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Multiple Sclerosis – Cannabis Research

Multiple Sclerosis Research Dashboard

138

Primary Studies

118

Related Studies

256

Total Studies

Clinical Studies

12

Clinical Meta-analyses

19

Double-blind Clinical Trials

27

Clinical Trials

Pre-Clinical Studies

62

Meta-analyses/Reviews

14

Animal Studies

4

Laboratory Studies

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As a subscriber, you will be able to access dashboard insights including chemotype overviews and dosing summaries for medical conditions and organ system and receptor breakdowns for cannabinoid and terpene searches. Study lists present important guidance including dosing and chemotype information with the ability to drill down to the published material. And all outputs are fully filterable, to help find just the information you need. Stay up-to-date with the science of cannabis and the endocannabinoid system with CannaKeys.

CannaKeys has 256 studies associated with Multiple Sclerosis.

Here is a small sampling of Multiple Sclerosis studies by title:

  • Application of the Bayesian network theory in clinical trial data: Severity shift in spasticity numeric rating scale in patients with multiple sclerosis
  • Nabiximols is Efficient as Add-On Treatment for Patients with Multiple Sclerosis Spasticity Refractory to Standard Treatment: A Systematic Review and Meta-Analysis of Randomised Clinical Trials
  • Efficacy of nabiximols oromucosal spray on spasticity in people with multiple sclerosis: Treatment effects on Spasticity Numeric Rating Scale, muscle spasm count, and spastic muscle tone in two randomized clinical trials
  • Botanically-Derived Δ 9-Tetrahydrocannabinol and Cannabidiol, and Their 1:1 Combination, Modulate Toll-like Receptor 3 and 4 Signalling in Immune Cells from People with Multiple Sclerosis
  • Medical cannabis use in Canadians with multiple sclerosis

Components of the Multiple Sclerosis Research Dashboard

  • Dosing information available for Multiple Sclerosis
  • Chemotype guidance for treating Multiple Sclerosis with cannabis
  • Synopsis of cannabis research for Multiple Sclerosis
  • Individual study details for Multiple Sclerosis

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Overview - Multiple Sclerosis

Description of Multiple Sclerosis

Orthodox medicine considers multiple sclerosis (MS) a chronic, inflammatory, and degenerative neurological illness with no cure or exact cause.


MS is characterized by the autoimmune breakdown of thin sheaths covering the brain and spinal cord. These fat-based myelin sheets typically provide insulation and protection, but nerve impulses misfire across the damaged insulation when lesions occur, causing varying debilitating symptoms over distinct periods.


MS is an autoimmune disease that inappropriately prompts adhesion molecules to summon immune cells to fight healthy tissue with inflammation and thus contribute to destroying myelin sheaths.


Depending on the locations and severity of the inflammation, symptoms can vary and come and go over time. If the MS progresses gradually, permanent disability may occur in 10 to 15 years.


Several types of MS may be diagnosed by how the disease progresses:



  • Relapsing-remitting (70-80%)

  • Primary progressive (15%)

  • Secondary progressive Progressive relapsing (5%)

  • Clinically isolated syndrome (CIS)

  • Fulminant

  • Benign


Other likely culprits include genetic and immune factors, infections, and influences such as decreased sun exposure and insufficient vitamin D.


The current mainstay of treatment is still disease-modifying immunotherapy (e.g., DMARDs). Providers should also know how to treat acute relapses by targeting underlying triggers like infections or metabolic derangements and consider symptomatic treatment, a short course of oral steroids, and possibly PT/OT rehab.

Disease Classification

Condition: Multiple Sclerosis
Disease Family: Neurological Condition
Organ System: Nervous System
ICD-10 Chapter: Diseases of the Nervous System
ICD-10 Code: G35

Multiple Sclerosis Symptoms:

Muscle spasms (e.g., eyes, bladder, and bowels), vision loss or double vision, numbness, increased weakness, ataxia, vertigo, tremor, fatigue, paresthesias, urinary and bowel symptoms like incontinence, retention, urgency, constipation, diarrhea, reflux, slurred speech, acute and chronic pain, mood disorders (e.g., anxiety, depression, mood swings)

Also known as:

MS, chronic progressive multiple sclerosis, multiple sclerosis with behavioral disturbance, multiple sclerosis with dementia, dementia due to multiple sclerosis and altered Behavior, exacerbation of multiple sclerosis, chronic / Progressive multiple sclerosis, multiple sclerosis exacerbation, primary Progressive multiple sclerosis, relapsing Progressive multiple sclerosis, relapsing-remitting multiple sclerosis, secondary Progressive multiple sclerosis, primary Progressive multiple sclerosis, remittent Progressive multiple sclerosis, disseminated multiple sclerosis, generalized multiple sclerosis, multiple sclerosis not otherwise specified, multiple sclerosis of the brainstem, multiple sclerosis of chord.

