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A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms.
Clin Rehabil 2003; 17(1):21-9CR

Abstract

OBJECTIVES

To determine whether plant-derived cannabis medicinal extracts (CME) can alleviate neurogenic symptoms unresponsive to standard treatment, and to quantify adverse effects.

DESIGN

A consecutive series of double-blind, randomized, placebo-controlled single-patient cross-over trials with two-week treatment periods.

SETTING

Patients attended as outpatients, but took the CME at home.

SUBJECTS

Twenty-four patients with multiple sclerosis (18), spinal cord injury (4), brachial plexus damage (1), and limb amputation due to neurofibromatosis (1).

INTERVENTION

Whole-plant extracts of delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), 1:1 CBD:THC, or matched placebo were self-administered by sublingual spray at doses determined by titration against symptom relief or unwanted effects within the range of 2.5-120 mg/24 hours. Measures used: Patients recorded symptom, well-being and intoxication scores on a daily basis using visual analogue scales. At the end of each two-week period an observer rated severity and frequency of symptoms on numerical rating scales, administered standard measures of disability (Barthel Index), mood and cognition, and recorded adverse events.

RESULTS

Pain relief associated with both THC and CBD was significantly superior to placebo. Impaired bladder control, muscle spasms and spasticity were improved by CME in some patients with these symptoms. Three patients had transient hypotension and intoxication with rapid initial dosing of THC-containing CME.

CONCLUSIONS

Cannabis medicinal extracts can improve neurogenic symptoms unresponsive to standard treatments. Unwanted effects are predictable and generally well tolerated. Larger scale studies are warranted to confirm these findings.

Authors+Show Affiliations

Oxford Centre for Enablement, Windmill Road, Oxford, UK. derick.wade@dial.pipex.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12617376

Citation

Wade, Derick T., et al. "A Preliminary Controlled Study to Determine Whether Whole-plant Cannabis Extracts Can Improve Intractable Neurogenic Symptoms." Clinical Rehabilitation, vol. 17, no. 1, 2003, pp. 21-9.
Wade DT, Robson P, House H, et al. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clin Rehabil. 2003;17(1):21-9.
Wade, D. T., Robson, P., House, H., Makela, P., & Aram, J. (2003). A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clinical Rehabilitation, 17(1), pp. 21-9.
Wade DT, et al. A Preliminary Controlled Study to Determine Whether Whole-plant Cannabis Extracts Can Improve Intractable Neurogenic Symptoms. Clin Rehabil. 2003;17(1):21-9. PubMed PMID: 12617376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. AU - Wade,Derick T, AU - Robson,Philip, AU - House,Heather, AU - Makela,Petra, AU - Aram,Julia, PY - 2003/3/6/pubmed PY - 2003/5/21/medline PY - 2003/3/6/entrez SP - 21 EP - 9 JF - Clinical rehabilitation JO - Clin Rehabil VL - 17 IS - 1 N2 - OBJECTIVES: To determine whether plant-derived cannabis medicinal extracts (CME) can alleviate neurogenic symptoms unresponsive to standard treatment, and to quantify adverse effects. DESIGN: A consecutive series of double-blind, randomized, placebo-controlled single-patient cross-over trials with two-week treatment periods. SETTING: Patients attended as outpatients, but took the CME at home. SUBJECTS: Twenty-four patients with multiple sclerosis (18), spinal cord injury (4), brachial plexus damage (1), and limb amputation due to neurofibromatosis (1). INTERVENTION: Whole-plant extracts of delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), 1:1 CBD:THC, or matched placebo were self-administered by sublingual spray at doses determined by titration against symptom relief or unwanted effects within the range of 2.5-120 mg/24 hours. Measures used: Patients recorded symptom, well-being and intoxication scores on a daily basis using visual analogue scales. At the end of each two-week period an observer rated severity and frequency of symptoms on numerical rating scales, administered standard measures of disability (Barthel Index), mood and cognition, and recorded adverse events. RESULTS: Pain relief associated with both THC and CBD was significantly superior to placebo. Impaired bladder control, muscle spasms and spasticity were improved by CME in some patients with these symptoms. Three patients had transient hypotension and intoxication with rapid initial dosing of THC-containing CME. CONCLUSIONS: Cannabis medicinal extracts can improve neurogenic symptoms unresponsive to standard treatments. Unwanted effects are predictable and generally well tolerated. Larger scale studies are warranted to confirm these findings. SN - 0269-2155 UR - https://www.unboundmedicine.com/medline/citation/12617376/A_preliminary_controlled_study_to_determine_whether_whole_plant_cannabis_extracts_can_improve_intractable_neurogenic_symptoms_ L2 - http://journals.sagepub.com/doi/full/10.1191/0269215503cr581oa?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -