Evidence review of medical marijuana for neurological conditions
Clinical evidence supported cannabinoid use for MS spasticity, refractory pain, and nausea, while lower-level evidence suggested potential for epilepsy, dystonia, tics, and tremors.
Quick Facts
What This Study Found
This expert review assessed the evidence for cannabinoids in neurological diseases. High-quality clinical trial evidence supported the safety and efficacy of cannabinoids for four indications: spasticity in multiple sclerosis, pain not responding to opioids, glaucoma, and nausea/vomiting.
Lower-level clinical evidence indicated potential usefulness for dystonia, tics, tremors, epilepsy, migraine, and weight loss, though more research was needed. The review distinguished between THC (psychoactive) and CBD (neuroprotective in preclinical studies without psychoactive effects).
Common adverse effects included weakness, mood changes, and dizziness. Cardiovascular side effects and potential pulmonary effects from chronic smoking were noted. Fatalities were described as rare even with recreational use. Psychological dependence was a concern, but physical dependence was less well documented.
Key Numbers
Four indications had high-quality clinical evidence. Six additional conditions had lower-level evidence. CBD was highlighted as neuroprotective without psychoactive effects. Fatalities were rare even in recreational use.
How They Did This
Expert review of published clinical trials, preclinical studies, and safety data on cannabinoids for neurological indications.
Why This Research Matters
Neurological patients represent a significant proportion of medical cannabis users. This review from neurologists provided a clinical framework for understanding which conditions had adequate evidence and which remained speculative.
The Bigger Picture
This review was published at a pivotal moment: before CBD gained FDA approval for epilepsy (2018) but after sufficient preclinical evidence had accumulated to suggest neuroprotective potential. The authors positioned cannabinoids as a compassionate-use option for severe cases when standard treatments fail.
What This Study Doesn't Tell Us
The evidence base was limited by small sample sizes in many studies. Safety data were incomplete, especially for long-term use. The wide variety of cannabis preparations and routes of administration made comparing studies difficult.
Questions This Raises
- ?Which neurological conditions have gained stronger evidence for cannabinoid treatment since 2014?
- ?How does the route of administration (smoked, oral, spray) affect neurological outcomes?
- ?Can CBD-only preparations provide neurological benefits without the risks of THC?
Trust & Context
- Key Stat:
- Four neurological indications with strong evidence; six more with emerging data
- Evidence Grade:
- Expert review synthesizing varied quality evidence, from high-quality RCTs to case reports and preclinical data.
- Study Age:
- Published in 2014, before CBD received FDA approval for epilepsy in 2018.
- Original Title:
- Medical marijuana in neurology.
- Published In:
- Expert review of neurotherapeutics, 14(12), 1453-65 (2014)
- Authors:
- Benbadis, Selim R, Sanchez-Ramos, Juan(2), Bozorg, Ali, Giarratano, Melissa, Kalidas, Kavita, Katzin, Lara, Robertson, Derrick, Vu, Tuan, Smith, Amanda, Zesiewicz, Theresa
- Database ID:
- RTHC-00770
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Which neurological conditions have the best evidence for cannabis treatment?
As of this 2014 review, the strongest evidence was for MS spasticity, pain not responding to opioids, nausea/vomiting, and glaucoma. Lower-level evidence existed for epilepsy, dystonia, tics, tremors, and migraine.
Is medical cannabis safe for neurological patients?
Common side effects included weakness, mood changes, and dizziness. Cardiovascular effects and potential lung effects from smoking were noted. The review described fatalities as rare even in recreational use, but physical dependence potential was not fully characterized.
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Cite This Study
https://rethinkthc.com/research/RTHC-00770APA
Benbadis, Selim R; Sanchez-Ramos, Juan; Bozorg, Ali; Giarratano, Melissa; Kalidas, Kavita; Katzin, Lara; Robertson, Derrick; Vu, Tuan; Smith, Amanda; Zesiewicz, Theresa. (2014). Medical marijuana in neurology.. Expert review of neurotherapeutics, 14(12), 1453-65. https://doi.org/10.1586/14737175.2014.985209
MLA
Benbadis, Selim R, et al. "Medical marijuana in neurology.." Expert review of neurotherapeutics, 2014. https://doi.org/10.1586/14737175.2014.985209
RethinkTHC
RethinkTHC Research Database. "Medical marijuana in neurology." RTHC-00770. Retrieved from https://rethinkthc.com/research/benbadis-2014-medical-marijuana-in-neurology
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.