Exploring the Therapeutic Potential of Medicinal Cannabis in Multiple Sclerosis
PDF (Português (Brasil))

Keywords

Esclerose múltipla
cannabis medicinal
tratamento

How to Cite

Pereira Levada, L., Morgado Costa, A. L., Paiva, P., Ferro Radicchi, L., Cavalcante Ribeiro, J., Della Torre Soler, J. V., de Oliveira Lemes, M. C., & Castelo Branco Pupe, C. (2024). Exploring the Therapeutic Potential of Medicinal Cannabis in Multiple Sclerosis. Brazilian Journal of Implantology and Health Sciences, 6(4), 190–214. https://doi.org/10.36557/2674-8169.2024v6n4p190-214

Abstract

The medicinal use of cannabis dates back to various ancient societies with diverse objectives, such as pain and anxiety control. Despite contemporary prejudice against the recreational use of cannabis and its derivatives, they are among the most studied medications today, especially in the treatment of refractory neurological conditions like Multiple Sclerosis (MS). The review encompassed recent studies on the use of medicinal cannabis in the treatment of MS, highlighting different cannabinoids and their effectiveness in symptoms such as spasticity, central pain, urinary dysfunction, and sleep quality. While some cannabinoids have shown significant benefits in studies, such as nabiximols and THC/CBD in oromucosal spray, the efficacy of smoked Cannabis Sativa remains uncertain. The review also emphasized challenges such as adverse effects, lack of crucial information in studies, and the emergence of VSN16R as a potential alternative. Studies on long-term effects yielded disparate results, underscoring the need for further research. Economic analysis addressed the issue of cost-effectiveness, highlighting the importance of considering not only clinical aspects but also financial impacts. From this review, it is concluded that there are improvements in MS symptoms, while also pointing out challenges and underscoring the importance of overcoming ethical, economic, and political barriers to advance research on medicinal cannabis.

https://doi.org/10.36557/2674-8169.2024v6n4p190-214
PDF (Português (Brasil))

References

ALLAN, G. M. et al. Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms. Canadian Family Physician Medecin De Famille Canadien, v. 64, n. 2, p. e78–e94, 1 fev. 2018.

Number of people with MS | Atlas of MS. Disponível em: <https://www.atlasofms.org/map/global/epidemiology/number-of-people-with-ms>. ‌

BAKER, D. et al. Big conductance calcium-activated potassium channel openers control spasticity without sedation. British Journal of Pharmacology, v. 174, n. 16, p. 2662–2681, 7 jul. 2017.

BOGDAN, C. Nitric oxide and the immune response. Nature Immunology, v. 2, n. 10, p. 907–916, out. 2001. ‌

BOSNJAK-PASIĆ, M. et al. Treatment of multiple sclerosis. Acta Clinica Croatica, v. 48, n. 3, p. 349–353, 1 set. 2009. ‌

ERKU, D.; SHRESTHA, S.; SCUFFHAM, P. Cost-Effectiveness of Medicinal Cannabis for Management of Refractory Symptoms Associated With Chronic Conditions: A Systematic Review of Economic Evaluations. Value in Health, v. 24, n. 10, p. 1520–1530, out. 2021.

FRY, D. K. et al. Randomized Control Trial of Effects of a 10-Week Inspiratory Muscle Training Program on Measures of Pulmonary Function in Persons with Multiple Sclerosis. Journal of Neurologic Physical Therapy, v. 31, n. 4, p. 162–172, dez. 2007. ‌

GROOM, A. J.; SMITH, T.; TURSKI, L. Multiple Sclerosis and Glutamate. Annals of the New York Academy of Sciences, v. 993, n. 1, p. 229–275, maio 2003. ‌

GROSSELINK R, KOVACS L, DECRAMER M. Respiratory muscle involvement in multiple sclerosis. Eur Respir J 1999;13(2):449–54

HADDAD, FATMA et al. “The Efficacy of Cannabis on Multiple Sclerosis-Related Symptoms.” Life (Basel, Switzerland) vol. 12,5 682. 5 May. 2022, doi:10.3390/life12050682

HAUSER, STEPHEN et al. A Mapping Literature Review of Medical Cannabis Clinical Outcomes and Quality of Evidence in Approved Conditions in the USA from 2016 to 2019. Medical Cannabis and Cannabinoids, v. 4, n. 1, p. 21–42, 25 fev. 2021

KOPPEL, B. S. et al. Systematic review: Efficacy and safety of medical marijuana in selected neurologic disorders: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, v. 82, n. 17, p. 1556–1563, 28 abr. 2014.

