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From the Department of Neurology (Drs. Killestein, Hoogervorst, Kalkers, Uitdehaag, and Polman), Pharmacy (Dr. Loenen), Clinical Epidemiology and Biostatistics (Dr. Uitdehaag), VU Medical Center, Amsterdam, the Netherlands; the European Institute for Oncological and Immunological Research (Dr. Reif), Berlin, Germany; TNO Prevention and Health (P.G.M. Staats), Division of Public Health, Leiden, the Netherlands; and the Department of Family and Community Medicine (Dr. Gorter), University of California at San Francisco Medical School.
Address correspondence and reprint requests to Dr. J. Killestein, VU Medical Center, Department of Neurology, P.O. Box 7057, 1007 MB, Amsterdam, the Netherlands; e-mail: J.Killestein{at}vumc.nl
The authors conducted a randomized, double-blind, placebo-controlled, twofold crossover study in 16 patients with MS who presented with severe spasticity to investigate safety, tolerability, and efficacy of oral 
9-Tetrahydrocannabinol (THC) and Cannabis sativa plant extract. Both drugs were safe, but adverse events were more common with plant-extract treatment. Compared with placebo, neither THC nor plant-extract treatment reduced spasticity. Both THC and plant-extract treatment worsened the participant’s global impression.
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