Endocannabinoids in Multiple Sclerosis and ALS: From Symptom Relief to Neuroprotection | Research

The takeaway

Research showed cannabinoids can relieve MS spasticity and may also slow neurodegeneration in both MS and ALS animal models, suggesting potential beyond symptom management.

Read this if you have MS or ALS and are interested in the potential of cannabinoid-based treatments.

Neuroprotective effects in animal models of both MS and ALS

What the researchers found

This review examined the role of the endocannabinoid system in multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS), two neurodegenerative conditions sharing the symptom of spasticity.

Anecdotal reports of cannabis relieving MS symptoms were confirmed by animal models and clinical trials, leading to the approval of medicinal cannabis (nabiximols) for MS spasticity. Beyond symptom relief, experimental studies showed cannabinoids had neuroprotective effects in animal models of both MS and ALS.

The neuroprotective potential was particularly notable: cannabinoids appeared to slow neurodegeneration rather than just masking symptoms. This suggested the endocannabinoid system could be a target for disease-modifying therapies, not just symptom control.

Why it matters

While cannabis-based medicines are approved for MS symptom management, the possibility that they could also slow disease progression would represent a fundamental shift from palliative to disease-modifying therapy.

The numbers in context

Nabiximols approved for MS spasticity; neuroprotective effects demonstrated in animal models of MS and ALS; endocannabinoid system components identified as potential disease-modifying targets

How the study worked

Review of published preclinical and clinical evidence on the endocannabinoid system in MS and ALS, published in the Handbook of Experimental Pharmacology.

What this study cannot tell us

Neuroprotective effects were primarily from animal models. Human clinical evidence for disease modification was limited. MS and ALS have different pathologies, and cannabinoid effects may differ between them.

How to read the evidence

Review in a reference pharmacology handbook. Symptom relief evidence is established; neuroprotective evidence is primarily preclinical.

When this study was published

Published in 2015. Clinical trials of cannabinoids for neuroprotection in MS continue.

The bigger picture

If cannabinoids can both relieve symptoms and protect nerves, they could serve dual purposes in neurodegenerative disease. However, translating neuroprotective effects from animal models to human clinical benefit remains one of the biggest challenges in neuroscience.

Questions still open

Can the neuroprotective effects seen in animals be demonstrated in human clinical trials? Would long-term cannabinoid use slow MS or ALS progression? Is the neuroprotective mechanism CB1-mediated, CB2-mediated, or both?

Common questions

Can cannabis slow down MS?

Animal studies suggest cannabinoids may have neuroprotective effects that could slow disease progression. However, this has not been definitively proven in human clinical trials. Currently approved cannabinoid treatments for MS target symptoms, primarily spasticity.

Does cannabis help with ALS?

In animal models of ALS, cannabinoids showed neuroprotective effects. Human evidence is very limited. People with ALS sometimes use cannabis for symptom relief (spasticity, pain), but disease-modifying effects have not been established.

Read the original research

Endocannabinoids in Multiple Sclerosis and Amyotrophic Lateral Sclerosis.

Handbook of experimental pharmacology, 231, 213-31

View on PubMed ↗Publisher’s paper ↗

Citation

Pryce, Gareth; Baker, David. (2015). Endocannabinoids in Multiple Sclerosis and Amyotrophic Lateral Sclerosis.. Handbook of experimental pharmacology, 231, 213-31. https://doi.org/10.1007/978-3-319-20825-1_7