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Both physical and cognitive disability, as well as treatments, may affect the ability to drive. Spasticity is a common symptom associated with <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>, and it may affect driving performance either directly or via the medications used to treat it. In this article, we review the evidence relating the antispasticity medicine, \u0394<jats:sup>9<\/jats:sup>\u2010tetrahydrocannabinol:cannabidiol (<jats:styled-content style=\"fixed-case\">THC<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>) oromucosal spray (Sativex<jats:sup>\u00ae<\/jats:sup>), and its potential impact on driving performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Articles were identified by searching PubMed from 1\/1\/2000 to 30\/6\/2017 using a specified list of search terms. The articles identified using these search terms were augmented with relevant references from these papers and other articles known to the authors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results from <jats:styled-content style=\"fixed-case\">THC<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content> oromucosal spray driving studies and real\u2010world registries did not show any evidence of an increase in motor vehicle accidents associated with <jats:styled-content style=\"fixed-case\">THC<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content> oromucosal spray. The majority of patients reported an improvement in driving ability after starting <jats:styled-content style=\"fixed-case\">THC<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content> oromucosal spray, and it was speculated that this may be related to reduced spasticity and\/or better cognitive function. It should be noted that <jats:styled-content style=\"fixed-case\">THC<\/jats:styled-content> blood levels are significantly lower than the levels associated with recreational use of herbal cannabis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">THC<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content> oromucosal spray was shown not to impair driving performance. However, periodic assessment of patients with <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> driving ability is recommended, especially after relapses and changes in treatment. Blood <jats:styled-content style=\"fixed-case\">THC<\/jats:styled-content> measurements might be above authorized thresholds for some countries following administration of <jats:styled-content style=\"fixed-case\">THC<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content> oromucosal spray, thus specific knowledge of each country's driving regulations and a medical certificate are recommended.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.962","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T21:55:26Z","timestamp":1523051726000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["The influence of <scp>THC<\/scp>:<scp>CBD<\/scp> oromucosal spray on driving ability in patients with multiple sclerosis\u2010related spasticity"],"prefix":"10.1002","volume":"8","author":[{"given":"Elisabeth G.","family":"Celius","sequence":"first","affiliation":[{"name":"Department of Neurology Oslo University Hospital, and Institute of Health and Society University of Oslo  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Vila","sequence":"additional","affiliation":[{"name":"Almirall Neurology Global Medical Affairs  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,4,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e536"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617714000368"},{"key":"e_1_2_11_4_1","unstructured":"Berning A. 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