Cannabis and multiple sclerosis

Expert Rev Neurother. 2020 Aug;20(8):849-854. doi: 10.1080/14737175.2020.1776610. Epub 2020 Jun 18.

Abstract

Introduction: Patients with multiple sclerosis (MS) may suffer from spasticity and pain during their disease course. Baclofen, dantrolene, diazepam and gabapentin have been used as first-line options to treat these conditions, with modest results. Medical use of marijuana smoking has bypassed traditional clinical trials and has been legalized as a therapeutic option for MS-related spasticity and pain in some countries. Cannabis-derived drugs have been tested and approved for medical use.

Areas covered: With the development of nabiximols by the pharmaceutical industry, more countries have made it possible for patients with MS to have legal access to cannabis-related therapies. The evidence-based data on nabiximols and MS-related spasticity, pain, and urinary symptoms is consistent. There are over 7,500 patients reported in 33 studies (12 from the United Kingdom and 11 from Italy).

Expert opinion: Nabiximols is safe and effective for patients with MS whose spasticity could not be treated with the first-line oral drugs. At present, legislation, bureaucracy and costs involved in prescribing this drug limit the experience of neurologists from many countries. There is no scientific evidence that smoking marijuana can be beneficial to patients with MS.

Keywords: Multiple sclerosis; cannabis; legislation; nabiximols; pain; spasticity.

Publication types

  • Review

MeSH terms

  • Cannabidiol / therapeutic use*
  • Cannabinoid Receptor Modulators / therapeutic use*
  • Dronabinol / therapeutic use*
  • Drug Combinations
  • Humans
  • Medical Marijuana / therapeutic use*
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / drug therapy*
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / etiology
  • Pain / drug therapy*
  • Pain / etiology
  • Urologic Diseases / drug therapy*
  • Urologic Diseases / etiology

Substances

  • Cannabinoid Receptor Modulators
  • Drug Combinations
  • Medical Marijuana
  • Cannabidiol
  • Dronabinol
  • nabiximols