Adding CBD in a Small MS Cannabis-Extract Trial Was Associated With More Adverse Events

A small MS trial summarized in the early human CBD review reported more adverse events with a CBD-containing cannabis extract than with THC alone. The combination did not demonstrate a general safety advantage.

The study had a defined clinical comparison

The review describes a four-week crossover study involving 16 patients with multiple sclerosis. It compared a flexible-dose CBD-containing cannabis extract with THC alone and placebo. Adverse events such as dizziness, somnolence and ataxia occurred more often with the combination than with THC alone.

The efficacy findings were not a compensating positive result

The review reports no positive efficacy trends for the assessed pain, tremor, spasticity or cognitive outcomes. Both active treatments also worsened participants’ global impressions relative to placebo. These findings should accompany the adverse-event comparison rather than being omitted from a general discussion of CBD’s potential protective role.

The combination does not isolate every constituent’s contribution

An extract-versus-THC comparison does not necessarily hold every other constituent and exposure feature constant. It therefore cannot establish that CBD alone caused each adverse event or that every CBD–THC product has the same risk. It does limit the claim that adding CBD invariably makes THC treatment better tolerated. The useful conclusion is specific to a small historical MS trial, with its preparation, duration and mix of efficacy and adverse outcomes retained.

Related analysis: the broader review findings and limitations.

Research cited

This analysis draws on the supplied review. Individual studies are discussed as summarized there: Zhornitsky and Potvin (2012). Cannabidiol in Humans—The Quest for Therapeutic Targets.

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