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|Title||Clinical investigation of delta-9-tetrahydrocannabinol (THC) as an alternative therapy for overactive bladders in spinal cord injury (SCI) patients.|
|Author(s)||Hagenbach U, Ghafoor N, Brenneisen R, Luz S, Mäder M.|
|Journal, Volume, Issue||2001 Congress on Cannabis and the Cannabinoids, Cologne, Germany: International Association for Cannabis as Medicine, p. 10.|
|Major outcome(s)||Significant improvement of some parameters of bladder function|
|Indication||Spinal cord injury||Abstract
We are presenting the preliminary results of a pilot study. THC was administered over a period of 6 weeks. In 15 patients with spastic spinal cord injury the effect of THC on the overactive bladder has been investigated. The effect of THC was compared with urodynamic and clinical parameters, first without any bladder medication and after 6 weeks medication with THC. There are no data of invasive investigation in literature up till now.
Patients and methods:
THC was administered for 6 weeks in two different groups orally as Dronabinol (Marinol®) in 9 patients and rectally as THC-Hemisuccinate suppositories (THC-HS-supp) in 6 patients in several individual dosages per day. An urodynamic investigation, urine analysis and urine bacteriology was performed at the beginning of the study (without any bladder medication and without any spasmolytic therapy) and in the end after 6 weeks treatment. On the last day of medication all patients have been administered either 10 mg Dronabilon or 10 mg THC-HS-supp 2 h before the urodynamic investigation (relating to the group they were in).
Investigated parameters: first desire to void (FDV), maximum cystometric capacity (MCC), intravesical pressure (IVP), bladder compliance (CPL), post void residual urine volume (RV), volume at first detrusor contraction (VFC).
The dronabinol group showed an increase of the CPL from mean 34.3 ml/cm H2O (9 – 100) to mean 52.2 ml/cm H2O (11 – 200). All other parameters have not been changed essentially.
The THC-HS-supp group showed a trend with increase of MCC from mean 227 ml (143 – 323) to mean 278 ml (121 – 322) (p value = 0.075), and an increase of the VFC from mean 191.3 ml (121 – 322) to mean 224.6 ml (96 – 407), CPL increased from mean 21.3 ml/cm H2O (6 – 60) to mean 40 ml/cm H2O (10 – 120) significantly
(p value = 0.028). All other parameters have not been changed essentially.
These preliminary results indicate a reduction of the overactivity of the detrusor of the bladder especially in the THC-HS-supp group with potential therapeutic consequences. The different results between oral and rectal application may demonstrate their different bioavailability.
|Participants||15 patients with spastic spinal cord injury|
|Type of publication||Meeting abstract|
|Address of author(s)||REHAB Basel, Rehabilitationszentrum für Querschnittgelähmte und Hirnverletzte, Schweizerisches Paraplegikerzentrum, Im Burgfelderhof 40, CH-4055 Basel|