A review of the latest clinical trials on the use of cannabinoids in the treatment of multiple sclerosis Review article
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Published:
Sep 30, 2025
Keywords:
cannabinoids, multiple sclerosis, tetrahydrocannabinol, cannabidiol
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Abstract
Cannabinoids represent one therapeutic option for the symptomatic treatment of multiple sclerosis. Clinical trial results indicate that the use of a preparation containing a mixture of tetrahydrocannabinol and cannabidiol may provide a moderate yet clinically significant improvement in spasticity in patients for whom standard treatment is ineffective, which led to the approval of this preparation. According to patients, it provides subjectively perceived benefits, although many objective analyses do not show a statistically significant improvement between the group receiving the cannabis-based preparation and the control group receiving a placebo. Data on its effects on other symptoms, such as sleep disturbances, bladder function, or quality of life, remain inconclusive and require further research. The safety profile of approved cannabinoid preparations is considered acceptable; however, adverse effects such as drowsiness, dizziness, or mood swings may limit tolerability in some patients. Current evidence supports the use of cannabinoids as an alternative therapy, particularly for treatment-resistant spasticity, while emphasizing the need for further, more advanced studies to definitively confirm their efficacy.
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References
1. Johnson JK, Colby A. History of Cannabis Regulation and Medicinal Therapeutics: It’s Complicated. Clin Ther. 2023; 45(6): 521-6.
2. Charitos IA, Gagliano-Candela R, Santacroce L et al. The Cannabis Spread throughout the Continents and its Therapeutic Use in History. Endocr Metab Immune Disord Drug Targets. 2021; 21(3): 407-17.
3. Bezalwar A, Patil PS, Pajai S et al. Journey of Marijuana From „Folk Tales” to „Doors of Justice”: A Comprehensive Review. Cureus. 2024; 16(3): e57190.
4. Xie Z, Mi Y, Kong L et al. Cannabis sativa: origin and history, glandular trichome development, and cannabinoid biosynthesis. Hortic Res. 2023; 10(9): uhad150.
5. Zuardi AW. History of cannabis as a medicine: a review. Braz J Psychiatry. 2006; 28(2): 153-7.
6. Walsh KB, McKinney AE, Holmes AE. Minor Cannabinoids: Biosynthesis, Molecular Pharmacology and Potential Therapeutic Uses. Front Pharmacol. 2021; 12: 777804.
7. Radwan MM, Chandra S, Gul S et al. Cannabinoids, Phenolics, Terpenes and Alkaloids of Cannabis. Molecules. 2021; 26(9): 2774.
8. Stasiłowicz A, Tomala A, Podolak I et al. Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment. Int J Mol Sci. 2021; 22(2): 778.
9. Blebea NM, Pricopie AI, Vlad RA et al. Phytocannabinoids: Exploring Pharmacological Profiles and Their Impact on Therapeutical Use. Int J Mol Sci. 2024; 25(8): 4204.
10. Finn DP, Haroutounian S, Hohmann AG et al. Cannabinoids, the endocannabinoid system, and pain: a review of preclinical studies. Pain. 2021; 162(Suppl 1): S5-S25.
11. Gülck T, Møller BL. Phytocannabinoids: Origins and Biosynthesis. Trends Plant Sci. 2020; 25(10): 985-1004.
12. Lapierre É, Monthony AS, Torkamaneh D. Genomics-based taxonomy to clarify cannabis classification. Genome. 2023; 66(8): 202-11.
13. Lu HC, Mackie K. Review of the Endocannabinoid System. Biol Psychiatry Cogn Neurosci Neuroimaging. 2021; 6(6): 607-15.
14. Bonini SA, Premoli M, Tambaro S et al. Cannabis sativa: A comprehensive ethnopharmacological review of a medicinal plant with a long history. J Ethnopharmacol. 2018; 227: 300-15.
15. Bilbao A, Spanagel R. Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. BMC Med. 2022; 20: 259.
16. Jardim C, Delgado-Charro MB. The Regulatory Environment Surrounding Cannabis Medicines in the EU, the USA, and Australia. Pharmaceutics. 2025; 17(5): 635.
