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CBD for multiple sclerosis

No trial has tested CBD alone for MS spasticity. The evidence is for nabiximols (Sativex), a registered mouth spray that contains THC as well as CBD.

Facts checked 13 November 20264 min readHow we research
Not enough evidence

No randomised trial of CBD alone for MS spasticity was found. There is moderate evidence for nabiximols, a 1:1 THC:CBD spray that contains THC.

How we grade evidence

There is not enough evidence to say whether CBD alone does anything for multiple sclerosis (MS), because it has not been tested in a randomised trial. The cannabis medicine with evidence in MS is nabiximols (Sativex), a mouth spray that contains THC as well as CBD. Its results cannot be applied to CBD-only products.

What the research shows

CBD alone

We found no randomised controlled trial of CBD on its own for MS spasticity. Spasticity means muscle stiffness and spasms. It is the symptom that the main review finding below concerns.

Nabiximols and other THC-containing medicines

A 2022 Cochrane review is the most thorough summary. Cochrane reviews gather every good trial on a question and weigh them together.

  • It covered 25 trials and 3,763 participants.1
  • It found that nabiximols probably reduces the severity of spasticity in the short term. The reviewers rated this as moderate-certainty evidence.1
  • The trials tested THC and CBD combinations, THC-like medicines and cannabis extracts. None tested CBD on its own.1

Nabiximols contains THC and CBD in a ratio of about 1 to 1. THC is the compound in cannabis that causes a high, and it acts on the body differently from CBD. See CBD vs THC.

Because the trials tested the combination, they cannot show what CBD contributed, if anything. This is why the grade on this page is “not enough evidence” for CBD, even though a registered medicine that contains CBD has moderate evidence. See how we grade the evidence.

Other MS symptoms

For pain, the wider evidence on CBD alone is negative. A 2024 review found that 15 of 16 randomised trials of pharmaceutical-grade CBD showed no benefit over placebo for pain.2 See CBD for chronic pain.

What doses were tested

No dose of CBD alone has been tested for MS spasticity.

Nabiximols is a mouth spray, and a prescriber sets the dose. Every spray delivers THC together with CBD, so it cannot be taken as a CBD-only medicine. See the registered cannabis medicines.

What Australian medical bodies say

  • Registered medicines. As of November 2026, only two cannabis medicines are registered in Australia: nabiximols (Sativex) and cannabidiol (Epidyolex). Everything else is an unapproved product.3
  • NPS MedicineWise has published an evidence summary on medicinal cannabis for MS for health professionals.4
  • TGA. The Therapeutic Goods Administration’s guidance says medicinal cannabis should be considered only when registered medicines have been tried and failed, and that treatment should be stopped if benefit has not been shown.5
  • RACGP. The Royal Australian College of General Practitioners describes the overall evidence base for medicinal cannabis as “limited and inconclusive”.6

See what Australian medical bodies say about CBD.

Risks to know about

  • THC effects. Nabiximols contains THC. The TGA’s patient information lists fatigue, sedation, vertigo, nausea and dry mouth among the side effects of medicinal cannabis, and notes that CBD-rich products have fewer side effects than high-THC products.7
  • Driving. The TGA’s guidance says patients should be advised they are not able to drive while being treated with medicinal cannabis.5 See CBD and driving.
  • Drug tests. Products containing THC can cause a positive drug test. In one study, even CBD-dominant cannabis with a small amount of THC led to confirmed positive urine tests in 2 of 6 people.8 See will CBD show up on a drug test?.
  • Interactions. CBD blocks liver enzymes that process many medicines, and it adds to the drowsiness caused by other sedating medicines.9 The US prescribing information for purified CBD (Epidiolex) specifically lists tizanidine, a muscle relaxant, among medicines whose levels may rise.9 See CBD drug interactions.
  • Pregnancy. The TGA says medicinal cannabis is not appropriate for women who are pregnant, planning pregnancy or breastfeeding.7 See CBD in pregnancy and breastfeeding.

If you are considering it

  • Talk to your neurologist or MS nurse about spasticity. Ask which treatments have been tried and what the options are.
  • Be aware that the trial evidence in MS is for the registered THC and CBD spray, not for CBD-only oil.
  • If a cannabis medicine is raised, questions worth asking: Does it contain THC, and what would that mean for my driving and my work? Could it interact with my current MS medicines? How will we judge whether it is working, and when would we stop?

Footnotes

  1. Filippini G, et al. Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis. Cochrane Database of Systematic Reviews, 2022. https://pubmed.ncbi.nlm.nih.gov/35510826/ ↩ ↩2 ↩3

  2. Moore A, Straube S, Fisher E, Eccleston C. Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. The Journal of Pain, 2024. https://doi.org/10.1016/j.jpain.2023.10.009 ↩

  3. NPS MedicineWise. Medicinal cannabis: what you need to know. https://www.nps.org.au/professionals/medicinal-cannabis-what-you-need-to-know ↩

  4. NPS MedicineWise. Medicinal cannabis evidence summary: multiple sclerosis. https://www.nps.org.au/assets/Medicinal-cannabis-evidence-summary-multiple-sclerosis.pdf ↩

  5. Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in Australia: overview. https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-australia-overview ↩ ↩2

  6. Royal Australian College of General Practitioners. Position statement: use of medicinal cannabis products in Australia (2019 update). https://www.racgp.org.au/advocacy/position-statements/view-all-position-statements/clinical-and-practice-management/medical-cannabis ↩

  7. Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in Australia: patient information. https://www.tga.gov.au/sites/default/files/guidance-use-medicinal-cannabis-australia-patient-information.pdf ↩ ↩2

  8. Study of urine drug testing after pure cannabidiol and CBD-dominant cannabis, 2019. https://pubmed.ncbi.nlm.nih.gov/31682266/ ↩

  9. US National Library of Medicine, DailyMed. Epidiolex (cannabidiol) oral solution prescribing information, revised 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec ↩ ↩2

Common questions

Does CBD help MS?

There is not enough evidence to say. No randomised trial of CBD alone for MS spasticity has been found. The trials that showed a benefit used nabiximols, which contains THC as well as CBD, or other THC-based medicines.

What is Sativex?

Sativex is the brand name of nabiximols, a mouth spray containing THC and CBD in roughly equal amounts. It is one of only two cannabis medicines registered in Australia. A Cochrane review found it probably reduces the severity of MS spasticity in the short term.

Is Sativex the same as CBD oil?

No. Sativex contains THC, the compound in cannabis that causes a high, in about the same amount as CBD. CBD oil that contains little or no THC is a different product and has not been tested in MS spasticity trials.

Can I drive while using a THC and CBD spray for MS?

Medicines containing THC can impair driving, and THC can be detected in roadside drug tests. The TGA's guidance says patients should be advised they are not able to drive while being treated with medicinal cannabis. Ask your prescriber what applies in your state.

This page is general information, not medical or legal advice. Laws and evidence change; we show the date we last checked the facts at the top of every page. Talk to your doctor or pharmacist before starting, stopping or changing any medicine.

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