The following information is presented for educational purposes only.
Medical Marijuana Inc. provides this information to provide an understanding
of the potential applications of cannabidiol. Links to third party websites
do not constitute an endorsement of these organizations by Medical Marijuana
Inc. and none should be inferred.
Dystonia is a movement disorder that is characterized by involuntary muscle
spasms. Studies have shown cannabis reduces the contractions associated with
Overview of Dystonia
Dystonia is a disorder that is associated with involuntary muscle
contractions that cause slow, repetitive or twisting movements. Depending on
the form of dystonia, one muscle, a group of muscles or muscles throughout
the body can be affected. The spasms, which can be mild or severe, can
interfere with performing day-to-day tasks and can cause abnormal postures.
Sometimes the involuntary movements are painful.
The spasms associated with dystonia can begin with a foot cramp or a
tendency for one foot to drag, or handwriting worsening. In some cases, the
contractions can cause the neck to turn involuntarily. Eyes may blink
rapidly or be forced closed. The tremors can also cause speaking
difficulties. Symptoms can worsen with fatigue or stress.
The cause of some forms of dystonia is genetic, but the cause of most cases
is unknown. According to the National Institute of Neurological Disorders
and Stroke, researchers believe that damage or an abnormality in the brain’s
basal ganglia or other regions that control movement are responsible for
dystonia. Dystonia can also be a symptom of another disease or condition,
such as Parkinson’s disease, Huntington’s disease, Wilson’s disease,
traumatic brain injury, stroke, brain tumors, and infections. It can also
develop in response to certain medications.
There is no cure for dystonia. Medications can help manage symptoms. In some
cases, surgery can disable or regulate nerves or regions in the brain.
Findings: Effects of Cannabis on Dystonia
Research has found that cannabis improves dystonia. Two of the major
cannabinoids found in cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD),
activate the CB1 and CB2 receptors of the endocannabinoid system, which in
turn regulate the excitatory and inhibitory neurotransmitters necessary to
curtail spasticity and muscle tremors (Pertwee, 2002) (Syed, McKeage &
Scott, 2014) (Smith, 2002). Studies support that medical cannabis offers
significant improvements in muscle spasticity, both in mice trials and in
human subjects (Borgelt, Franson, Nussbaum & Wang, 2013) (Baker, et al.,
One study found that five patients undergoing daily treatments of CBD
experienced a 20 to 50% improvement in dystonia (Consroe, Sandyk & Snider,
1986). The same researchers had previously reported that CBD treatments
caused significant dystonia improvements in both a 65-year-old woman and a
31-year-old man (Sandyk, Snider, Consroe & Elias, 1986).
Numerous case studies have supported cannabis’ dystonia-curtailing benefits.
In one, a 52-year old woman with multiple sclerosis experienced a decreased
frequency of dystonia in response to cannabis-based medications. She also
reported improvements in sleep quality and anxiety (Deutsch, et al., 2008).
In another, a 42-year-old chronic pain patient reported an improvement in
dystonia following cannabis inhalation (Chatterjee, Almahrezi, Ware &
Fitzcharles, 2002). Smoking cannabis also caused a marked improvement in
dystonia in a patient with Wilson’s disease (Uribe Roca, Michelli & Viotti,
2005). A 38-year-old pianist saw an improvement in motor control following
THC intake, causing the researchers to conclude that THC significantly
improves focal dystonia (Jabusch, Schneider & Altenmuller, 2004).
Along with pain, muscle spasm is the most common reason that medical
cannabis is recommended and prescribed by medical professionals (Borgelt,
Franson, Nussbaum & Wang, 2013).
States That Have Approved Medical Marijuana for Dystonia
Currently, only the states of Illinois and New
Mexico (cervical dystonia)
have approved medical marijuana for the treatment of dystonia. However, in Washington
D.C., any condition can be approved for medical marijuana as long as a
DC-licensed physician recommends the treatment. In addition, various other
states will consider allowing medical marijuana to be used for the treatment
of dystonia with the recommendation from a physician. These states include: California (any
debilitating illness where the medical use of marijuana has been recommended
by a physician), Connecticut (other
medical conditions may be approved by the Department of Consumer
Protection), Massachusetts (other
conditions as determined in writing by a qualifying patient’s physician), Nevada (other
conditions subject to approval), Oregon (other
conditions subject to approval), Rhode
Island (other conditions
subject to approval), and Washington (any
“terminal or debilitating condition”).