17. MacCallum CA, Lo LA, Pistawka CA et al. Cannabis vaporisation: Understanding products, devices and risks. Drug Alcohol Rev. 2024; 43(3): 732-45.
18. Leal WE, Moscrop-Blake K. The many forms of cannabis use: Prevalence and correlates of routes of administration among nationally representative samples of U.S. adult and adolescent cannabis users. Addict Behav. 2024; 159: 108146.
19. Stella B, Baratta F, Della Pepa C et al. Cannabinoid Formulations and Delivery Systems: Current and Future Options to Treat Pain. Drugs. 2021; 81(13): 1513-57.
20. Spindle TR, Bonn-Miller MO, Vandrey R. Changing landscape of cannabis: novel products, formulations, and methods of administration. Curr Opin Psychol. 2019; 30: 98-102.
21. Filipiuc SI, Neagu AN, Uritu CM et al. The Skin and Natural Cannabinoids-Topical and Transdermal Applications. Pharmaceuticals (Basel). 2023; 16(7): 1049.
22. Klimkiewicz A. Konopie i medyczne zastosowanie kannabinoidów – praktyczne rekomendacje; Warszawa 2022: 262-74.
23. Ustawa z dnia 29 lipca 2005 r. o przeciwdziałaniu narkomanii; https://eli.gov.pl/eli/DU/2005/1485/ogl.
24. Belackova V, Petruzelka B, Cihak J et al. „The whole picture”: A review of international research on the outcomes of regulated cannabis supply. Int J Drug Policy. 2025; 142: 104796.
25. Hall W, Lynskey M. Assessing the public health impacts of legalizing recreational cannabis use: the US experience. World Psychiatry. 2020; 19(2): 179-86.
26. Khoj L, Zagà V, Amram DL et al. Effects of cannabis smoking on the respiratory system: A state-of-the-art review. Respir Med. 2024; 221: 107494.
27. Cho CM, Hirsch R, Johnstone S. General and oral health implications of cannabis use. Aust Dent J. 2005; 50(2): 70-4.
28. Hoch E, Volkow ND, Friemel CM. Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits. Eur Arch Psychiatry Clin Neurosci. 2025; 275(2): 281-92.
29. Meier MH, Caspi A, R Knodt Am et al. Long-Term Cannabis Use and Cognitive Reserves and Hippocampal Volume in Midlife. Am J Psychiatry. 2022; 179(5): 362-74.
30. Rezkalla SH, Kloner RA. A Review of Cardiovascular Effects of Marijuana Use. J Cardiopulm Rehabil Prev. 2025; 45(1): 2-7.
31. Jeffers AM, Glantz S, Byers AL et al. Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. J Am Heart Assoc. 2024; 13(5): e030178.
32. Robinson T, Fischer B, Hautala R et al. Risk thresholds for the frequency of cannabis use during pregnancy and adverse neonatal outcomes: protocol for a systematic review and dose-response meta-analysis. Syst Rev. 2024; 13(1): 307.
33. Gerede A, Stavros S, Chatzakis C et al. Cannabis Use during Pregnancy: An Update. Medicina (Kaunas). 2024; 60(10): 1691.
34. Mulligan MK, Hamre KM. Influence of prenatal cannabinoid exposure on early development and beyond. Adv Drug Alcohol Res. 2023; 3: 10981.
35. Swenson K. Cannabis for morning sickness: areas for intervention to decrease cannabis consumption during pregnancy. J Cannabis Res. 2023; 17; 5(1): 22.
36. Lo JO, Hedges JC, Girardi G. Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes. Am J Obstet Gynecol. 2022; 227(4): 571-81.
37. Urits I, Charipova K, Gress K et al. Adverse Effects of Recreational and Medical Cannabis. Psychopharmacol Bull. 2021; 51(1): 94-109.
