A new guideline from the American Academy of Neurology suggests there is little evidence that most complementary or alternative medicine therapies treat the symptoms of multiple sclerosis.
However, the guideline states the CAM therapies oral cannabis and oral medical marijuana spray may ease patients reported symptoms of spasticity, pain related to spasticity and frequent urination in multiple sclerosis.
The guideline, published in the March 25 issue of the journal Neurology, states there is not enough evidence to show whether smoking marijuana is helpful in treating MS symptoms.
Using different CAM therapies is common in 33% to 80% of people with MS, particularly those who are female, have higher education levels and report poorer health, the lead author of the guidelines, Vijayshree Yadav, MD, MCR, of Oregon Health & Science University, Portland, and a member of the American Academy of Neurology, said in a news release. People with MS should let their doctors know what types of these therapies they are taking, or thinking about taking.
There is not enough information to show whether CAM therapies interact with prescription MS drugs, according to the guideline. Most CAM therapies are not regulated by the Food and Drug Administration. The FDA approved dronabinol and nabilone, synthetic forms of key ingredients in marijuana, as treatments for nausea and vomiting associated with cancer chemotherapy if the symptoms do not respond to standard treatments. Dronabinol also is approved for loss of appetite associated with weight loss in patients with AIDS.
The guideline found that certain forms of medical marijuana, in pill or oral spray form only, may help reduce patients reported spasticity symptoms, pain due to spasticity and frequent urination, but not loss of bladder control. The therapy may not help reduce tremor.
Long-term safety of medical marijuana use in pill or oral spray is not known, according to the guideline. Most of the studies are short, lasting six to 15 weeks. Medical marijuana in pill or oral spray form may cause side effects, some of which can be serious. Examples are seizures, dizziness, thinking and memory problems and psychological problems such as depression, which may be of special concern because some people with MS are at an increased risk for depression or suicide. Clinicians and patients must weigh the possible side effects that medical marijuana in pill or oral spray form can cause.
Among other CAM therapies studied for MS, ginkgo biloba might possibly help reduce fatigue but not thinking and memory problems. Magnetic therapy may also help reduce fatigue but not depression.
Reflexology possibly helps ease symptoms such tingling, numbness and other unusual skin sensations. Bee sting therapy, a low-fat diet with fish oil and a therapy called the Cari Loder regimen all do not appear to help MS symptoms such as disability, depression and tiredness. Bee stings can cause a life-threatening allergic reaction and dangerous infections.
Moderate evidence shows that omega-3 fatty acids such as fish oil likely do not reduce relapses, disability, tiredness or MRI brain scan lesions, nor do they improve quality of life in people with MS.
Neurology is the medical journal of the American Academy of Neurology. Guideline: www.neurology.org/content/82/12/1083.full