LAUER, K. Environmental risk factors in multiple sclerosis. Expert Review of Neurotherapeutics, v. 10, n. 3, p. 421–440, mar. 2010. ‌

LONGORIA, V. et al. Neurological Benefits, Clinical Challenges, and Neuropathologic Promise of Medical Marijuana: A Systematic Review of Cannabinoid Effects in Multiple Sclerosis and Experimental Models of Demyelination. Biomedicines, v. 10, n. 3, p. 539, 1 mar. 2022.

MOREIRA, M. A. et al. Esclerose Múltipla: estudo descritivo de suas formas clínicas em 302 casos. Arquivos de Neuro-Psiquiatria, v. 58, n. 2B, p. 460–466, jun. 2000. ‌

MUTLUAY, F. K. et al. Breathing-enhanced upper extremity exercises for patients with multiple sclerosis. Clinical Rehabilitation, v. 21, n. 7, p. 595–602, jul. 2007. ‌

O´SULLIVAN S. B. Fisioterapia: Avaliação e tratamento. 2.ed. São Paulo: Manole, 1993.

PAVAN, K. et al. Avaliação da fatigabilidade em pacientes com Esclerose Múltipla através do dinamômetro manual. Arquivos de Neuro-Psiquiatria, v. 64, n. 2a, p. 283–286, jun. 2006. ‌

RODRIGUES, I. F.; NIELSON, M. B. P.; MARINHO, A. R. Avaliação da fisioterapia sobre o equilíbrio e a qualidade de vida em pacientes com Esclerose Múltipla. Revista Neurociências, v. 16, n. 4, p. 269–274, 30 abr. 1999. ‌

SAVCI, S. et al. Six-minute walk distance as a measure of functional exercise capacity in multiple sclerosis. Disability and Rehabilitation, v. 27, n. 22, p. 1365–1371, jan. 2005. ‌

SCOTT, E. P.; BRENNAN, E.; BENITEZ, A. A Systematic Review of the Neurocognitive Effects of Cannabis Use in Older Adults. Current Addiction Reports, v. 6, n. 4, p. 443–455, 22 out. 2019.

SMITH, K. J.; MCDONALD, W. I. The pathophysiology of multiple sclerosis⋮ the mechanisms underlying the production of symptoms and the natural history of the disease. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences, v. 354, n. 1390, p. 1649–1673, 29 out. 1999. ‌

Global Burden of Disease Study 2017 (GBD 2017) Data Resources | GHDx. Disponível em: <https://ghdx.healthdata.org/gbd-2017>. ‌

FRAGOSO, Y. D. Modifiable environmental factors in multiple sclerosis. Arquivos de Neuro-Psiquiatria, v. 72, n. 11, p. 889–894, nov. 2014.

KORN, T. Pathophysiology of multiple sclerosis. Journal of Neurology, v. 255, n. S6, p. 2–6, dez. 2008.

O’Sullivan SB. Esclerose Múltipla. In: O’Sullivan SB, Schmitz TS. Fisioterapia avaliação e tratamento. 2a ed. São Paulo: Manole, 1993, 527-48

FRY, D. K. et al. Randomized Control Trial of Effects of a 10-Week Inspiratory Muscle Training Program on Measures of Pulmonary Function in Persons with Multiple Sclerosis. Journal of Neurologic Physical Therapy, v. 31, n. 4, p. 162–172, dez. 2007.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2024 Leonardo Pereira Levada, Ana Luiza Morgado Costa, Pedro Paiva, Leonardo Ferro Radicchi, Jeferson Cavalcante Ribeiro, João Vitor Della Torre Soler, Maria Clara de Oliveira Lemes, Camila Castelo Branco Pupe