38. Connor JP, Stjepanović D, Le Foll B et al. Cannabis use and cannabis use disorder. Nat Rev Dis Primers. 2021; 7(1): 16.
39. Connor JP, Stjepanović D, Budney AJ et al. Clinical management of cannabis withdrawal. Addiction. 2022; 117(7): 2075-95.
40. Bahji A, Meyyappan AC, Hawken ER et al. Pharmacotherapies for cannabis use disorder: A systematic review and network meta-analysis. Int J Drug Policy. 2021; 97: 103295.
41. Sturm D, Gurevitz SL, Turner A. Multiple sclerosis: a review of the disease and treatment options. Consult Pharm. 2014; 29(7): 469-79.
42. Lorenzut S, Negro ID, Pauletto G et al. Exploring the Pathophysiology, Diagnosis, and Treatment Options of Multiple Sclerosis. J Integr Neurosci. 2025; 24(1): 25081.
43. Olejnik P, Roszkowska Z, Adamus S et al. Multiple sclerosis: a narrative overview of current pharmacotherapies and emerging treatment prospects. Pharmacol Rep. 2024; 76(5): 926-43.
44. Haki M, Al-Biati HA, Al-Tameemi ZS et al. Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment. Medicine (Baltimore). 2024; 103(8): e37297.
45. Ward M, Goldman MD. Epidemiology and Pathophysiology of Multiple Sclerosis. Continuum (Minneap Minn). 2022; 28(4): 988-1005.
46. Ghasemi N, Razavi S, Nikzad E. Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy. Cell J. 2017; 19(1): 1-10.
47. Otero-Romero S, Sastre-Garriga J, Comi G et al. Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper. Multiple Sclerosis Journal. 2016; 22(11): 1386-96.
48. Halabchi F, Alizadeh Z, Sahraian MA et al. Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurol. 2017; 17(1): 185.
49. Gold R, Oreja-Guevara C. Advances in the management of multiple sclerosis spasticity: multiple sclerosis spasticity guidelines. Expert Rev Neurother. 2013; 13(12 Suppl): 55-9.
50. Hugos CL, Cameron MH. Assessment and Measurement of Spasticity in MS: State of the Evidence. Curr Neurol Neurosci Rep. 2019; 19(10): 79.
51. Farrar JT, Troxel AB, Stott C et al. Validity, reliability, and clinical importance of change in a 0-10 numeric rating scale measure of spasticity: a post hoc analysis of a randomized, double-blind, placebo-controlled trial. Clin Ther. 2008; 30(5): 974-85.
52. Zakrzewska-Pniewska B, Adamczyk-Sowa M, Brola W et al. Leczenie i postępowanie objawowe w stwardnieniu rozsianym Rekomendacje Sekcji SM i Neuroimmunologii Polskiego Towarzystwa Neurologicznego. Polski Przegląd Neurologiczny. 2019; 15(14): 191-217.
53. Zajicek JP, Hobart JC, Slade A et al. Multiple sclerosis and extract of cannabis: results of the MUSEC trial. J Neurol Neurosurg Psychiatry. 2012; 83(11): 1125-32.
54. Zajicek JP, Sanders HP, Wright D et al. Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. J Neurol Neurosurg Psychiatry. 2005; 76(12): 1664-9.
55. Filippini G, Minozzi S, Borrelli F et al. Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis. Cochrane Database of Systematic Reviews. 2022; 5: CD013444.
56. AlHabil Y, Saadeddin L, Ishkirat H et al. Assessing the Role of Cannabis in Managing Spasticity in Multiple Sclerosis: A Systematic Review and Meta-Analysis. Clin Ther. 2025: S0149-2918(25)00246-2.
57. Azadvari M, Pourshams M, Guitynavard F et al. Cannabinoids for spasticity in patients with multiple sclerosis: A systematic review and meta-analysis. Mult Scler J Exp Transl Clin. 2024; 10(4): 20552173241282379.
58. Dykukha I, Essner U, Schreiber H et al. Effects of Sativex® on cognitive function in patients with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord. 2022; 68: 104173.
