Cannabinoids for MS Spasticity and Pain: What the Clinical Trials Show
A review found Class 1 and 2 evidence supporting cannabinoid products for MS spasticity and pain, but raised concerns about cognitive side effects in a population already prone to cognitive impairment.
Quick Facts
What This Study Found
This review synthesized evidence from randomized trials on cannabinoid use for two of the most troubling MS symptoms: spasticity and pain.
Several randomized trials provided Class 1 and 2 evidence (the highest levels) supporting cannabinoid products for these indications. However, the optimal ratio of THC to CBD and the ideal dosing were not yet established.
The review raised an important cautionary note: the safety and long-term cognitive effects of cannabinoid products in people with MS have not been evaluated. Since short-term memory and processing speed are already significantly impaired in many MS patients, the potential for cannabinoids to worsen cognitive function is a particular concern in this population.
Key Numbers
Class 1 and 2 evidence from multiple randomized trials. Optimal THC:CBD ratio and doses not yet determined. Short-term memory and processing speed already impaired in many MS patients.
How They Did This
Clinical review of randomized controlled trials examining cannabinoid products for spasticity and pain in MS, published in Current Treatment Options in Neurology.
Why This Research Matters
MS spasticity and pain significantly affect quality of life and are often inadequately managed by existing treatments. Having Class 1-2 evidence supporting cannabinoids is notable, but the cognitive concern is especially important because MS patients cannot afford additional cognitive burden.
The Bigger Picture
Cannabinoids represent one of the better-studied treatment options for MS symptoms, with higher-quality evidence than exists for many other conditions. The tension between symptom relief and cognitive risk reflects a broader challenge in MS treatment: many effective medications carry cognitive or fatigue side effects.
What This Study Doesn't Tell Us
The review noted that optimal dosing and formulation remain undefined. Long-term safety data in MS patients are lacking. The cognitive concern, while theoretically important, has not been systematically studied in cannabis-using MS patients.
Questions This Raises
- ?Do cannabinoid products worsen cognitive function in MS patients?
- ?Can formulations be optimized to provide symptom relief while minimizing cognitive effects?
Trust & Context
- Key Stat:
- Class 1-2 evidence supports cannabinoids for MS spasticity and pain
- Evidence Grade:
- This review draws on Class 1 and 2 evidence (randomized controlled trials), providing strong evidence for efficacy in MS spasticity and pain.
- Study Age:
- Published in 2016. Additional clinical experience and some longer-term data on cannabinoids in MS have accumulated since then.
- Original Title:
- Use of Cannabinoids for Spasticity and Pain Management in MS.
- Published In:
- Current treatment options in neurology, 18(1), 1 (2016)
- Authors:
- Chohan, Hardeep, Greenfield, Ariele L, Yadav, Vijayshree(4), Graves, Jennifer
- Database ID:
- RTHC-01127
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Are cannabinoids recommended for MS?
Multiple randomized trials support their use for spasticity and pain in MS, and nabiximols (Sativex) has been approved in many countries for MS spasticity. However, concerns about cognitive effects in a population already prone to cognitive impairment warrant careful clinical consideration.
Why might cognitive effects be especially concerning in MS?
Many MS patients already experience significant impairments in short-term memory and processing speed. Adding a substance that can further impair these functions could compound existing deficits and affect daily functioning, making the risk-benefit calculation different than for cognitively healthy individuals.
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Cite This Study
https://rethinkthc.com/research/RTHC-01127APA
Chohan, Hardeep; Greenfield, Ariele L; Yadav, Vijayshree; Graves, Jennifer. (2016). Use of Cannabinoids for Spasticity and Pain Management in MS.. Current treatment options in neurology, 18(1), 1. https://doi.org/10.1007/s11940-015-0385-y
MLA
Chohan, Hardeep, et al. "Use of Cannabinoids for Spasticity and Pain Management in MS.." Current treatment options in neurology, 2016. https://doi.org/10.1007/s11940-015-0385-y
RethinkTHC
RethinkTHC Research Database. "Use of Cannabinoids for Spasticity and Pain Management in MS..." RTHC-01127. Retrieved from https://rethinkthc.com/research/chohan-2016-use-of-cannabinoids-for
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.