Friday, 27 April 2018

Improving the taste of cannabis spray

AIM:

Complaints about Δ9-tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray (Sativex®; GW Pharma Ltd, Sailsbury, UK) in the management of multiple sclerosis spasticity include unpleasant taste and oral mucosal anomalies. This pilot study assessed the use of sugar-free chewing gum and/or a refrigerated bottle of THC:CBD oromucosal spray to mitigate these effects.

MATERIALS & METHODS:

Patients with multiple sclerosis spasticity (n = 52) at six sites in Italy who were receiving THC:CBD oromucosal spray and had associated oral mucosal effects were randomized into Group A (chewing gum; n = 15); Group B (cold bottle; n = 20); and Group C (cold bottle + chewing gum; n = 17).

RESULTS:

Taste perception in patients receiving chewing gum ± cold bottle intervention (Groups A and C combined) was significantly (p = 0.0001) improved from baseline to week 4 while maintaining spasticity control.

CONCLUSION:

Patient comfort, satisfaction and treatment adherence may benefit from these interventions
This article may be useful to anyone who gets sativex. Sativex is an alcoholic extract of cannabis (i.e a tincture), I thik with a peppermint flavour, so it is like a Creme-de-Menthe spray under the toungue. However, as it is reletively pure alcohol,means that it is going to be a fixative to the inside of the cheek and it is going to taste unpleasant. We know this because in the placebo controlled tirals where people could have 0-20+ puffs of the sativex inhaler and those on placebo where there is no drug to work, should have been puffing away, but they didn't ,and on average had lesss than a half of available. This says the taste isn't good. However, above may be some use if you can get access to treatment

4 comments:

  1. (Sativex®; GW Pharma Ltd, Sailsbury, UK) in the management of multiple sclerosis spasticity

    Wonder how this fares against baclophen..?

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    Replies
    1. My experience of Sativex is that its not as effective as baclofen for spasticity but does not have the same side effects/consequences so is worth considering as an alternative. For me there have been no noticeable side effects for Sativex other than a dry mouth - many others report forgetfulness and poor concentration, appetite changes (the munchies?) though.

      I came of baclofen because as well as reducing spasticity in my legs, it reduced muscle tone elsewhere and after a year I realised that it was impacting me more widely. Once I came off baclofen, I realised how much better I was feeling and how much more energy I had. My ability to concentrate for long times also returned.

      I'm now on combination of Tizanidine and Sativex. Sativex instructions says come off other meds first - I found this impractical advice, so I slowly reduced the old one and introduced Sativex slowly. I'm now using Tizanidine as my core medicine with regularly timed doses, and using Sativex as and when needed - it takes 15-45 minutes to take effect and lasts up to 6 hours (4 more realistically) so is more responsive and practical than changing doses of other medicines. I typically use Sativex last thing at night to make me sleep well and stop spasms (Tizanidine seems not as good as baclofen at this), and I also use it first thing in the morning which is when my spasticity tends to be at its worst.

      My recommendation with MS meds for spasticity is try them all and see what works for you - we are all different. Combinations seem to be the most effective for me, so make sure you discuss options with your consultant/MS nurses.

      Hope that helps

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    2. Adding to my (anonymous) post above, I should add that while its effects on spasticity are reasonable to good, it has dramatically improved bladder urgency problems in a way other medicines have not. Worth trying for this alone.

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  2. Sativex does taste pretty bad the first few times you use it, but you quickly don't notice it. For me it tastes nothing like peppermint, though. It certainly tastes better when the dispenser is new and it gradually tastes worse the more you use the same dispenser. Although the taste is a consequence of the ingredients (as explained by MouseDoctor), perhaps we should think of the bad taste as a subliminal deterrent for overuse?

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