59. Patti F, Chisari C, Solaro C et al. Effects of THC/CBD oromucosal spray on spasticity-related symptoms in people with multiple sclerosis: results from a retrospective multicenter study. Neurol Sci. 2020; 41: 2905-913.
60. D’hooghe M, Willekens B, Delvaux V et al. Sativex® (nabiximols) cannabinoid oromucosal spray in patients with resistant multiple sclerosis spasticity: the Belgian experience. BMC Neurol. 2021; 21: 227.
61. Bethoux FA, Farrell R, Checketts D et al. A randomized, double-blind, placebo-controlled trial to evaluate the effect of nabiximols oromucosal spray on clinical measures of spasticity in patients with multiple sclerosis. Mult Scler Relat Disord. 2024; 89: 105740.
62. De Blasiis P, Siani MF, Fullin A et al. Short and long term effects of Nabiximols on balance and walking assessed by 3D-gait analysis in people with Multiple Sclerosis and spasticity. Mult Scler Relat Disord. 2021; 51: 102805.
63. Haupts MR, Essner U, Mäurer M. Patient-reported benefits from nabiximols treatment in multiple sclerosis-related spasticity exceed conventional measures. Neurodegener Dis Manag. 2024; 14(1): 11-20.
64. Pau M, Porta M, Spinicci G et al. Change in upper limb function in people with multiple sclerosis treated with nabiximols: a quantitative kinematic pilot study. Neurol Sci. 2023; 44(2): 685-91.
65. Sartori A, Dinoto A, Stragapede L et al. Nabiximols and botulinum toxin injections for patients with multiple sclerosis: efficacy on spasticity and spasms in a single-centre experience. Neurol Sci. 2021; 42: 5037-43.
66. Chisari CG, Solaro C, Annunziata P et al. Nabiximols discontinuation rate in a large population of patients with multiple sclerosis: a 18-month multicentre study. J Neurol Neurosurg Psychiatry. 2020; 91(9): 914-20.
67. Gustavsen S, Søndergaard H, Linnet K et al. Safety and efficacy of low-dose medical cannabis oils in multiple sclerosis. Mult Scler Relat Disord. 2021; 48: 102708.
68. Patti F, Chisari CG, Fernández Ó et al. A real-world evidence study of nabiximols in multiple sclerosis patients with resistant spasticity: Analysis in relation to the newly described ’spasticity-plus syndrome’. Eur J Neurol. 2022; 29(9): 2744-53.
69. Stavrogianni K, Kitsos DK, Giannopapas V et al. Evaluating Vaporized Cannabinoid Therapy in Multiple Sclerosis: Findings from a Prospective Single- Center Clinical Study. J Clin Med. 2025; 14(6): 2121.
2. Charitos IA, Gagliano-Candela R, Santacroce L et al. The Cannabis Spread throughout the Continents and its Therapeutic Use in History. Endocr Metab Immune Disord Drug Targets. 2021; 21(3): 407-17.
3. Bezalwar A, Patil PS, Pajai S et al. Journey of Marijuana From „Folk Tales” to „Doors of Justice”: A Comprehensive Review. Cureus. 2024; 16(3): e57190.
4. Xie Z, Mi Y, Kong L et al. Cannabis sativa: origin and history, glandular trichome development, and cannabinoid biosynthesis. Hortic Res. 2023; 10(9): uhad150.
5. Zuardi AW. History of cannabis as a medicine: a review. Braz J Psychiatry. 2006; 28(2): 153-7.
6. Walsh KB, McKinney AE, Holmes AE. Minor Cannabinoids: Biosynthesis, Molecular Pharmacology and Potential Therapeutic Uses. Front Pharmacol. 2021; 12: 777804.
7. Radwan MM, Chandra S, Gul S et al. Cannabinoids, Phenolics, Terpenes and Alkaloids of Cannabis. Molecules. 2021; 26(9): 2774.
8. Stasiłowicz A, Tomala A, Podolak I et al. Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment. Int J Mol Sci. 2021; 22(2): 778.
