2), 67-73.

Meinck et al (1989). Effects of cannabinoids on spasticity and ataxia in multiple sclerosis.  Journal of Neurology.  236: 120-122.

Notcutt, W. G., Sharief, M., Mutiboko, I., Hawkes, C., Bolt, J., & Sarantis, N. (2006). Cannabis based medicine (Sativex) for chronic pain due to multiple sclerosis or other neurological dysfunction: a randomised controlled trial. European Journal of Pain, (in press).

Page SA, Verhoef MJ, Stebbins RA, Metz LM & Levy JC. (2003). Cannabis use as described by people with multiple sclerosis.  Canadian Journal of Neurological Sciences. 30(3): 201-205.

Pertwee RG. (2002). Cannabinoids and multiple sclerosis.  Pharmacol Ther. 95(2):165-74.

Petro D. (1980). Marijuana as a therapeutic agent for muscle spasm or spasticity.  Psychosomatics. 21: 81-85.

Petro DJ. (2002). Cannabis in multiple sclerosis: Women’s health concerns.  Journal of Cannabis Therapeutics, 2(3-4):161-75.

Rog DJ, Numikko TJ, Friede T & Young CA. (2005). Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis.  Neurology. 65(6): 812-9.

Rog DJ et al (2007). Oromucosal delta-9-tetrahydrocannabinol/Cannabidiol for Neuropathic pain associated with multiple sclerosis: an uncontrolled, open label, 2-year extension trial.  Clinical Therapeutics. 29:2068-79.

Ungerleider et al (1987). Delta-9-THC in the treatment of spasticity associated with multiple sclerosis.  Advances in Alcohol and Substance Abuse. 7: 39-50.

Vaney et al (2004).  Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover study.  Multiple Sclerosis.  10: 417-424.

Wade et al (2003).  A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms.  Clinical Rehabilitation. 17: 21-29.

Wade DT, Makela P, Robson P, House H, & Bateman C. (2004). Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients. Mult Scler, 10(4), 434-41.

Wade DT, Makela PM, House H, Bateman C & Robson PJ. (2006). Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosis. Multiple Sclerosis, 12, 639-645.

Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A, et al.(2003).  Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomized placebo-controlled trial.  The Lancet, 362(9395): 1517-1526.

Zajicek, J. P., Sanders, H. P., Wright, D. E., Vickery, P. J., Ingram, W. M., Reilly, S. M., et al. (2005). Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. J Neurol Neurosurg Psychiatry, 76(12), 1664-1669.