Emerging treatment options for spasticity in multiple sclerosis – clinical utility of cannabinoids
John C Ashton
Department of Pharmacology and Toxicology, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand
Abstract: Multiple sclerosis (MS) is a widespread and common disabling autoimmune disease of the central nervous system. The main disabling symptom is muscle spasticity, which occurs in most patients. Treatment of spasticity with existing drugs is often poor, and there is a need for new and additional treatments. This article reviews the use of cannabinoids for the treatment of symptoms in MS, focusing on the pharmacology of Δ9-tetrahydrocannabinol (Δ9-THC), cannabidiol and analog drugs in various formulations, the rationale for their use, and their efficacy and safety in the treatment of MS. It is concluded that of all currently available formulations, only sublingual spray containing Δ9-THC has a sufficient evidence base to justify its use in treatment of spasticity and patient quality of life, particularly in patients' refractory to current treatments.
Keywords: MS, Δ9-tetrahydrocannabinol, Δ9-THC, cannabis
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