9. Blebea NM, Pricopie AI, Vlad RA et al. Phytocannabinoids: Exploring Pharmacological Profiles and Their Impact on Therapeutical Use. Int J Mol Sci. 2024; 25(8): 4204.
10. Finn DP, Haroutounian S, Hohmann AG et al. Cannabinoids, the endocannabinoid system, and pain: a review of preclinical studies. Pain. 2021; 162(Suppl 1): S5-S25.
11. Gülck T, Møller BL. Phytocannabinoids: Origins and Biosynthesis. Trends Plant Sci. 2020; 25(10): 985-1004.
12. Lapierre É, Monthony AS, Torkamaneh D. Genomics-based taxonomy to clarify cannabis classification. Genome. 2023; 66(8): 202-11.
13. Lu HC, Mackie K. Review of the Endocannabinoid System. Biol Psychiatry Cogn Neurosci Neuroimaging. 2021; 6(6): 607-15.
14. Bonini SA, Premoli M, Tambaro S et al. Cannabis sativa: A comprehensive ethnopharmacological review of a medicinal plant with a long history. J Ethnopharmacol. 2018; 227: 300-15.
15. Bilbao A, Spanagel R. Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. BMC Med. 2022; 20: 259.
16. Jardim C, Delgado-Charro MB. The Regulatory Environment Surrounding Cannabis Medicines in the EU, the USA, and Australia. Pharmaceutics. 2025; 17(5): 635.
17. MacCallum CA, Lo LA, Pistawka CA et al. Cannabis vaporisation: Understanding products, devices and risks. Drug Alcohol Rev. 2024; 43(3): 732-45.
18. Leal WE, Moscrop-Blake K. The many forms of cannabis use: Prevalence and correlates of routes of administration among nationally representative samples of U.S. adult and adolescent cannabis users. Addict Behav. 2024; 159: 108146.
19. Stella B, Baratta F, Della Pepa C et al. Cannabinoid Formulations and Delivery Systems: Current and Future Options to Treat Pain. Drugs. 2021; 81(13): 1513-57.
20. Spindle TR, Bonn-Miller MO, Vandrey R. Changing landscape of cannabis: novel products, formulations, and methods of administration. Curr Opin Psychol. 2019; 30: 98-102.
21. Filipiuc SI, Neagu AN, Uritu CM et al. The Skin and Natural Cannabinoids-Topical and Transdermal Applications. Pharmaceuticals (Basel). 2023; 16(7): 1049.
22. Klimkiewicz A. Konopie i medyczne zastosowanie kannabinoidów – praktyczne rekomendacje; Warszawa 2022: 262-74.
23. Ustawa z dnia 29 lipca 2005 r. o przeciwdziałaniu narkomanii; https://eli.gov.pl/eli/DU/2005/1485/ogl.
24. Belackova V, Petruzelka B, Cihak J et al. „The whole picture”: A review of international research on the outcomes of regulated cannabis supply. Int J Drug Policy. 2025; 142: 104796.
25. Hall W, Lynskey M. Assessing the public health impacts of legalizing recreational cannabis use: the US experience. World Psychiatry. 2020; 19(2): 179-86.
26. Khoj L, Zagà V, Amram DL et al. Effects of cannabis smoking on the respiratory system: A state-of-the-art review. Respir Med. 2024; 221: 107494.
27. Cho CM, Hirsch R, Johnstone S. General and oral health implications of cannabis use. Aust Dent J. 2005; 50(2): 70-4.
28. Hoch E, Volkow ND, Friemel CM. Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits. Eur Arch Psychiatry Clin Neurosci. 2025; 275(2): 281-92.
29. Meier MH, Caspi A, R Knodt Am et al. Long-Term Cannabis Use and Cognitive Reserves and Hippocampal Volume in Midlife. Am J Psychiatry. 2022; 179(5): 362-74.
30. Rezkalla SH, Kloner RA. A Review of Cardiovascular Effects of Marijuana Use. J Cardiopulm Rehabil Prev. 2025; 45(1): 2-7.
