Prescribing Cannabinoids for Multiple Sclerosis

Abstract

Anecdotal evidence and preclinical and clinical data indicate that cannabis and individual cannabinoids can suppress muscle spasticity/spasm and pain associated with multiple sclerosis (MS). Anecdotal data come from the responses to a questionnaire by 112 patients with MS who self-medicated with cannabis. The preclinical data come from animal experiments showing that cannabinoid receptor agonists are antinociceptive and can depress motor function, reduce the severity of primary generalised dystonia, and decrease inflammation and the intensity of behavioural signs of experimental autoimmune encephalomyelitis. The clinical data derive from 7 clinical trials, albeit involving small numbers of patients, which indicate that cannabis itself, the cannabinoid Δ9-tetrahydrocannabinol (Δ9-THC) and the synthetic analogue of Δ9-THC nabilone can reduce the intensity of several symptoms in patients with MS or spinal cord injury, including spasticity, pain, tremor and nocturia.