TY - JOUR T1 - A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment. AU - Jones,Éamon, AU - Vlachou,Styliani, Y1 - 2020/10/25/ PY - 2020/08/11/received PY - 2020/10/02/revised PY - 2020/10/07/accepted PY - 2020/10/29/entrez PY - 2020/10/30/pubmed PY - 2021/4/13/medline KW - animal models KW - cannabidiol KW - cannabinoid KW - cognition KW - experimental autoimmune encephalomyelitis KW - inflammation KW - multiple sclerosis KW - neuropathic pain KW - neuroprotection KW - spasticity KW - Δ9-tetrahydrocannabinol JF - Molecules (Basel, Switzerland) JO - Molecules VL - 25 IS - 21 N2 - 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. SN - 1420-3049 UR - https://www.unboundmedicine.com/medline/citation/33113776/A_Critical_Review_of_the_Role_of_the_Cannabinoid_Compounds_Δ9_Tetrahydrocannabinol__Δ9_THC__and_Cannabidiol__CBD__and_their_Combination_in_Multiple_Sclerosis_Treatment_ DB - PRIME DP - Unbound Medicine ER -