Using medical cannabis in adults with dystonia improves symptoms and eases pain
The use of medical cannabis in adults with dystonia improves symptoms and alleviates associated pain, according to results of a study presented at the International Congress of the Society of Parkinson's Disease and Movement Disorders (MDS) Virtual Congress 2021, which took place from September 17 to 22, 2021.
benefits previous research found that medical cannabis can help treat involuntary muscle contractions and reduce associated pain in patients with dystonia by activating cannabinoid receptors in the basal ganglia that release γ-aminobutyric acid (GABA) . This could potentially reduce the severity and improve the quality of life for patients with dystonia. Since 2013, the Israeli Ministry of Health (MOH) has accepted the use of medical cannabis for the symptomatic treatment of patients with movement disorders and associated pain.
The current study aimed to assess the effect of medical cannabis on dystonia muscle activity and associated pain in patients with a medical cannabis license approved by the MOH.
Researchers at Tel Aviv University in Israel contacted dystonia patients (n = 23) with a medical cannabis license approved by the Ministry of Health by phone. Using a 5-point Likert scale, participants' demographics, their use of medical cannabis, and the effects of treatment were assessed.
A total of 11 women and 12 men, with a mean age of 52,7 years, were included in the analysis. The etiologies of dystonia were generalized (n = 9), focal (n = 6), segmental (n = 5), hemidystonia (n = 2) or multifocal (n = 1) caused by Parkinson's disease (n = 6 ), monogenic (n = 4) or unknown (n = 13) variants.
On average, participants reported using medical cannabis for 2 to 10 years. The average consumption used per month is 20 to 22 grams at a rate of 3-4 uses per day. Medicinal cannabis was made up of 6-11% THC and 6-8% CBD. Participants also specified that 47,8% of them used oil, 43,5% flowers and 8,7% reported using both forms.
The subjective and self-reported efficacy of cannabis use for dystonia is an improvement in symptoms for 3,5 / 5 of patients, 3,7 / 5 experienced a decrease in their pain and 3,6 / 5 experienced benefits on their quality of life. 70% of participants also reported improvement in their sleep.
Participants who experienced more improvements in their dystonia reported using a higher dose of THC than those who showed little improvement, with a positive correlation between the dose of THC and improvement in dystonia symptoms ( R2 = 0,012).
Participants who smoked medical cannabis compared to those who consumed the oil were more likely to report improvement in symptoms of dystonia.
Adverse effects included dry mouth (65%), worsening mood (n = 3), anxiety (n = 2), anxiety with hallucinations (n = 1) and suicidal thoughts. (n = 1). Three participants stopped receiving medical cannabis treatment because of its ineffectiveness or side effects.
Limitations of the study include its small size and the inclusion of patients with different dystonia symptoms, using uncontrolled dosing and administration methods. Therefore, these results should be validated in a larger, controlled study.
“Medical cannabis appears to improve symptoms of dystonia and associated pain. A higher daily dose of THC and smoking rather than taking sublingual oil are significantly more effective, ”the researchers concluded.Anis S, Faust-Socher A, Sverdlov D, et al. A real-life study of the effect of medical cannabis on adults with dystonia. Presented at: MDS Virtual Congress 2021; from September 17 to 22, 2021.