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The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews

  • Suzanne Nielsen
  • Rada Germanos
  • Megan Weier
  • John Pollard
  • Louisa Degenhardt
  • Wayne Hall
  • Nicholas Buckley
  • Michael Farrell
Neurology of Systemic Diseases (J Biller, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neurology of Systemic Disease

Abstract

Purpose of Review

Pharmaceutical cannabinoids such as nabiximols, nabilone and dronabinol, and plant-based cannabinoids have been investigated for their therapeutic potential in treating multiple sclerosis (MS) symptoms. This review of reviews aimed to synthesise findings from high quality systematic reviews that examined the safety and effectiveness of cannabinoids in multiple sclerosis. We examined the outcomes of disability and disability progression, pain, spasticity, bladder function, tremor/ataxia, quality of life and adverse effects.

Recent Findings

We identified 11 eligible systematic reviews providing data from 32 studies, including 10 moderate to high quality RCTs. Five reviews concluded that there was sufficient evidence that cannabinoids may be effective for symptoms of pain and/or spasticity in MS. Few reviews reported conclusions for other symptoms.

Summary

Recent high quality reviews find cannabinoids may have modest effects in MS for pain or spasticity. Future research should include studies with non-cannabinoid comparators; this is an important gap in the evidence.

Keywords

Multiple sclerosis Cannabinoid Pain Spasticity Nabiximols Dronabinol Cannabis 

Notes

Acknowledgements

The editors would like to thank Dr. John Brust and Dr. José Biller for taking the time to review this manuscript.

Funding

Funding was received from the Commonwealth Department of Health and the NSW Government Centre for Medicinal Cannabis Research and Innovation, who determined the topics and scope of the reviews to be conducted and funded the salary of MW. SN and LD are supported by NHMRC research fellowships (no. 1132423 and no. 1041472). The National Drug and Alcohol Research Centre at the University of New South Wales is supported by a funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grant Fund.

Compliance with Ethical Standards

Conflict of Interest

SN, MF and LD have all been investigators on untied investigator-driven educational grants funded by Reckitt Benckiser. MF and LD have received untied educational grant from Mundipharma for post-marketing surveillance studies of new opioid medications. SN, MF and LD have been investigators on untied investigator-driven educational grants funded by Indivior and Reckitt-Benckiser. NB is a member of the medical cannabis expert panel for New South Wales Health. WH provided evidence to parliamentary committees on medical uses of cannabis in Australia and the United Kingdom and is a member of the Australian Advisory Council on Medical Uses of Cannabis. SN, WH, MF, MW and LD have previously published manuscripts on the topic of therapeutic use of cannabis. Other authors declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Supplementary material

11910_2018_814_MOESM1_ESM.docx (156 kb)
ESM 1 (DOCX 189 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.National Drug and Alcohol Research CentreUniversity of New South Wales SydneySydneyAustralia
  2. 2.Centre for Youth Substance Abuse ResearchThe University of Queensland, Royal Brisbane and Women’s Hospital BrisbaneBrisbaneAustralia
  3. 3.School of Medical SciencesThe University of SydneySydneyAustralia

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