Objective: We performed an open study of delta-9-tetrahydrocannabinol and cannabidiol (THC:CBD) oromucosal spray (Nabiximols, Sativex®) in 6 patients with suboptimal responsive adult-onset dystonia.

Background: Cannabinoids can influence dopaminergic, GABAergic and glutamatergic neurotransmission.

Methods: The primary effectiveness endpoint was to evaluate the effect in the main body area affected by dystonia and secondary effectiveness endpoint in other affected body areas. Severity and duration of dystonia were measured using the Unified Dystonia Rating Scale (UDRS), the Global Dystonia Rating Scale (GDS), Patient and Clinical Global Impression of Improvement (PGI-I and CGI-I) scales. All measures were recorded at baseline and after nabiximols treatment.

Results: The medication provided clinically relevant response in all the patients. Three patients discontinued treatment because of reversible side effects. The other three subjects showed a relevant and well-tolerated response maintained for up to 24 months. In these subjects, UDRS and GDS scores showed a percentage change of dystonia of 52,7/54,2 and 58,3/51,9 for the main and secondary affected body areas, respectively. Upper facial and cervical regions showed the best clinical improvements.

Conclusions: THC:CBD oromucosal spray, when tolerated, can be an adjuvant or alternative treatment for suboptimal responsive dystonia, especially when upper facial and cervical dystonia are prominent.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/significant-improvement-of-adult-onset-dystonia-with-cannabinoids-based-oromucosal-spray/