Can medical cannabis benefit symptoms of motor neurone disease (MND)?

Every day, six people are diagnosed with motor neurone disease, and for each and every one of them, this news is devastating. 

The term motor neurone disease (MND) covers a range of rare conditions that attack the nerve cells (or motor neurones) in the brain and spinal cord. At the moment there is no cure for motor neurone disease, and unfortunately, it is fatal.

While there are treatments available to help ease the symptoms of MND, according to statistics from The Motor Neurone Disease Association, one in three patients die within a year of their diagnosis, and more than half lose their lives within two years. 

Statistics like these highlight just how crucial raising awareness for this condition is, and, considering it's Motor Neurone Disease Day tomorrow, that’s exactly what we’re going to do.

So, what is motor neurone disease (MND)?

The term motor neurone disease covers a range of conditions, all of which are rare and progressive. Amyotrophic lateral sclerosis (ALS) is the most common form of MND, and it's believed to affect around 5000 people in the UK at any one time. 

Primary lateral sclerosis (PLS), progressive muscular atrophy (PMA), progressive bulbar palsy (PBP) and Kennedy’s disease are other forms of motor neurone disease. 

These conditions are progressive, and so, they gradually cause a loss of functioning in motor nerves. 

Motor neurones (or nerves) are responsible for movement control, and they can be found in the brain, spine and peripheral nerves. When MND occurs, it attacks these motor neurones and causes the body to become weaker, and weaker, eventually leading to death. 

At the moment, it’s unclear exactly what causes motor neurone disease to occur. For the most part MND is not believed to be hereditary, although the NHS do state you may be more likely to get motor neurone disease if a close relative has it, or has frontotemporal dementia. 

What are the typical signs and symptoms of MND?

Although everyone’s journey is different, typically, early signs of motor neurone disease include clumsiness, slurred speech, and feeling weak.

Often weakness in the leg or ankle starts first, which can be a trip hazard, and it makes stairs a real struggle. Others people develop a weak grip, and find it hard to do up their buttons or frequently drop things.

Muscle cramps, twitches, and weight loss are other symptoms of motor neurone disease which is regularly accompanied by pain, and some find it hard to stop themselves laughing or crying in inappropriate situations. 

Over time, walking, gripping, speaking, swallowing, and eventually breathing can become increasingly difficult, and this leads many to feel as if they’re trapped in a failing body. Most don’t start to show signs until they are in their 60s and 70s, but motor neurone disease can affect adults of all ages, and it progresses rapidly. 

Because of the deteriorative effects motor neurone disease can have, it is also not uncommon for patients with MND to develop comorbid mental health conditions, such as anxiety and depression. 

What treatment options are available for patients with motor neurone disease?

The impact motor neurone disease has on patients, and their loved ones, can be catastrophic. 

While we await a cure for the disease, it’s important that those affected by MND are aware of the treatments options available that may help to prolong independence, improve quality of life, and minimise the severity of their symptoms. 

At the moment, there is no test that confirms whether an individual has MND or not, and so, this diagnosis is normally met after other health conditions are ruled out through a process of elimination. 

After this, the NHS typically prescribe treatments, or recommend therapies, that reduce the severity, or progression, of symptoms, whilst facilitating independence for as long as possible. 

Typically, a medication called riluzole is prescribed to help slow the progression of motor neurone disease, and medicines to target pain, relieve muscle stiffness, and improve mood are common. Occupational therapy and physiotherapy are also routinely recommended to help prolong independence and maintain strength. 

Could medical cannabis help alleviate symptoms of motor neurone disease?

While research into both motor neurone disease and medical cannabis is still ongoing, there is evidence to suggest that cannabis-based treatments may help combat or relieve some of the most common symptoms people with MND experience. This includes pain, muscle stiffness, poor appetite, poor sleep, and low mood. 

Pain and muscle stiffness

Much like patients with fibromyalgia and multiple sclerosis, patients with motor neurone disease frequently encounter muscle stiffness, spasms, and twitches which are often accompanied by pain. 

However, reputable evidence demonstrates cannabis-based treatments can act as a muscle relaxant, and alleviate spasticity and muscle cramps. 

In fact, a study of MS patients showed a 49% reduction in spasticity was noted within just 12 weeks of treatment with Sativex, which is one of the three licensed cannabis-based medicines available on (but rarely prescribed by) the NHS. 

Cannabis contains hundreds of natural chemical compounds, but the two most abundant are the cannabinoids, or phytocannabinoids, cannabidiol (CBD) and tetrahydrocannabinol (THC). When these compounds enter the body, they can influence the brain’s perception of pain, and so far they’ve demonstrated great potential in alleviating pain at the source. 

Poor sleep

Medical cannabis has also shown powerful potential in managing sleeping disorders because of the sedative effects it can have when applied appropriately. 

For example, just last year, the results of a double-blind placebo controlled trial conducted in Australia revealed overall sleep quality improved by 80% when patients with insomnia administered medical cannabis oil. 

It’s believed when these compounds interact with our bodies' endocannabinoid system, they can influence the responses it typically issues. In the case of sleep, research shows THC can reduce REM cycle sleep. In turn, this enhances the light sleep component, and increases deep sleep, which is when the body can get to work restoring cells and tissues. 

CBD on the other hand has relaxing properties that promote a sense of calm, which makes it easier to unwind and relax before bed. This can help reduce the amount of time it can take to fall asleep, and increase the sensation of sleepiness. 

Low mood

One of the most common conditions we treat with medical cannabis at Releaf is depression. 

Scientists now believe CBD can work in a similar fashion to conventional SSRIs, and interact with 5-HT1A receptors in the brain, effectively boosting their levels of serotonin production. 

Those with depression tend to have lower levels of serotonin, which is the bodies natural ‘feel good’ chemical, responsible for regulating mood. So, unsurprisingly, CBD is now becoming increasingly popular as a treatment to combat low mood. 

On the other hand, THC, cannabis’ psychoactive component, has proven useful in managing secondary symptoms of depression, such as issues with sleep, appetite, and quality of life. 

While it’s important that these treatments are overseen by qualified healthcare professionals to ensure safety and efficacy, data from the UK’s largest medical cannabis observation study shows depression scores decreased by 50% within 3 months of treatment with cannabis based options. 

And finally, are patients with motor neurone disease eligible for medical cannabis in the UK?

In the UK, patients with motor neurone disease that have found conventional or licensed medicines to be ineffective in managing their symptoms may be eligible for medical cannabis, or cannabis-based medicines at Releaf. 

Because of the complexities involved in using medical cannabis in randomised controlled clinical trials, there is a lack of ‘gold-standard’ evidence that explores how medical cannabis directly affects certain conditions - like motor neurone disease. 

However, because there is a reputable mass of evidence that demonstrates cannabis-based treatments can be effective in managing the symptoms MND causes, these options can be prescribed to patients with MND, and their treatments are carefully monitored by qualified healthcare professionals. 

At Releaf, our team of expert specialist consultants hold virtual consultations with patients who have been struggling with symptoms like this on a daily basis, and evaluate whether medical cannabis may be a suitable option they could try. 

If cannabis-based options are deemed appropriate, our team curate a bespoke medical cannabis treatment plan taking the patient's individual needs, lifestyle, budget, and preferences into account. 

To find out if you may be eligible for these options, click here.