Summary of evidence-based guidelines: complementary and alternative medicine in multiple sclerosis

This report of the Guideline Development Subcommittee of the American Academy of Neurology addressed the following questions: 1) In patients with MS, do complementary and alternative medicine (CAM) therapies reduce specific symptoms and prevent relapses or disability? 2) Can CAM use worsen MS or cause serious adverse effects? 3) Can CAM use interfere with MS disease-modifying therapies?

Because studies were unavailable or, where available, had a high risk of bias, were in conflict, or lacked statistical precision, they found the evidence insufficient to support or refute the effectiveness of the following therapies in MS: acetyl-L-carnitine, acupuncture, biofeed-back, carnitine, chelation therapy, Chinese medicine, chiropractic medicine, creatine monohydrate, dental amalgam replacement, glucosamine sulfate, hippotherapy, hyperbaric oxygen, inosine, linoleic acid, low-dose naltrexone, massage therapy, mindfulness training, music therapy, naturopathic medicine, neural therapy, Padma 28, progressive muscle relaxation therapy, tai chi, threonine, transdermal histamine, and yoga.

Data also were insufficient to determine whether any CAM therapies worsen MS or interfere with disease-modifying therapies. Otherwise, according to the review, oral cannabinoids resulted effective and Sativex oromucosal spray are probably effective for improving subjective spasticity symptoms, pain and urinary frequency. Ginkgo biloba was possibly effective for reducing fatigue. Reflexology was possibly effective for reducing paresthesia and magnetic therapy was probably effective for reducing fatigue.

Authors: Yadav V, Bever C Jr
Source: Neurology. 2014 Mar 25;82(12):1083-92. doi: 10.1212/WNL.0000000000000250
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