Lack of effect of cannabis-based treatment on clinical and laboratory measures in multiple sclerosis

Neurol Sci. 2009 Dec;30(6):531-4. doi: 10.1007/s10072-009-0136-5. Epub 2009 Sep 19.


The endocannabinoid system (ECS) is involved in the pathophysiology of multiple sclerosis (MS), and relief from pain and spasticity has been reported in MS patients self-medicating with marijuana. A cannabis-based medication containing Delta(9)-tetrahydrocannabinol and cannabidiol (Sativex) has been approved in some countries for the treatment of MS-associated pain. The effects of this pharmaceutical preparation on other clinically relevant aspects of MS pathophysiology, however, are still unclear. In 20 MS patients, we measured the effects of Sativex on clinically measured spasticity and on neurophysiological and laboratory parameters that correlate with spasticity severity or with the modulation of the ECS. Sativex failed to affect spasticity and stretch reflex excitability. This compound also failed to affect the synthesis and the degradation of the endocannabinoid anandamide, as well as the expression of both CB1 and CB2 cannabinoid receptors in various subpopulations of peripheral lymphocytes.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arachidonic Acids / metabolism
  • Cannabidiol
  • Cannabinoids / therapeutic use*
  • Dronabinol
  • Drug Combinations
  • Endocannabinoids
  • Female
  • Humans
  • Lymphocytes / drug effects
  • Lymphocytes / metabolism
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / physiopathology
  • Muscle Spasticity / drug therapy
  • Muscle Spasticity / etiology
  • Muscle Spasticity / physiopathology
  • Pain / drug therapy
  • Pain / etiology
  • Pain / physiopathology
  • Plant Extracts / therapeutic use*
  • Polyunsaturated Alkamides / metabolism
  • Receptor, Cannabinoid, CB1 / metabolism
  • Receptor, Cannabinoid, CB2 / metabolism
  • Reflex, Stretch / drug effects
  • Treatment Outcome
  • Young Adult


  • Arachidonic Acids
  • Cannabinoids
  • Drug Combinations
  • Endocannabinoids
  • Plant Extracts
  • Polyunsaturated Alkamides
  • Receptor, Cannabinoid, CB1
  • Receptor, Cannabinoid, CB2
  • Cannabidiol
  • Dronabinol
  • nabiximols
  • anandamide