Canabinóides no tratamento da espasticidade associada a doenças neurológicas: uma revisão sistemática

Abstract

Introduction: Spasticity, characterized by abnormal increases in muscle tone, is a debilitating condition commonly found in neurological diseases such as multiple sclerosis, cerebral palsy, and stroke. This condition significantly affects patients’ quality of life, causing pain and functional limitations. Conventional treatments, while widely used, often provide insufficient relief and can lead to adverse effects. Recently, cannabinoids like tetrahydrocannabinol (THC) and cannabidiol (CBD) have shown therapeutic potential in reducing spasticity, particularly in multiple sclerosis. Objectives: This study evaluated the efficacy of cannabinoids, focusing on THC and CBD combinations, in treating spasticity across various neurological diseases, specifically assessing muscle tone reduction, adverse effects, and impact on patients’ quality of life. Justification: The search for safe therapeutic alternatives for spasticity is urgent due to the limitations of current treatments. Cannabinoids, despite their promising potential, lack standardized studies regarding dosage and treatment duration. This systematic review addresses some of these gaps, providing a detailed analysis for clinical use. Methodology: This review followed the PICO strategy to select studies from the PubMed, ScienceDirect, and Cochrane Library databases, including articles on cannabinoid use in neurological diseases associated with spasticity. Outcomes such as muscle tone reduction, safety, and quality of life were analyzed. Results: Of the 329 studies screened, eight met the inclusion criteria. Significant spasticity reduction was observed with the use of THC spray, with average daily doses ranging from 12.75 to 24.3 mg of CBD and 13.77 to 24.3 mg of THC. Most adverse effects were mild to moderate, and patients reported improved quality of life. Conclusion: Cannabinoids, particularly in THC combinations, were effective and safe in managing spasticity. Additional studies are needed to standardize treatment protocols and expand research to other neurological diseases.