Treating Parkinson’s Disease with Cannabis – Marijuana.com (blog)

Excerpt from Cannabis Revealed: How the worlds most misunderstood plant is healing everything from chronic pain to epilepsy

Parkinsons disease (PD) is a neurodegenerative disorder that primarily affects motor function and coordination. PD results from the death of dopamine-producing nerve cells in the area of the brain in the basal ganglia called the substantia nigra, an area responsible for movement. The cause of PD in most cases is unknown. However, a small percentage of cases are genetic. There are some environmental risk factors that have been associated with increased risk of PD, including pesticide exposure and head injury. PD patients suffer with tremor, rigidity, slowness of movement, and postural instability. Patients can also have depression, cognitive decline, sleep disorders, and occasionally psychosis. The mainstay of treatment is medications, rehabilitation with exercise and occupational therapy, and surgery in advanced cases.

There is limited scientific literature on the effectiveness of medical cannabis for treatment of PD symptoms. One study reported no improvement in tremor with smoked cannabis. (1) In a survey of 339 patients with PD in the Czech Republic, 25% reported experimenting with cannabis to treat symptoms. Almost half of those using cannabis reported improvement with at least once-a-day use. Use over three months resulted in more significant alleviation of symptoms. Only four patients reported worsening symptoms with cannabis use. The researchers reported that long-term regular use of cannabinoids is crucial to obtaining good results with cannabis for PD. (2)

In 2014, Israeli researchers reported that 22 patients were evaluated for severity of symptoms at baseline and after smoked cannabis treatment. The patients reported significant improvement in tremor, rigidity and slowness of movement, with improvement of sleep and pain as well. (3)

In a recent survey of PD patients using alternative treatments in Colorado, nine patients (out of 207) reported using cannabis resulting in improved sleep and mood. Two of the nine patients reported improved motor symptoms and quality of life. (4)

A small study of six patients with psychosis of PD (which may have been related to medication) who were given high-dose CBD for four weeks, showed that all patients had significant improvement of thinking, less withdrawal, better sleep, less hallucinations, and some improvement in motor function. (5)

Interestingly, the endocannabinoid system goes through various changes during the progression of PD, in part as a response to the onset of disease, and then as a result of the disease. It appears that certain cannabinoids may help early in the disease process and then may aggravate the condition as it progresses. (6)

There is experimental evidence that CBD is effective at delaying the progression of PD due to its neuroprotective, anti-inflammatory and antioxidant properties. Another phytocannabinoid, THCV, has been investigated for use in PD in combination with CBD as it has anti-inflammatory properties with no psychoactivity. (7,8)

A number of my patients with PD have reported benefits using different methods of delivery and different cannabinoid profiles. Some patients have found relief of tremors with inhaled THC while others have not. A few patients have found relief with high doses of CBD-rich cannabis taken sublingually. Some patients are using combination CBD+THC.

As mentioned, trial and error is needed to find what cannabinoid profile and method will work best, and starting low-dose and titrating up is recommended, particularly with THC-rich cannabis. Unfortunately, THCV-rich strains are not readily available.

Leons Story

Leon* was enjoying his life as a retiree. He was in quite good health and loved to travel, hike, and spend time with his children and grandchildren. When Leon came to my office accompanied by his wife, he shared that he had been diagnosed with Parkinsons disease some months back after he started having hand tremors. Despite medication, the tremors persisted and he was starting to have symptoms of anxiety and depression. Leon had smoked cannabis recreationally on and off for years and had liked its effects, finding it helped him with relaxation and sleep. He told me that he had tried using cannabis more recently for the tremor and was not finding relief. I asked Leon if he knew the type of cannabis he had tried if it was THC-rich or if it possibly contained CBD and reported that it was very powerful and he could only take one or two puffs or else he felt too high. Since most THC-rich cannabis contains very little CBD, I encouraged Leon to start using CBD-rich cannabis oil on a daily basis, starting with a low dose and increasing the dose over a period of one month; I asked him to stop smoking THC for the following month to make sure any change was attributable to the CBD treatment. At a follow-up appointment six weeks later, he reported that he felt much better. His wife said she noticed that his tremor was significantly diminished and his demeanor was more easy-going. Leon has continued to use CBD-rich cannabis with good results for his tremor and mood. He has not had any side effects from the CBD and occasionally adds THC-rich cannabis at night for sleep.

*The patients name has been changed to protect privacy.

Sources:

(1) Frankel, J. P., et al. Marijuana for parkinsonian tremor. Journal of neurology, neurosurgery, and psychiatry 53.5 (1990): 436.

(2) Venderov, Kateina, et al. Survey on cannabis use in Parkinsons disease: subjective improvement of motor symptoms. Movement Disorders 19.9 (2004): 1102-1106.

(3) Lotan, Itay, et al. Cannabis (Medical Marijuana) Treatment for Motor and NonMotor Symptoms of Parkinson Disease: An Open-Label Observational Study. Clinical neuropharmacology 37.2 (2014): 41-44.

(4) Finseth, Taylor Andrew, et al. Self-Reported Efficacy of Cannabis and Other Complementary Medicine Modalities by Parkinsons Disease Patients in Colorado. Evidence-Based Complementary and Alternative Medicine 2015 (2015).

(5) Zuardi, A. W., et al. Cannabidiol for the treatment of psychosis in Parkinsons disease. Journal of Psychopharmacology (2008).

(6) FernndezRuiz, Javier. The endocannabinoid system as a target for the treatment of motor dysfunction. British journal of pharmacology 156.7 (2009): 1029-1040.

(7) Lastres-Becker, Isabel, et al. Cannabinoids provide neuroprotection against 6-hydroxydopamine toxicity in vivo and in vitro: relevance to Parkinsons disease. Neurobiology of disease 19.1 (2005): 96-107.

(8) FernndezRuiz, Javier, et al. Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid?. British journal of clinical pharmacology 75.2 (2013): 323-333.

Read the original post:
Treating Parkinson's Disease with Cannabis - Marijuana.com (blog)