CBD Improved Walking Speed in MS Patients but Did Not Reduce Spasticity
A randomized trial in 49 MS patients found that 4 weeks of escalating CBD doses improved walking test times and reduced maximum pain, but did not significantly reduce spasticity.
Quick Facts
What This Study Found
CBD treatment (escalating from 5 to 80 mg/day over 4 weeks) significantly improved walking speed on the T25-FW test (p=0.031) and reduced maximum pain (p=0.033) compared to placebo, but did not significantly reduce spasticity severity at 4 or 8 weeks.
Key Numbers
49 patients (24 CBD, 25 placebo). CBD escalated from 5 to 80 mg/day. T25-FW improvement: p=0.031. Maximum pain reduction: p=0.033. No significant spasticity reduction at 4 or 8 weeks.
How They Did This
Double-blind randomized controlled trial of 49 MS patients with spasticity-related walking difficulties, comparing escalating-dose sublingual pure CBD to placebo over 4 weeks at Ghaem Hospital, Iran.
Why This Research Matters
MS spasticity affects millions and current treatments have significant side effects. While CBD did not reduce spasticity per se, the functional improvement in walking speed is clinically meaningful.
The Bigger Picture
The disconnect between spasticity scores and walking improvement suggests CBD may help MS patients through pathways other than direct spasticity reduction, possibly through pain reduction, anxiety relief, or other mechanisms.
What This Study Doesn't Tell Us
Small sample size. Short 4-week treatment. Relatively low CBD doses. Single-center study in Iran. High dropout (9 of 49). Does not address long-term effects.
Questions This Raises
- ?Would higher CBD doses reduce spasticity directly?
- ?Why did walking improve without spasticity changes?
- ?How does pure CBD compare to THC/CBD combinations already approved for MS spasticity?
Trust & Context
- Key Stat:
- CBD improved MS walking speed (p=0.031) without reducing spasticity itself
- Evidence Grade:
- Double-blind RCT provides good internal validity, but small sample and short duration limit conclusions.
- Study Age:
- 2025 RCT from Iran, the first of its kind in that country.
- Original Title:
- A randomized trial on efficacy of purified cannabidiol on spasticity in multiple sclerosis patients with gait problems: first report in Iran.
- Published In:
- Naunyn-Schmiedeberg's archives of pharmacology, 398(12), 17435-17444 (2025)
- Authors:
- Mousavi, Pegah, Emadzadeh, Maryam, Karimikhoshnoudian, Bahar, Sahraian, Mohammad Ali, Ghaffari, Mehran, Shaygannejad, Vahid, Payere, Maryam, Baghaei, Ava, Zabeti, Aram, Nahayati, Mohammadali
- Database ID:
- RTHC-07198
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
Does CBD help with MS spasticity?
This trial found CBD did not directly reduce spasticity severity, but it did improve walking speed and reduce pain in MS patients with spasticity-related gait problems. The benefit may come through pain or other pathways rather than spasticity itself.
How much CBD was used in this MS study?
Patients started at 5 mg/day and escalated to 80 mg/day over 4 weeks. This is relatively low compared to some CBD studies, and higher doses might show different results.
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Cite This Study
https://rethinkthc.com/research/RTHC-07198APA
Mousavi, Pegah; Emadzadeh, Maryam; Karimikhoshnoudian, Bahar; Sahraian, Mohammad Ali; Ghaffari, Mehran; Shaygannejad, Vahid; Payere, Maryam; Baghaei, Ava; Zabeti, Aram; Nahayati, Mohammadali. (2025). A randomized trial on efficacy of purified cannabidiol on spasticity in multiple sclerosis patients with gait problems: first report in Iran.. Naunyn-Schmiedeberg's archives of pharmacology, 398(12), 17435-17444. https://doi.org/10.1007/s00210-025-04347-w
MLA
Mousavi, Pegah, et al. "A randomized trial on efficacy of purified cannabidiol on spasticity in multiple sclerosis patients with gait problems: first report in Iran.." Naunyn-Schmiedeberg's archives of pharmacology, 2025. https://doi.org/10.1007/s00210-025-04347-w
RethinkTHC
RethinkTHC Research Database. "A randomized trial on efficacy of purified cannabidiol on sp..." RTHC-07198. Retrieved from https://rethinkthc.com/research/mousavi-2025-a-randomized-trial-on
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.