Esclerosis múltiple (EM)

Multiple Sclerosis (MS) and Medical Cannabis

Definition

MS is a demyelinating disease, where the myelin sheath that protects and nerve cells is damaged. This impairs the conduction of signals across nerve cells, and over time can cause persistent muscle spasms and consistent nerve pain.

Potential Efficacy / Quality of Evidence (Low, Average, High) of Medical Marijuana for Multiple Sclerosis

High – in particular for MS arising from autoimmune dysfunction

Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help

CBD could be of particular use for MS, but only if there’s some THC in it as well. Some THCA may be helpful, too. The MS medication, Sativex, is a 1:1 CBD:THC ratio.

Terpenes like myrcene and linalool may help one relax.

CBD:THC 3:1; CBD:THC 1:1.

Medical Cannabis Pros

THC could help manage muscle spasms and stiffness.

Prevents swelling of the brain and optic nerve – many cannabinoids, including THC and CBD, may contribute to this effect.

CBD may be neuroprotective, and may even counteract MS’s development. This could be to the fact that it may prevent brain inflammation.

Help manage the pain of MS, as well as the side-effects of other medications, often causing nausea, fatigue and weight problems.

Cannabis may promote neurogenesis – the growth of new brain cells.

Medical Cannabis Cons

THC may cause confusion and other deleterious effects. This is why 1:1 THC:CBD ratios are considered most therapeutic for MS

Age of user also matters – younger MS sufferers may need to be careful with THC.

Side-effects of some psychoactive cannabinoids like THC may be overwhelming for some.

More About the Condition

MS is a condition where the body’s immune system attacks the body’s immune system.T-cells become activated in the lymph system, and, for those with MS, enter the central nervous system (CNS). Once in the CNS, the chemicals released by T-cells cause inflammation and damage.

T-cells activate helper B-cells, which activate antibodies and cause further damage to the CNS and the myelin sheath surrounding nerves.

There are a number of factors that could cause multiple sclerosis, although the precise cause or causes are not known. Genetics are definitely a factor, and there are approximately 200 genes that have been identified that where abnormalities could contribute to the development of MS. Environmental factors and having suffered a previous major condition may also be a factor in the development of MS.

T-regulatory cells dampen or turn off inflammation. In those with MS, these T-regulatory cells do not function properly.

Symptoms of MS include vision problems and possibly blindness over time. Fatigue, numbness, tingling, muscle spasms, mobility problems, confusion and problems with thinking & planning, depression and anxiety and nerve and muscle pain.

Onset of MS is usually between 20 and 40 years of age, but can arise at any age from 10 years old to 80 years old, with a mean of 32 years old.

Symptoms can build over time in a progressive manner in those with MS. In some cases, MS occurs in recurring, isolated attacks.

MS is the most common autoimmune disorder affecting the central nervous system (CNS).

Approximately 2.5 million people worldwide suffer from MS. The US makes up around 400,000 of total worldwide sufferers. Rates of MS are higher farther from the equator. According to Healthline, 200 new cases of MS arise in the US each week.

There is a medication in the UK developed for MS using THC, named Sativex. Sativex may also be of use for any neuropathic pain associated with MS. Sativex is produced by GW Pharmaceuticals, and is approximately a 1:1 THC: CBD ratio.

THC may help reduce the number of spasms and help reduce pain. CBD may help reduce some of the psychoactive effects of THC when in equal ratios, and thus help reduce some of the more confusing and fatiguing effects of THC.

Cannabinoids’ could help promote neurogenesis for older people, and so could be of use for those in MS.

Quotes from Experts

“A large proportion of patients with multiple sclerosis (MS) have spasticity, which has a marked impact on their quality of life. Anecdotal evidence suggests a beneficial effect of cannabis on spasticity as well as pain. Recently, randomized, double-blind, placebo-controlled studies have confirmed the clinical efficacy of cannabinoids for the treatment of spasticity in patients with MS. Based on these data, nabiximols (Sativex), a 1:1 mix of Δ-9-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, received approval for treating MS-related spasticity in various countries around the globe.” Source: Leussink, Verena Isabell et al. ‘Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity‘ Therapeutic advances in neurological disorders vol. 5,5 (2012): 255-66. doi:10.1177/1756285612453972