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A critical review of the role of the cannabinoid compounds Delta(9)-tetrahydrocannabinol (Delta(9)-THC) and cannabidiol (CBD) and their combination in multiple sclerosis treatment

Jones, Éamon orcid logoORCID: 0000-0001-9507-5985 and Vlachou, Styliani orcid logoORCID: 0000-0003-4283-9413 (2020) A critical review of the role of the cannabinoid compounds Delta(9)-tetrahydrocannabinol (Delta(9)-THC) and cannabidiol (CBD) and their combination in multiple sclerosis treatment. Molecules, 25 (21). ISSN 1420-3049

Abstract
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 Delta(9)-tetrahydrocannabinol (Delta(9)-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 Delta(9)-THC appear more effective in treating animal models of multiple sclerosis. While CBD reduces the amounts of cell infiltrates in the spinal cord, Delta(9)-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 Delta(9)-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 alpha 2 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.
Metadata
Item Type:Article (Published)
Refereed:Yes
Additional Information:Article number: 4930
Uncontrolled Keywords:multiple sclerosis; cannabinoid; Δ9-tetrahydrocannabinol; cannabidiol; spasticity; neuropathic pain; inflammation; experimental autoimmune encephalomyelitis; neuroprotection; cognition; animal models
Subjects:Medical Sciences > Pharmacology
DCU Faculties and Centres:DCU Faculties and Schools > Faculty of Science and Health > School of Psychology
Publisher:MDPI
Official URL:https://doi.org/10.3390/molecules25214930
Copyright Information:© 2020 by The Authors. Open Access (CC-BY 4.0)
Funders:e Dublin City University Faculty of Science and Health Internship Award to Principal Investigator Styliani Vlachou and the Behavioural Neuroscience Laboratory. Éamon Jones was successfully selected as the intern to work on this review paper.
ID Code:26861
Deposited On:29 Mar 2022 10:44 by Vidatum Academic . Last Modified 29 Mar 2022 10:49
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