Home > A critical review of the role of the cannabinoid compounds Δ-tetrahydrocannabinol (Δ-THC) and cannabidiol (CBD) and their combination in multiple sclerosis treatment.

Jones, Éamon and Vlachou, Styliani (2020) A critical review of the role of the cannabinoid compounds Δ-tetrahydrocannabinol (Δ-THC) and cannabidiol (CBD) and their combination in multiple sclerosis treatment. Molecules, 25, (21), . https://doi.org/10.3390/molecules25214930.

External website: https://www.mdpi.com/1420-3049/25/21/4930

Many people with MS (pwMS) use unregulated cannabis or cannabis products to treat the symptoms associated with the disease. In line with this, Sativex, a synthetic combination of cannabidiol (CBD) and Δ-tetrahydrocannabinol (Δ-THC) has been approved to treat symptoms of spasticity. In animals, CBD is effective in reducing the amounts of T-cell infiltrates in the spinal cord, suggesting CBD has anti-inflammatory properties. By doing this, CBD has shown to delay symptom onset in animal models of multiple sclerosis and slow disease progression. Importantly, combinations of CBD and Δ-THC appear more effective in treating animal models of multiple sclerosis. While CBD reduces the amounts of cell infiltrates in the spinal cord, Δ-THC reduces scores of spasticity. In human studies, the results are less encouraging and conflict with the findings in animals. Drugs which deliver a combination of Δ-THC and CBD in a 1:1 ratio appear to be only moderately effective in reducing spasticity scores, but appear to be almost as effective as current front-line treatments and cause less severe side effects than other treatments, such as baclofen (a GABA-B receptor agonist) and tizanidine (an α2 adrenergic receptor agonist). The findings of the studies reviewed suggest that cannabinoids may help treat neuropathic pain in pwMS as an add-on therapy to already established pain treatments. It is important to note that treatment with cannabinoid compounds may cause significant cognitive dysfunction. Long term double-blind placebo studies are greatly needed to further our understanding of the role of cannabinoids in multiple sclerosis treatment.


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