34 patients with progressive multiple sclerosis were treated with titrated doses of Sativex (9-delta-tetrahydrocannabinol and cannabidiol oromucosal spray) or placebo in a randomly assigned order for 4 weeks each. The purpose of the study was to determine if of 9-delta-tetrahydrocannabinol and cannabidiol treatment significantly improves neurophysiological and clinical measures of spasticity, pain, function, fatigue and functional performance compared to placebo. There were no significant differences in improvements between treatments with regards to neurophysiological measures of spasticity, pain, function, fatigue and functional performance, but patients given 9-delta-tetrahydrocannabinol and cannabidiol had significantly improved modified Ashworth scale scores and a significantly larger percentage responded to treatment compared to placebo. Rates of side effects were similar between groups. Nine of the 43 enrolled patients were excluded from analysis.