Sixteen states have approved medical marijuana for the treatment of spasms.
These states include: Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Maryland, Michigan, Minnesota, Montana, Nevada, New
Hampshire, Oregon, Rhode
Island and Washington.
Several states have approved medical marijuana specifically to treat
“chronic pain,” which can develop in some cases of dystonia. These states
include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New
Mexico, Ohio, Oregon, Pennsylvania, Rhode
Island and Vermont.
The states of Nevada, New
Dakota, Montana, Ohio and Vermont allow
medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have
approved cannabis for the treatment of “intractable pain.”
Recent Studies on Cannabis’ Effect on Dystonia
Dystonia was reduced in a woman following cannabis-based
medication treatments. Current
status of cannabis treatment of multiple sclerosis with an
illustrative case presentation of a patient with MS, complex
vocal tics, paroxysmal dystonia, and marijuana dependence
treated with dronabinol.(http://www.ncbi.nlm.nih.gov/pubmed/18496477)
Spasms that had previously proven to be untreatable by
traditional efforts were significantly reduced after four weeks
of cannabis treatment.A
double-blind, randomized, placebo-controlled, parallel-group
study of Sativex, in subjects with symptoms of spasticity due to
Baker, D., Pryce, G., Croxford, J.L., Brown, P., Pertwee, R.G., Huffman,
J.W., and Layward, L. (2000, March 2). Cannabinoids control spasticity and
tremor in a multiple sclerosis model. Nature,
Borgelt, L.M., Franson, K.L., Nussbaum, A.M., and Wang, G.S. (2013,
February). The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy,
Chatterjee, A., Almahrezi, A., Ware, M., and Fitzcharles, M.A. (2002, July).
A dramatic response to inhaled cannabis in a woman with central thalamic
pain and dystonia. Journal
of Pain and Symptom Management, 24(1), 4-6.
Consroe, P., Sandyk, R., and Snider, S.R. (1986, November). Open label
evaluation of cannabidiol in dystonic movement disorders. The
International Journal of Neuroscience, 30(4), 277-82.
Deutsch, S.I., Rosse, R.B., Connor, J.M., Burket, J.A., Murphy, M.E., and
Fox, F.J. (2008, May). Current status of cannabis treatment of multiple
sclerosis with an illustrative case presentation of a patient with MS,
complex vocal tics, paroxysmal dystonia, and marijuana dependence treated
with dronabinol. CNS
Spectrums, 13(5), 393-403.
Dystonia. (2015, November 25). Mayo
Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/dystonia/home/ovc-20163692.
Dystonias Fact Sheet. (2015, July 6). National
Institute of Neurological Disorders and Stroke. Retrieved from http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm.
Jabusch, H.C., Schneider, U., and Altenmuller, E. (2004, August).
Delta9-tetrahydrocannabinol improves motor control in a patient with
musician’s dystonia. Movement
Disorders, 19(8), 990-1.
Pertwee, R.G. (2002, August). Cannabinoids and multiple sclerosis. Pharmacology
& Therapeutics, 95(2), 165-74.
Sandyk, R., Snider, S.R., Consroe, P., and Elias, S.M. (1986, July).
Cannabidiol in dystonic movement disorders. Psychiatry
Research, 18(3), 291.
Smith, P.F., (2002, June). Cannabinoids in the treatment of pain and
spasticity in multiple sclerosis. Current
Opinion in Investigational Drugs, 3(6), 859-64.
Syed, Y.Y., McKeage, K., and Scott, L.J. (2014, April).
Delta-9-tetrahydrocannabinol-cannabidiol (Sativex): a review of its use in
patients with moderate to severe spasticity due to multiple sclerosis. Drugs,
Uribe Roca, M.C., Micheli, F., and Viotti, R. (2005, January). Cannabis
sativa and dystonia secondary to Wilson’s disease. Movement
Disorders, 20(1), 113-5.
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