title: Evolution of multiple sclerosis spasticity-associated symptoms: latest data.
abstract: In addition to muscle stiffness and increasing mobility restrictions, symptoms commonly associated with multiple sclerosis (MS) spasticity are spasms, sleep disturbances, pain, fatigue and bladder dysfunction. Treatment options include trigger factor avoidance, physiotherapy and antispasticity medication. Oral antispasticity agents commonly used in Germany are baclofen, tizanidine and gabapentin, but physician and patient satisfaction with their effectiveness is low. Over the past few years, randomized controlled trials, observational studies and registry data have demonstrated the positive risk:benefit profile of add-on 9-delta-tetra-hydrocannabinol:cannabidiol oromucosal spray for moderate-to-severe resistant MS spasticity. Herein, evidence for this novel therapeutic option is reviewed. A case study illustrates the level of improvement in daily functioning that is possible in treatment responders.
authors.affiliation: Neurological Rehabilitation Center Quellenhof, Bad Wildbad, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Flachenecker
mesh_terms: D000284:Administration, Oral; D002185:Cannabidiol / Q000627:therapeutic use*; D013759:Dronabinol / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000209:etiology* / Q000628:therapy*; D064887:Observational Studies as Topic; D010936:Plant Extracts; D016032:Randomized Controlled Trials as Topic
chemical_list: D004338:Drug Combinations; D009125:Muscle Relaxants, Central; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols
keywords: antispasticity drugs; clinical trials; multiple sclerosis; observational studies; registry studies; spasticity-associated symptoms