A role for cannabinoids in the treatment of myotonia? Report of compassionate use in a small cohort of patients.
Adult
Aged
Cannabidiol
/ administration & dosage
Cannabinoid Receptor Modulators
/ administration & dosage
Chronic Disease
Cohort Studies
Compassionate Use Trials
Dronabinol
/ administration & dosage
Drug Combinations
Female
Humans
Male
Middle Aged
Muscular Dystrophies
/ drug therapy
Myalgia
/ drug therapy
Myotonia
/ drug therapy
Oils
Treatment Outcome
Cannabidiol
Cannabis
Myotonia
Myotonic dystrophy
Tetrahydrocannabinol
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
29
06
2019
accepted:
18
10
2019
revised:
09
09
2019
pubmed:
28
10
2019
medline:
24
11
2020
entrez:
28
10
2019
Statut:
ppublish
Résumé
The symptomatic treatment of myotonia and myalgia in patients with dystrophic and non-dystrophic myotonias is often not satisfactory. Some patients anecdotally report symptoms' relief through consumption of cannabis. A combination of cannabidiol and tetrahydrocannabinol (CBD/THC) was prescribed as compassionate use to six patients (four patients with myotonic dystrophy types 1 and 2, and 2 patients with CLCN1-myotonia) with therapy-resistant myotonia and myalgia. CBD/THC oil was administered on a low dose in the first 2 weeks and adjusted to a higher dose in the following 2 weeks. Myotonia behaviour scale (MBS), hand-opening time, visual analogue scales (VAS) for myalgia and myotonia, and fatigue and daytime sleepiness severity scale (FSS, ESS) were performed weekly to monitor treatment response. All patients reported an improvement of myotonia especially in weeks 3 and 4 of treatment: MBS improved of at least 2 points in all patients, the hand-opening time variously improved in 5 out of 6 patients. Chronic myalgia was reported by both DM2 patients at baseline, one of them experienced a significant improvement of myalgia under treatment. Some gastrointestinal complaints, as abdominal pain and diarrhoea, improved in 3 patients; however, 4 out of 6 patients reported new-onset constipation. No other relevant side effect was noticed. These first empirical results suggest a potentially beneficial role of CBD/THC in alleviating myotonia and should encourage further research in this field including a randomized-controlled trial on larger cohorts.
Sections du résumé
BACKGROUND
BACKGROUND
The symptomatic treatment of myotonia and myalgia in patients with dystrophic and non-dystrophic myotonias is often not satisfactory. Some patients anecdotally report symptoms' relief through consumption of cannabis.
METHODS
METHODS
A combination of cannabidiol and tetrahydrocannabinol (CBD/THC) was prescribed as compassionate use to six patients (four patients with myotonic dystrophy types 1 and 2, and 2 patients with CLCN1-myotonia) with therapy-resistant myotonia and myalgia. CBD/THC oil was administered on a low dose in the first 2 weeks and adjusted to a higher dose in the following 2 weeks. Myotonia behaviour scale (MBS), hand-opening time, visual analogue scales (VAS) for myalgia and myotonia, and fatigue and daytime sleepiness severity scale (FSS, ESS) were performed weekly to monitor treatment response.
RESULTS
RESULTS
All patients reported an improvement of myotonia especially in weeks 3 and 4 of treatment: MBS improved of at least 2 points in all patients, the hand-opening time variously improved in 5 out of 6 patients. Chronic myalgia was reported by both DM2 patients at baseline, one of them experienced a significant improvement of myalgia under treatment. Some gastrointestinal complaints, as abdominal pain and diarrhoea, improved in 3 patients; however, 4 out of 6 patients reported new-onset constipation. No other relevant side effect was noticed.
CONCLUSIONS
CONCLUSIONS
These first empirical results suggest a potentially beneficial role of CBD/THC in alleviating myotonia and should encourage further research in this field including a randomized-controlled trial on larger cohorts.
Identifiants
pubmed: 31655890
doi: 10.1007/s00415-019-09593-6
pii: 10.1007/s00415-019-09593-6
doi:
Substances chimiques
Cannabinoid Receptor Modulators
0
Drug Combinations
0
Oils
0
Cannabidiol
19GBJ60SN5
Dronabinol
7J8897W37S
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
415-421Références
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