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Cannabis had the strongest clinical evidence among all medicinal plants reviewed for multiple sclerosis symptom management

ReviewModerate evidence
The takeaway

A review of clinical evidence for medicinal plants in MS found Cannabis sativa had the highest level of support, with cannabinoids showing efficacy for spasticity, fatigue, incontinence, and tremor.

Read this if you want to know how cannabis compares to other medicinal plants for managing MS symptoms.

Cannabis: highest clinical evidence level among all medicinal plants for MS

What the researchers found

Among ten medicinal plants with clinical evidence for MS symptom management, Cannabis sativa had the highest level of support. Its key bioactive compounds, THC and CBD, showed efficacy for spasticity, fatigue, urinary symptoms (incontinence, urgency, nocturia), memory performance, functional performance, and tremor.

Other plants with positive evidence included ginkgo biloba, ginseng, green tea (epigallocatechin-3-gallate), and boswellia. All herbal medicines reviewed were mostly well tolerated with mild to moderate adverse effects.

The review covered clinical studies only, spanning publications from 1966 to February 2017.

Why it matters

By placing cannabis in the broader context of all medicinal plants studied for MS, this review provides perspective: cannabis is not just another herbal remedy for MS but the one with the most and strongest clinical evidence. This helps clinicians and patients make informed decisions about complementary therapies.

The numbers in context

10 medicinal plants with clinical evidence for MS. Cannabis sativa: highest evidence level. Effective for: spasticity, fatigue, scotoma, incontinence, urgency, nocturia, memory, functional performance, tremor. Key compounds: THC, CBD.

How the study worked

Systematic review of clinical studies from the Cochrane Library, PubMed, and Scopus (1966-2017). Only clinical studies evaluating medicinal plants for MS symptoms were included.

What this study cannot tell us

The abstract does not detail the number or quality of cannabis studies included. "Highest level of evidence" is relative to other herbal medicines, which generally have limited clinical data. The review included all plant-based therapies, not just cannabis, so cannabis-specific analysis may be limited.

How to read the evidence

Systematic review of clinical studies from major databases. Good methodology but the evidence base for herbal medicines in MS is generally limited.

When this study was published

Published in 2017. Cannabis-based treatments for MS, particularly Sativex, have continued to accumulate clinical evidence.

The bigger picture

MS patients frequently seek complementary therapies. This review provides an evidence-based ranking of options, with cannabis at the top. The breadth of MS symptoms that respond to cannabinoids (motor, urinary, cognitive, and neurological) reflects the widespread distribution of cannabinoid receptors throughout the nervous system.

Questions still open

  • Which specific cannabis formulations and doses are most effective for each MS symptom? Can cannabis-based treatments replace conventional MS medications or only complement them? Would combining cannabis with other evidence-based medicinal plants produce additive benefits?

Common questions

Is cannabis the best herbal treatment for MS?
Among the ten medicinal plants reviewed, cannabis had the most and strongest clinical evidence supporting its use for MS symptoms. However, this does not mean it is more effective than conventional MS medications, which were not compared in this review.
What MS symptoms does cannabis help with?
The review found clinical evidence for cannabis benefiting spasticity, fatigue, urinary symptoms (incontinence, urgency, nighttime urination), memory, functional performance, and tremor in MS patients.

Read the original research

Efficacy and Tolerability of Phytomedicines in Multiple Sclerosis Patients: A Review.

CNS drugs, 31(10), 867-889

Citation

Farzaei, Mohammad Hosein; Shahpiri, Zahra; Bahramsoltani, Roodabeh; Nia, Marjan Moghaddam; Najafi, Fariba; Rahimi, Roja. (2017). Efficacy and Tolerability of Phytomedicines in Multiple Sclerosis Patients: A Review.. CNS drugs, 31(10), 867-889. https://doi.org/10.1007/s40263-017-0466-4

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