title: Evaluation of the tolerability and efficacy of Sativex in multiple sclerosis.
abstract: Refractory spasticity, central neuropathic pain and bladder dysfunction are common clinical problems in patients with multiple sclerosis (MS). None of the currently available oral medications has proven to be reliably effective and can be limited by toxicity. Cannabinoids have shown therapeutic effects on those MS-associated symptoms. Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) Sativex (nabiximols) is an oromucosal spray formulation that contains THC and CBD in an approximate 1:1 ratio and is described as an endocannabinoid system modulator. The efﬁcacy of THC/CBD on MS-associated spasticity, pain and bladder dysfunction has been studied in clinical trials as well as in clinical practice studies. Adverse effects are usually mild or moderate and the low rate of drug discontinuation provides good evidence of long-term tolerability. This article focuses on the pharmacological properties, clinical efﬁcacy and tolerability of THC/CBD in MS patients.
authors.affiliation: Hospital Universitario Puerta de Hierro, Laboratorio de Neuroinmunologia, Majadahonda, 28222, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Moreno Torres
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Sanchez
authors.forename: Antonio
authors.initials: A
authors.lastname: Garcia-Merino
mesh_terms: D002185:Cannabidiol; D013759:Dronabinol; D004338:Drug Combinations; D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009128:Muscle Spasticity / Q000188:drug therapy*; D009437:Neuralgia / Q000188:drug therapy*; D010936:Plant Extracts / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols
keywords: Sativex; cannabinoids; central neuropathic pain; multiple sclerosis; nabiximols; spasticity