Tags

Type your tag names separated by a space and hit enter

A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms.

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.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Oxford Centre for Enablement, Windmill Road, Oxford, UK. derick.wade@dial.pipex.com

    , , ,

    Source

    Clinical rehabilitation 17:1 2003 Feb pg 21-9

    MeSH

    Administration, Oral
    Analgesics, Non-Narcotic
    Cannabidiol
    Cannabis
    Cross-Over Studies
    Double-Blind Method
    Dronabinol
    Humans
    Hypotension
    Muscle Spasticity
    Nervous System Diseases
    Pain
    Phytotherapy
    Placebos
    Plant Preparations
    Severity of Illness Index
    Spasm
    Urination Disorders

    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 -