(HealthDay News) — The American Academy of Neurology (AAN) has released evidence-based recommendations for complementary and alternative medicine (CAM) for multiple sclerosis (MS). The guideline was published in the March 25 issue of Neurology.
Vijayshree Yadav, MD, of the Oregon Health & Science University in Portland, and other members of the AAN’s Guideline Development Subcommittee, conducted a literature search to develop these evidence-based recommendations.
The researchers suggest that clinicians may offer oral cannabis extract (Level A) or tetrahydrocannabinol (Level B) for spasticity symptoms and pain (excluding central neuropathic pain), but should counsel patients that these agents are probably ineffective for objective spasticity (short-term)/tremor (Level B) and possibly effective for spasticity and pain (long-term; Level C). Sativex oromucosal cannabinoid spray (nabiximols) can be suggested for spasticity symptoms, pain, and urinary frequency (Level B), but clinicians should counsel patients that these agents are probably ineffective for objective spasticity/urinary incontinence (Level B). Magnetic therapy is probably effective for fatigue, but probably ineffective for depression (Level B). Among common supplements, clinicians can counsel patients that fish oil is probably ineffective for relapses, disability, fatigue, magnetic resonance imaging lesions, and quality of life (Level B); ginkgo biloba is ineffective for cognition (Level A), but possibly effective for fatigue (Level C); and reflexology is possibly effective for paresthesia (Level C). Possibly ineffective therapies (Level C) include Cari Loder for disability, depression, and fatigue, and bee sting therapy for relapses, disability, fatigue, and lesion burden/volume.
“Clinicians should exercise caution regarding standardized versus nonstandardized cannabis extracts and overall CAM quality control/nonregulation,” the authors write.