Cannabis Extracts Helped Bladder Problems in Advanced MS Patients | Research

The takeaway

An open-label trial found that cannabis extracts containing THC and CBD significantly reduced urinary urgency, incontinence, and frequency in MS patients with bladder problems that had not responded to standard treatments.

Read this if you have MS with bladder problems that have not responded to standard treatments.

All primary bladder measures improved significantly (p<0.05) in treatment-resistant MS

What the researchers found

In 15 evaluable MS patients with refractory lower urinary tract symptoms, cannabis extracts delivered by sublingual spray produced significant improvements across multiple bladder measures. Urinary urgency, number and volume of incontinence episodes, frequency, and nocturia all decreased significantly (p<0.05). Pain, spasticity, and sleep quality also improved significantly, with pain improvement persisting to a median of 35 weeks.

Patients first received THC:CBD extract (2.5 mg each per spray) for 8 weeks, then THC-only extract for 8 weeks, followed by a long-term extension. Few troublesome side effects were reported.

Why it matters

Bladder dysfunction affects the majority of MS patients and significantly impacts quality of life. Standard treatments often provide inadequate relief. This study was one of the first to specifically evaluate cannabis-based medicines for MS bladder symptoms, finding improvements across multiple urinary measures that had been resistant to other treatments.

The numbers in context

Twenty-one patients recruited, 15 evaluated. THC:CBD extract: 2.5 mg each per spray. Treatment: 8 weeks THC:CBD, then 8 weeks THC. Pain improvement persisted to median 35 weeks. All primary bladder measures improved significantly (p<0.05).

How the study worked

This was an open-label pilot study in 21 recruited patients (15 evaluable). Patients with advanced MS and refractory bladder symptoms received sublingual spray extracts: THC:CBD for 8 weeks, then THC-only for 8 weeks, with option for long-term extension. Assessments included urinary frequency/volume charts, incontinence pad weights, cystometry, and visual analogue scales.

What this study cannot tell us

This was an open-label study without placebo control, so expectation effects cannot be ruled out. The sample was small (15 evaluable patients). Daily total voided volume and incontinence pad weights also decreased, which complicates the interpretation of reduced incontinence episodes. The sequential design (THC:CBD then THC) makes it difficult to compare the two formulations directly.

How to read the evidence

This is an open-label pilot study without placebo control in 15 patients, providing preliminary evidence.

When this study was published

Published in 2004. Bladder dysfunction has been included in subsequent larger cannabis-MS trials.

The bigger picture

Bladder dysfunction was subsequently included as one of the symptoms addressed in the large CAMS trial and in the clinical development of Sativex. The finding that cannabis extracts could address this often-neglected MS symptom contributed to the broader understanding of cannabinoid therapeutic applications in MS beyond just spasticity.

Questions still open

Is THC:CBD more effective than THC alone for bladder symptoms? Would a placebo-controlled trial confirm these findings? Could cannabis-based treatments replace or complement existing bladder medications for MS patients?

Common questions

Can cannabis help with MS bladder problems?

This pilot study found significant improvements in urgency, incontinence, frequency, and nighttime urination in MS patients whose symptoms had not responded to other treatments. However, the lack of a placebo control means these findings need confirmation in larger controlled trials.

How long did the benefits last?

Pain improvement persisted to a median of 35 weeks in the long-term extension phase, suggesting sustained benefit with continued use. Bladder improvements were maintained during the treatment period.

Read the original research

An open-label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis.

Multiple sclerosis (Houndmills, Basingstoke, England), 10(4), 425-33

View on PubMed ↗

Citation

Brady, C M; DasGupta, R; Dalton, C; Wiseman, O J; Berkley, K J; Fowler, C J. (2004). An open-label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis.. Multiple sclerosis (Houndmills, Basingstoke, England), 10(4), 425-33.