27 patients with amyotrophic lateral sclerosis (ALS) were randomized to receive either 5 mg dronabinol twice daily or placebo for 2 weeks in a randomized sequence. The purpose of this study was to determine if dronabinol decreases frequency and intensity of cramps and fasciculations compared to placebo, and if there are any improvements in sleep quality, functional ability, appetite and depression scores. Dronabinol was not significantly different from placebo for all outcomes, and there were 2 serious unrelated adverse events requiring hospitalization. 22 patients completed the study.