Tuesday, 7 May 2013

Two is better than one. Combining anti-spastic drugs

Multiple sclerosis (MS)-related spasticity is associated with disability and impairment in quality of life. We report on a patient with secondary progressive MS and spastic tetraparesis (Expanded Disability Status Scale score 8.5). The right arm exhibited flexor spasticity resulting in functional disability despite multimodal symptomatic treatment. Intrathecal baclofen led to side effects despite decreasing efficacy. Low-dose nabiximols improved spasticity and function with recovery of daily-life activities and spasticity-related symptoms. Reduction of intrathecal baclofen ameliorated adverse drug reactions. Add-on cannabinoid therapy was effective in therapy-refractory spasticity with supra-additive effect in combining intrathecal baclofen and nabiximols, hypothetically explained by mutually complementing mechanisms of action.

Nabiximols is another name for sativex so this study says that balcofen causes side effects but if cannabis was added to the treatment then there  was increased efficacy and this may allow you to reduce doses of drugs that cause the side effect, Good management of drug mixtures can work wonders. 

CoI: MD is developing competing agents to treat spasticity.


  1. MouseDoc, I was listening to an interview with Prof Dame Nancy Rothwell the BBC has done and thought you may like it because she talks about stuff you're into.


    1. Didn't know Nancy Rothwell was into Heavy Metal! ;-)
      Will give it a listen.

  2. Spasticity treatments are lacking for MS as well as other conditions. In the U.S. sativex is not FDA approved but they debate the use of medical marijuana??? Can't get marinol script for MS only used for wasting complications in AIDs patients and in cancer chemo. Frustrating.

    1. Hi Steve,
      Your right about it being frustrating. Spasticity treatments are a rather Cinderella area in Neurology. Hopefully this is changing (we have a commercial interest in this field and I know pharma is also getting interested now, we need alternatives to baclofen etc). Hopefully sativex will get FDA approval but in the meantime can you get access to medical marijuana? Worth a try?


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