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This Article Figures Only Full Text Full Text (PDF) Take the CME quiz CME: Take the course for this article: Volume 71, Number 3, July 15, 2008 All Versions of this Article: 01.wnl.0000304046.23960.25v1 71/3/164    most recent Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Related articles in Neurology Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Ghaffar, O. Articles by Feinstein, A. PubMed PubMed Citation Articles by Ghaffar, O. Articles by Feinstein, A. Related Collections All Neuropsychology/Behavior Attention All Psychiatric disorders Multiple sclerosis

Multiple sclerosis and cannabis

A cognitive and psychiatric study

From the Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Canada.

Address correspondence and reprint requests to Anthony Feinstein, Department of Psychiatry, Sunnybrook Health Sciences Centre, FG08-2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5

Background: A significant minority of patients with multiple sclerosis (MS) use cannabis, yet no study has examined the possible effects on mentation. Here, we report the emotional and cognitive correlates of street cannabis use in patients with MS.

Methods: A sample of 140 consecutive patients with MS were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Axis I disorders (SCID-IV) from which details of cannabis use were recorded. Cognition was assessed using the Neuropsychological Battery for MS supplemented with the Symbol Digit Modalities Test (SDMT), an index of information processing speed, working memory, and sustained attention.

Results: Ten subjects (7.7%) were defined as current cannabis users based on use within the last month. Compared to non-cannabis users (n = 130), they were younger (p = 0.001). Each of the 10 current cannabis users was matched on demographic and disease variables to four subjects with MS who did not use cannabis (total control sample n = 40). Group comparisons revealed that the proportion of patients meeting DSM-IV criteria for a psychiatric diagnosis was higher in cannabis users (p = 0.04). In addition, on the SDMT, cannabis users had a slower mean performance time (p = 0.006) and a different pattern of response compared to matched controls (group x time interaction; p = 0.001).

Conclusions: Inhaled cannabis is associated with impaired mentation in patients with multiple sclerosis, particularly with respect to cognition. Future studies are required to clarify the direction of this relationship.

GLOSSARY: 7/24 = 7/24 Spatial Learning Test; BSS = Beck Suicide Scale; COWAT = Controlled Oral Word Association Test; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders; EDSS = Expanded Disability Status Scale; HADS = Hospital Anxiety and Depression Scale; MS = multiple sclerosis; NPBMS = Neuropsychological Battery for MS; PASAT = Paced Auditory Serial Addition Task; SCID-IV = Structured Clinical Interview for DSM-IV Axis I disorders; SDMT = Symbol Digit Modalities Test; SRT = Selective Reminding Test; SSSI = Social Stress and Support Inventory.

ant.feinstein{at}utoronto.ca

Editorial, page 160

e-Pub ahead of print on February 13, 2008, at www.neurology.org.

The study was funded by grant 15001 from the Canadian Institutes for Health Research (CIHR). O.G. is supported by a CIHR Fellowship.

Disclosure: O.G. has received honoraria from Cerebrio, a continuing medical education company. A.F. has received lecture honoraria from Berlex Canada, Serono Canada, Serono USA, Teva Neuroscience, and Avanir Pharmaceuticals.

Received July 30, 2007. Accepted in final form October 30, 2007.

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