Cannabis Extract Capsules Reduced Spasticity in MS Patients Who Took Enough of the Medication

This was a prospective, randomized, double-blind, placebo-controlled crossover study conducted during inpatient rehabilitation. Fifty-seven MS patients received standardized cannabis extract capsules (2.5 mg THC and 0.9 mg CBD each) with dose escalation from 15 to 30 mg THC daily. Outcomes included daily self-reported spasm frequency, Ashworth Scale, Rivermead Mobility Index, 10-m timed walk, nine-hole peg test, and cognitive tests.

The split between intention-to-treat and per-protocol results highlights a common challenge in cannabis research: dosing compliance matters. When patients took enough of the medication, measurable benefits emerged. This distinction is important for understanding how cannabis-based medicines might work in clinical practice.

This trial is part of a body of research from the early 2000s testing cannabis-based medicines for MS spasticity. The finding that benefits only reached significance in compliant patients is a pattern seen across several cannabis trials, suggesting that adequate dosing is necessary for therapeutic effects to emerge.

The intention-to-treat analysis did not show significant benefits. The per-protocol analysis, while positive, excludes patients who could not tolerate the full dose, potentially inflating the apparent benefit. The crossover design during inpatient rehabilitation may not reflect real-world use. Sample size was relatively small.