Efficacy of Cannabinoids in Amyotrophic Lateral Sclerosis or Motor Neurone Disease

Inclusion Criteria: 1. Affected by ALS/MND, either of definite or probable according to the El Escorial revised criteria 2. Can provide written informed consent 3. Able and willing to comply with all study requirement 4. Male or female, ages 25-80 years old 5. Onset of first symptom within the last 2 years 6. Forced Vital Capacity (FVC) of at least 60% on baseline Exclusion Criteria: 1. Participants who are bedridden 2. Have used or taken cannabis or cannabinoid-based medications within 30 days of study entry 3. History of any psychiatric disorder other than depression associated with their underlying condition including immediate family history of schizophrenia 4. Heavy consumption of alcohol or use of illicit drug 5. Hypersensitivity to cannabinoids or any of the excipients 6. Any of the following: eGFR \<30 mL/min/1.73m2, ejection fraction \<35%, or ASL and ALT \>5 X ULN 7. Unwillingness of a female participant of child bearing potential, or their partner, to use effective contraception during the study and 30 days thereafter 8. Pregnant, lactating mother or female participant planning pregnancy during the course of the study and for 30 days thereafter 9. Received any investigational drug or medical device within 30 days prior randomisation 10. Any other significant disease or disorder which, in the opinion of the investigator, may either put the participant at risk because of participation in the study, or may influence the result of the study, or the participant's ability to participate in the study 11. Inability to cooperate with the study procedures 12. Unwilling to stop driving vehicle or operating dangerous machinery whilst on study drug. 13. Close affiliation with the study team, e.g. close relative of the investigator