The findings from this study may interest some of our readers. Cannabis use in MS is licensed for spasticity management and to a lesser extent proven to be helpful with refractory neuropathic pain. Some also use cannabis to manage the psychological downsides of MS. Given it’s increasingly popularity since legalisation, the authors set out to determine whether discontinuing cannabis worsened MS symptoms. The study consists of scoring anxiety and depression before and after cannabis withdrawal (CW) or continuation (CC).
They study group consisted of 44 MS participants who had smoked cannabis for ~ 8 years. Symptoms of anxiety and depression were recorded using the Hospital Anxiety and Depression Scale (HADS).
Surprisingly, they found that the depression scores (HADS-D) declined in those in the CW intervention group, whilst remaining unchanged in the CC group (see Table below; p=0.048); this was despite an increase in insomnia in the CW group (p=0.030). The threshold for significant depression in HADS-D is 8 to give you an idea of what the scores mean. Anxiety (HADS-A), on the other hand was no different between the two groups.
Although this is a relatively small study, the surprising outcome warrants further scrutiny. If true, chronic cannabis use should be monitored in users with MS.
Mult Scler. 2020 Jun 26;1352458520934070. doi: 10.1177/1352458520934070. Online ahead of print.
Discontinuing Cannabis Improves Depression in People With Multiple Sclerosis: A Short Report
To assess whether symptoms of depression change when people with multiple sclerosis (pwMS) discontinue cannabis use, 40 cognitively impaired pwMS who smoked cannabis almost daily were randomly assigned to either a cannabis continuation (CC) or cannabis withdrawal (CW) group. Both groups were followed for 28 days. All participants completed the Hospital Anxiety and Depression Scale. At day 28 the 11-nor-9-carboxy-Δ9-tetrahydro-cannabinol (THCCOOH)/creatinine ratio in the CW group declined to zero (p = 0.0001), but remained unchanged in the CC group (p = 0.709). Depression scores in those pwMS who were using cannabis to manage their depression remained statistically unchanged in the CC group, but declined in the CW group (p = 0.006). Despite pwMS using cannabis to help their mood, depression improved significantly off the drug. Our finding provides a cautionary note in relation to cannabis use in pwMS, at least with respect to depression.