Medical marijuana in the form of a pill or oral spray could help ease symptoms of multiple sclerosis, according to a new guideline from the American Academy of Neurology.

However, the guideline, published in the journal Neurology, noted that there is not enough evidence to say smoking medical marijuana actually helps, or is safe, for MS patients.

Other complementary or alternative medicine (CAM) therapies -- such as ginkgo biloba, omega-3 fatty acids, bee sting therapy and reflexology -- showed little, if any, evidence for easing multiple sclerosis symptoms.

The Guideline Development Subcommittee of the American Academy of Neurology wanted to develop recommendations for CAM use among multiple sclerosis patients, considering 33 to 80 percent of people with the condition use CAM therapies. The guideline looked specifically at whether CAM reduced MS symptoms, had adverse effects, and interfered with other MS therapies.

The researchers found strong evidence that the pill form of medical marijuana decreased spasticity and pain from spasticity among MS patients, as well as moderate evidence that synthetic medical marijuana in pill form decreases spasticity and pain from spasticity. However, they found moderate evidence that tremor symptoms were not relieved by taking either medical marijuana or synthetic medical marijuana in pill form. There was not enough evidence to indicate whether bladder control could be aided by medical marijuana pills.

They also evaluated how the spray form of medical marijuana affected MS patients. They found moderate evidence that medical marijuana spray improved spasticity and pain caused by spasticity, as well as frequent urination in MS patients. However, there was moderate evidence that this form of medical marijuana does not help with incontinence, and there is weak evidence that it relieves tremors.

It should be noted that there are potential side effects from taking the oral or spray form of medical marijuana, such as dizziness, cognitive issues, balance problems, drowsiness and seizures, as well as a possible risk for depression, the researchers said.

Other CAM therapies investigated in the guideline include:

Ginkgo biloba: Strong evidence that it does not help with cognitive abilities, and weak evidence that it reduces tiredness.

Consuming a low-fat diet with fish oil: Moderate evidence that it doesn't ease MS symptoms.

Magnetic therapy: Moderate evidence that it reduces tiredness, and moderate evidence that it doesn't reduce depression.

Reflexology: Weak evidence that it lessens uncomfortable skin sensations.

Bee sting therapy: Weak evidence that it does not ease MS symptoms.