31. Jeffers AM, Glantz S, Byers AL et al. Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. J Am Heart Assoc. 2024; 13(5): e030178.
32. Robinson T, Fischer B, Hautala R et al. Risk thresholds for the frequency of cannabis use during pregnancy and adverse neonatal outcomes: protocol for a systematic review and dose-response meta-analysis. Syst Rev. 2024; 13(1): 307.
33. Gerede A, Stavros S, Chatzakis C et al. Cannabis Use during Pregnancy: An Update. Medicina (Kaunas). 2024; 60(10): 1691.
34. Mulligan MK, Hamre KM. Influence of prenatal cannabinoid exposure on early development and beyond. Adv Drug Alcohol Res. 2023; 3: 10981.
35. Swenson K. Cannabis for morning sickness: areas for intervention to decrease cannabis consumption during pregnancy. J Cannabis Res. 2023; 17; 5(1): 22.
36. Lo JO, Hedges JC, Girardi G. Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes. Am J Obstet Gynecol. 2022; 227(4): 571-81.
37. Urits I, Charipova K, Gress K et al. Adverse Effects of Recreational and Medical Cannabis. Psychopharmacol Bull. 2021; 51(1): 94-109.
38. Connor JP, Stjepanović D, Le Foll B et al. Cannabis use and cannabis use disorder. Nat Rev Dis Primers. 2021; 7(1): 16.
39. Connor JP, Stjepanović D, Budney AJ et al. Clinical management of cannabis withdrawal. Addiction. 2022; 117(7): 2075-95.
40. Bahji A, Meyyappan AC, Hawken ER et al. Pharmacotherapies for cannabis use disorder: A systematic review and network meta-analysis. Int J Drug Policy. 2021; 97: 103295.
41. Sturm D, Gurevitz SL, Turner A. Multiple sclerosis: a review of the disease and treatment options. Consult Pharm. 2014; 29(7): 469-79.
42. Lorenzut S, Negro ID, Pauletto G et al. Exploring the Pathophysiology, Diagnosis, and Treatment Options of Multiple Sclerosis. J Integr Neurosci. 2025; 24(1): 25081.
43. Olejnik P, Roszkowska Z, Adamus S et al. Multiple sclerosis: a narrative overview of current pharmacotherapies and emerging treatment prospects. Pharmacol Rep. 2024; 76(5): 926-43.
44. Haki M, Al-Biati HA, Al-Tameemi ZS et al. Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment. Medicine (Baltimore). 2024; 103(8): e37297.
45. Ward M, Goldman MD. Epidemiology and Pathophysiology of Multiple Sclerosis. Continuum (Minneap Minn). 2022; 28(4): 988-1005.
46. Ghasemi N, Razavi S, Nikzad E. Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy. Cell J. 2017; 19(1): 1-10.
47. Otero-Romero S, Sastre-Garriga J, Comi G et al. Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper. Multiple Sclerosis Journal. 2016; 22(11): 1386-96.
48. Halabchi F, Alizadeh Z, Sahraian MA et al. Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurol. 2017; 17(1): 185.
49. Gold R, Oreja-Guevara C. Advances in the management of multiple sclerosis spasticity: multiple sclerosis spasticity guidelines. Expert Rev Neurother. 2013; 13(12 Suppl): 55-9.
50. Hugos CL, Cameron MH. Assessment and Measurement of Spasticity in MS: State of the Evidence. Curr Neurol Neurosci Rep. 2019; 19(10): 79.
51. Farrar JT, Troxel AB, Stott C et al. Validity, reliability, and clinical importance of change in a 0-10 numeric rating scale measure of spasticity: a post hoc analysis of a randomized, double-blind, placebo-controlled trial. Clin Ther. 2008; 30(5): 974-85.
52. Zakrzewska-Pniewska B, Adamczyk-Sowa M, Brola W et al. Leczenie i postępowanie objawowe w stwardnieniu rozsianym Rekomendacje Sekcji SM i Neuroimmunologii Polskiego Towarzystwa Neurologicznego. Polski Przegląd Neurologiczny. 2019; 15(14): 191-217.
