| Cannabis fumada para la espasticidad de la esclerosis múltiple: estudio aleatorizado, controlado con placebo. |
Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial
Jody Corey-Bloom MD PhD, Tanya Wolfson MA, Anthony Gamst PhD, Shelia Jin MD MPH,
Thomas D. Marcotte PhD, Heather Bentley BA, Ben Gouaux BA
CMAJ 2012
Un estudio, publicado en Canadian Medical Association Journal, ha demostrado que el consumo de cannabis durante unos pocos días alivió la espasticidad muscular en 30 pacientes con esclerosis múltiple (EM). El estudio incluyó a pacientes con EM y espasticidad muscular que no respondían a los fármacos tradicionales. Se aleatorizó a los pacientes a fumar cannabis o un placebo con la misma forma, olor y sabor, pero sin el ingrediente activo (THC). Cada paciente fumó una vez al día durante tres días. Antes y después de cada vez, un observador independiente evaluó la espasticidad muscular de los participantes. En general, los niveles de espasticidad disminuyeron una media de 2,74 puntos en una escala de 24 puntos con el cannabis y no variaron con el placebo (p < 0,0001). El tratamiento también redujo la puntuación de dolor en una escala analógica visual una media de 5,28 puntos más que el placebo (p = 0,008), así como una media de 8,67 puntos (p = 0,003) en el Paced Auditory Serial Addition Test.
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| Efecto de la cannabis sobre la función cognitiva en pacientes con esclerosis múltiple |
Effects of cannabis on cognitive function in patients with multiple sclerosis.
Honarmand K, Tierney MC, O'Connor P, Feinstein A.
University of Toronto, 27 King's College Circle, Toronto, Ontario, Canada M5S.
Neurology. 2011 Mar 29;76(13):1153-60.
Abstract
BACKGROUND: While neuropsychological deficits have been reported in healthy individuals who use street cannabis, data in patients with multiple sclerosis (MS) are lacking. Given that MS is associated with cognitive deterioration, the aim of this study was to determine the neuropsychological effects of cannabis use in this population. METHODS: Two groups, each of 25 patients with MS (cannabis users and nonusers), were administered the Minimal Assessment of Cognitive Function in MS battery of neuropsychological tests, the Hospital Anxiety and Depression Scale (HADS), and the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I). Group-matching and regression analysis were used to control for the effects of age, sex, education, premorbid intelligence, disability, and disease course and duration on cognitive function. RESULTS: Cannabis users performed significantly more poorly than nonusers on measures of information processing speed, working memory, executive functions, and visuospatial perception. They were also twice as likely as nonusers to be classified as globally cognitively impaired. There were no between-group differences on the HADS measures of depression and anxiety or lifetime SCID-I psychiatric diagnoses. CONCLUSION: This cross-sectional study provides empirical evidence that prolonged use of inhaled or ingested street cannabis in patients with MS is associated with poorer performance on cognitive domains commonly affected in this population. Whatever subjective benefits patients may derive from using street cannabis (e.g., pain and spasticity relief) should be weighed against the associated cognitive side effects.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068013/?tool=pubmed
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| Nuevos abordajes en el tratamiento de la espasticidad de los pacientes con esclerosis múltiple; papel de los cannabinoides |
New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids.
Smith PF.
Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago, Dunedin, New Zealand.
Ther Clin Risk Manag. 2010 Mar 3;6:59-63.
Abstract
Cannabinoids such as Cannabis-based medicinal extracts (CBMEs) are increasingly being used in the treatment of spasticity associated with multiple sclerosis (MS). They have been shown to have a beneficial effect on spasticity; however, this evidence is largely based on subjective rating scales. Objective measurements using the Ashworth scale have tended to show no significant effect; however, the validity of this scale has been questioned. The available clinical trial data suggest that the adverse side effects associated with using CBMEs are generally mild, such as dry mouth, dizziness, somnolence, nausea and intoxication. However, most of these trials were run over a period of months and it is possible that other adverse side effects could develop with long-term use. There may be reason to be concerned about the use of therapeutic cannabinoids by adolescents, people predisposed to psychosis and pregnant women.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835560/?tool=pubmed
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