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Sativex – MS Spasticity (Repeated for Depth) — SCE Neurology MCQ

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ModerateMultiple Sclerosis & CNS InflammationSativex – MS Spasticity (Repeated for Depth)SCE Neurology

A 55-year-old woman with MS develops painful tonic flexor spasms in both legs that are waking her at night. She is on baclofen 20 mg TDS. She asks about cannabis-based medicinal products. What is the NHS position on Sativex (nabiximols) for MS spasticity?

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Correct answer: A — Sativex (THC:CBD oromucosal spray) is an add-on treatment for moderate-severe MS spasticity not responding to other antispasticity medications — a 4-week trial assesses response (≥20% improvement on NRS required for continuation)

Sativex (nabiximols — THC:CBD 1:1 oromucosal spray) is the only licensed cannabis-based medicinal product specifically for MS spasticity. NICE TA972 recommends it as an add-on when other treatments are inadequate. A 4-week trial determines response — continue only if ≥20% improvement on a spasticity NRS. It is a Schedule 2 controlled drug requiring specialist prescribing. Recreational cannabis products are not equivalent and are not recommended. A: Prescription-only controlled drug. C: Licensed medicinal cannabis products are legal on prescription. D: It is an add-on, not replacement. E: It is third/fourth-line.

Reference: NICE TA972 Nabiximols (2019)