53. Zajicek JP, Hobart JC, Slade A et al. Multiple sclerosis and extract of cannabis: results of the MUSEC trial. J Neurol Neurosurg Psychiatry. 2012; 83(11): 1125-32.
54. Zajicek JP, Sanders HP, Wright D et al. Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. J Neurol Neurosurg Psychiatry. 2005; 76(12): 1664-9.
55. Filippini G, Minozzi S, Borrelli F et al. Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis. Cochrane Database of Systematic Reviews. 2022; 5: CD013444.
56. AlHabil Y, Saadeddin L, Ishkirat H et al. Assessing the Role of Cannabis in Managing Spasticity in Multiple Sclerosis: A Systematic Review and Meta-Analysis. Clin Ther. 2025: S0149-2918(25)00246-2.
57. Azadvari M, Pourshams M, Guitynavard F et al. Cannabinoids for spasticity in patients with multiple sclerosis: A systematic review and meta-analysis. Mult Scler J Exp Transl Clin. 2024; 10(4): 20552173241282379.
58. Dykukha I, Essner U, Schreiber H et al. Effects of Sativex® on cognitive function in patients with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord. 2022; 68: 104173.
59. Patti F, Chisari C, Solaro C et al. Effects of THC/CBD oromucosal spray on spasticity-related symptoms in people with multiple sclerosis: results from a retrospective multicenter study. Neurol Sci. 2020; 41: 2905-913.
60. D’hooghe M, Willekens B, Delvaux V et al. Sativex® (nabiximols) cannabinoid oromucosal spray in patients with resistant multiple sclerosis spasticity: the Belgian experience. BMC Neurol. 2021; 21: 227.
61. Bethoux FA, Farrell R, Checketts D et al. A randomized, double-blind, placebo-controlled trial to evaluate the effect of nabiximols oromucosal spray on clinical measures of spasticity in patients with multiple sclerosis. Mult Scler Relat Disord. 2024; 89: 105740.
62. De Blasiis P, Siani MF, Fullin A et al. Short and long term effects of Nabiximols on balance and walking assessed by 3D-gait analysis in people with Multiple Sclerosis and spasticity. Mult Scler Relat Disord. 2021; 51: 102805.
63. Haupts MR, Essner U, Mäurer M. Patient-reported benefits from nabiximols treatment in multiple sclerosis-related spasticity exceed conventional measures. Neurodegener Dis Manag. 2024; 14(1): 11-20.
64. Pau M, Porta M, Spinicci G et al. Change in upper limb function in people with multiple sclerosis treated with nabiximols: a quantitative kinematic pilot study. Neurol Sci. 2023; 44(2): 685-91.
65. Sartori A, Dinoto A, Stragapede L et al. Nabiximols and botulinum toxin injections for patients with multiple sclerosis: efficacy on spasticity and spasms in a single-centre experience. Neurol Sci. 2021; 42: 5037-43.
66. Chisari CG, Solaro C, Annunziata P et al. Nabiximols discontinuation rate in a large population of patients with multiple sclerosis: a 18-month multicentre study. J Neurol Neurosurg Psychiatry. 2020; 91(9): 914-20.
67. Gustavsen S, Søndergaard H, Linnet K et al. Safety and efficacy of low-dose medical cannabis oils in multiple sclerosis. Mult Scler Relat Disord. 2021; 48: 102708.
68. Patti F, Chisari CG, Fernández Ó et al. A real-world evidence study of nabiximols in multiple sclerosis patients with resistant spasticity: Analysis in relation to the newly described ’spasticity-plus syndrome’. Eur J Neurol. 2022; 29(9): 2744-53.
69. Stavrogianni K, Kitsos DK, Giannopapas V et al. Evaluating Vaporized Cannabinoid Therapy in Multiple Sclerosis: Findings from a Prospective Single- Center Clinical Study. J Clin Med. 2025; 14(6): 2121.