Drug Interactions

THC Interaction with Pharmaceutical Drugs

  • Tetrahydrocannabinol (THC) can enhance the effects of drugs that cause sedation and depress the central nervous system, such as benzodiazepines, barbiturates, and alcohol. 
  • THC is metabolized by an inhibitor of several enzymatic liver pathways referred to as cytochrome P450 (aka CYP450). There are more than 50 enzymes belonging to this enzyme family, several of which are responsible for the breakdown of common drugs such as antidepressants (e.g., amitriptyline, doxepin, fluvoxamine), antipsychotics (haloperidol, clozapine, Stelazine), beta-blockers (e.g., propranolol), bronchodilators (e.g., theophylline), or blood thinners (e.g., warfarin). Thus, patients taking these medication classes may find that THC increases the concentration and effects of these drugs and the impact duration.
  • Clinical observation (not yet confirmed by clinical trials) suggests no likely interactions with other pharmaceuticals at a total daily dose of up to 20mg THC.

If you are interested in the interaction potential of specific pharmaceuticals with THC, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

CBD Interaction with Pharmaceutical Drugs

  • Cannabidiol (CBD) may alter the action of metabolic enzymes (specific drug-transport mechanisms) and alter interactions with other drugs, some of which may produce therapeutic or adverse effects. For instance, CBD interacts with the enzyme cytochrome P450 3A4 and cytochrome P450 2C19, increasing the bioavailability of anti-epileptic drugs such as clobazam (a benzodiazepine). This makes it possible to achieve the same results at significantly lower dosages, reducing treatment costs and risks of adverse effects. 
  • Groups of drugs affected include anti-epileptics, psychiatric drugs, and drugs affecting metabolic enzymes.
  • Clinical observations (not yet confirmed by clinical trials) suggest no likely interactions with other pharmaceuticals at a total daily dose of up to 100mg CBD.

If you are interested in the interaction potential of specific pharmaceuticals with CBD, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

THC/CBD Interaction with Pharmaceutical Drugs

In general, when using cannabinoid-based therapeutics that contain both THC and CBD consider the ratio between them and weigh the relevant information displayed in the individual THC and CBD Drug Interaction windows accordingly.

If you are interested in the interaction potential of specific pharmaceuticals with both primary cannabinoids and THC/CBD, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

Concerns about Cannabis and Cancer-related Immunotherapies:
Some recent clinical observational studies have suggested that the co-administration of cannabinoid-based therapeutics and immunotherapy or immune checkpoint inhibitors in the treatment of certain types of cancer has been associated with worse overall survival rates (T. Taha et al., 2019; A. Biedny et al., 2020; G. Bar-Sela et al., 2020).

However, other studies have suggested that the co-commitment use of immune checkpoint inhibitors and cannabis-induced no such deleterious effects. More specifically, one trial was conducted on animals resulting in data suggesting that cannabis did not negatively affect the properties of immune checkpoint inhibitors (B. Waissengrin et al., 2023). The same authors compared the previous study results with findings from a cohort of 201 patients with metastatic non-small cell lung cancer who received treatment with monotherapy pembrolizumab as a first-line treatment and adjunct cannabis to treat mainly pain and loss of appetite. Their time to tumor progression was 6.1 versus 5.6 months, and overall survival differed between 54.9 versus 23.6 months in cannabis-naïve patients and cannabis-using patients, respectively. However, while numerically different, the authors write that these differences were not statistically significant, leading them to suggest that “These data provide reassurance regarding the absence of a deleterious effect of cannabis in this clinical setting.”

Dosing Considerations

THC Dosage Considerations

  • THC micro dose:  0.1 mg to 0.4 mg
  • THC low dose:  0.5 mg to 5 mg
  • THC medium dose:  6 mg to 20 mg
  • THC high dose:  21 mg to 50+ mg

CBD Dosage Considerations

  • CBD low dose:  0.4 mg to 19 mg
  • CBD medium dose: 20 mg to 99 mg
  • CBD high dose:  100 mg to 800+ mg (upper limits tested ~1,500mg)
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Disclaimer
Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own licensed physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease. If using a product, you should read carefully all product packaging. If you have or suspect that you have a medical problem, promptly contact your health care provider.

Information on this site is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your physician, nutritionally oriented health care practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.