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Review

A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment

Behavioural Neuroscience Laboratory, Neuropsychopharmacology Division, School of Psychology, Faculty of Science and Health, Dublin City University, Glasnevin, Dublin 9, Ireland
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Author to whom correspondence should be addressed.
Academic Editor: Eric J. Downer
Molecules 2020, 25(21), 4930; https://doi.org/10.3390/molecules25214930
Received: 11 August 2020 / Revised: 2 October 2020 / Accepted: 7 October 2020 / Published: 25 October 2020
(This article belongs to the Special Issue Role of Cannabinoids in Inflammation)
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 Δ9-tetrahydrocannabinol (Δ9-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 Δ9-THC appear more effective in treating animal models of multiple sclerosis. While CBD reduces the amounts of cell infiltrates in the spinal cord, Δ9-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 Δ9-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. View Full-Text
Keywords: multiple sclerosis; cannabinoid; Δ9-tetrahydrocannabinol; cannabidiol; spasticity; neuropathic pain; inflammation; experimental autoimmune encephalomyelitis; neuroprotection; cognition; animal models multiple sclerosis; cannabinoid; Δ9-tetrahydrocannabinol; cannabidiol; spasticity; neuropathic pain; inflammation; experimental autoimmune encephalomyelitis; neuroprotection; cognition; animal models
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MDPI and ACS Style

Jones, É.; Vlachou, S. A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment. Molecules 2020, 25, 4930. https://doi.org/10.3390/molecules25214930

AMA Style

Jones É, Vlachou S. A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment. Molecules. 2020; 25(21):4930. https://doi.org/10.3390/molecules25214930

Chicago/Turabian Style

Jones, Éamon, and Styliani Vlachou. 2020. "A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment" Molecules 25, no. 21: 4930. https://doi.org/10.3390/molecules25214930

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