Effects of baclofen, THC:CBD on spasticity-related walking impairments in MS

[ActiveMSers]

Journal
Expert Review of Neurotherapeutics

A review of the effects of baclofen and of THC:CBD oromucosal spray on spasticity-related walking impairment in multiple sclerosis

Rafael Arroyo González
Received 31 May 2018, Accepted 08 Aug 2018, Published online: 20 Sep 2018

Download citation https://doi.org/10.1080/14737175.2018.1510772

ABSTRACT

Introduction: Multiple sclerosis (MS) is a complex disease with a heterogeneous and unpredictable clinical course. Mobility impairment after progressive paralyses and muscle tone spasticity is common.

Areas covered: The prevalence, assessment, and pharmacological management of gait impairment and spasticity in MS and their effects on health-related quality of life (HRQoL) are discussed. The roles of oral and intrathecal baclofen and of delta-9-tetrahydrocannabinol/cannabidiol (THC:CBD) oromucosal spray in treating MS spasticity-related gait impairment are reviewed.

Expert commentary: Mobility impairment and spasticity are experienced by approximately 90% and 80% of MS patients, respectively, during the disease course. Prevalence and severity of gait impairment and spasticity increase as disease progresses. The symptoms are related and both impact negatively on HRQoL. Oral baclofen and tizanidine are generally used for first-line treatment of MS spasticity but are ineffective in approximately 40% of cases. Second-line therapy includes add-on THC:CBD spray for patients with resistant MS spasticity. Results of studies evaluating baclofen for treating MS spasticity gait impairment are equivocal.

In studies of patients with resistant MS spasticity, THC:CBD spray consistently improved the timed 10-meter walk test and significantly improved multiple spatial-temporal and kinematic gait parameters. THC:CBD oromucosal spray warrants further investigation as a treatment for MS spasticity-related gait impairment.

[DougR20]

Interesting study. I would like to see further research in this, particularly the dosages of each drug that provides the best results.

Have PPMS. I have taken 10mg baclofen tablets. They provided spasticity relief, but made me feel wobbly walking.

Currently take 25mg CBD capsules. Definitely help with spasticity, stiffness, pain and sleeping. Though I don’t see gait improvement.

Anyone else have comments on their experiences?

[Suebee]

I agree, very interesting study and I want to understand more how much is needed to help and what amt of spasticity drugs is it being added on to as therapy.

I did a quick google search and found this info on a spray (not avail in US).
“Sativex® is an oromucosal spray of a formulated extract of the cannabis sativa plant that contains the principal cannabinoids delta-9-tetrahydrocannibinol (THC) and cannabidiol (CBD) in a 1:1 ratio as well as specific minor cannabinoids and other non-cannabinoid components. We developed Sativex® to be administered as an oromucosal spray, whereby the active ingredients are absorbed in the lining of the mouth, either under the tongue or inside the cheek.l”.
The description doesn’t give enough info to compare to capsules. I don’t know if patent may specify mgs or if full clinical trials documentation would specify more. But I wonder if the method of absorbstion vs oral allows for smaller doses. .? Regardless, if US lawmakers could understand how awful spasticity is and how current pharmaceuticals aren’t helpful to many msers maybe these kind of studies will eventually lead to more relief from this awful symptom. Let,s hope.

[AMFADVENTURES]

I see there is a session on the first day of ECTRIMS next week, dealing with the use of cannabinoids and spasticity. That could be interesting, hope the general public can at least get to the abstracts.

By the way, in case you weren't aware, the US Government (the NIH) holds the patents on many of the non psychoactive cannabinoid compounds. I think those patents are scheduled to expire in just a couple of years. That could set up a free for all WRT new refined drugs from various cannabinoid compounds so stay tuned. If any of the hundreds of cannabinoid compounds can in fact relieve some MS symptoms, specifically pain and spasticity, they may be coming in an FDA approved version soon!

Google patent # 6630507

[teena marie]

Hello all,

I have been having tremendous relief from this spray. Much less spasticity and stiffness. I take a spray periodically throughout the day and night. Finding the right dose is highly individualistic and is a trial and error of start low and go slow.

http://thehydropothecary.com/products/elixir

Teena Marie

[Suebee]

awesome resource tm! and another readon ito
immigrate to Canada these days .. .
here is concentrations of this
from the sourc you gave

“Absorption can be felt typically from 30 to 45 minutes, and the effects can last from two to four hours.

Elixir CBD contains approximately 900** mg of CBD per 15 ml bottle. Each spray contains approximately 6 mg* of CBD.

Elixir THC contains approximately 400** mg of THC per 15 ml bottle. Each spray contains approximately 2.5 mg* of THC, a relatively small amount of THC allowing ..”

[randman]

I agree, very interesting study

[Fit Paul]

If you think that the synthetic stuff works, try the natural way. Amazing relief.