Pineapple Upside Down Cake is a Sativa marijuana strain made by crossing Pineapple Plus with Birthday Cake and Cherry Plus. This strain produces effects that relax muscles, relieve tension and improve mood. Pineapple Upside Down Cake smells like the pastry of its namesake with a sharp, loud aroma that is delicious and unique. Medical marijuana patients choose this strain to relieve symptoms associated with chronic pain, inflammation and depression.