Medical Cannabis for Parkinson’s: Can Cannabinoids Help People With Parkinson’s Disease (PD)?

Key Points

• Parkinson’s disease is a progressive neurological condition that affects millions of people around the world. It causes a loss of motor control and coordination, as well as cognitive issues that can lead to depression and memory loss.
• Some patients do not respond to conventional treatment methods to control motor symptoms. Medications that treat non-motor symptoms (e.g., cognitive deficits, depression, psychosis) can cause significant adverse reactions.
• Cannabidiol (CBD) is a non-psychoactive phytocannabinoid that has been shown to have neuroprotective effects in animal models. Preclinical and clinical data support the use of CBD to treat motor problems.
• CBD acts on the central nervous system (CNS). It has been shown to have antidepressant and antipsychotic effects that may be useful in PD cases. It’s also known to help improve sleep quality.
• Current data suggest that CBD can help with both motor and non-motor PD symptoms. However, more clinical trials are needed to determine its efficacy.

Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disorder. It affects the brain’s ability to control movement. The illness can be debilitating and affect many aspects of life, such as communication, mobility and cognition.

Treatment options are primarily aimed at managing symptoms. However, they can be limited in their efficiency. To make matters more complicated, many medications used for PD can cause serious side effects that may affect the patient’s willingness to continue their treatment. Therefore, there is a need for alternative therapeutics that are more effective and have fewer side effects.

Cannabidiol (CBD) is one of the alternative options that’s been breaking ground in the field of PD medicine. Unlike tetrahydrocannabinol (THC), CBD does not cause an altered state of mind that could harm PD patients. Although there is no known cure for Parkinson’s, research has shown that cannabis may alleviate some of the associated symptoms.

In this post, we’ll explain how medical cannabis may be able to help treat PD. We’ll also discuss some of the challenges facing this type of treatment.

What is Parkinson’s disease (PD)?

Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disease that affects motor functions. Parkinson’s symptoms include tremors, stiffness and slowed movement. It also causes non-motor symptoms such as depression, psychosis, and sleep disturbances.

Over 1-2% of those 65 years old and above develop PD in their lifetime.

Parkinson’s disease is caused by the death of dopamine-producing neurons in a part of your brain called the substantia nigra. These cells are responsible for sending signals to other parts of your brain that control movement. When they die, they can’t send those signals and cause symptoms like muscle stiffness, tremors and slow movements.

What are the symptoms of Parkinson’s disease?

Parkinson’s disease is a neurodegenerative disorder that causes the death of dopamine-producing neurons in the brain. The hallmark of PD is a tremor at rest (resting tremor) which worsen with actions such as walking.

The loss of these neurons results in other common symptoms, including:

• Rigidity (muscle stiffness and tightness)
• Bradykinesia (slowness of movement, such as walking or reaching)
• Postural instability (the inability to maintain balance while standing or walking)
• A reduction in facial expression and eye movement.
• Changes in gait (how you walk) include shuffling steps or stooping posture.
• Difficulty swallowing

Aside from motor impairments, PD can cause non-motor symptoms such as:

• Psychosis ( a break with reality that can include hallucinations or delusions)
• Depression
• Cognitive impairment (difficulty with thinking and learning)
• Chronic pain (reported in 40-80% of all PD cases)
• Sleep disturbances.
• Loss of smell and taste, which can be an early sign of PD

How is Parkinson’s disease diagnosed?

A diagnosis of Parkinson’s disease is based on the patient’s symptoms, a physical exam, and neurological tests. A brain scan may also rule out other causes for the symptoms the patient is experiencing.

Most people with PD are diagnosed between the ages of 50 and 60.

Tests can help determine if someone has Parkinson’s disease by measuring how much dopamine is in their brain and how well it functions. This can be done with the following:

• a blood test
• a brain scan (such as an MRI)
• a lumbar puncture (spinal tap)

Diagnosis of Parkinson’s disease can be challenging because no specific tests can confirm it. The symptoms of PD and other neurological conditions are similar, so the doctor will look at the patient’s medical history, perform a physical exam and order tests to rule out other causes for your symptoms.

Current treatment options for Parkinson’s disease

Managing Parkinson’s disease remains one of the greatest challenges in neurology. There is no cure for PD, but treatment can significantly improve a patient’s quality of life.

A treatment plan for PD usually includes medications to reduce symptoms, dietary changes, and physical therapy to manage complications.

Medications used to alleviate Parkinson’s symptoms include:

• antipsychotics (such as quetiapine, aripiprazole and clozapine)
• anticholinergics (such as trihexyphenidyl and benztropine)
• dopamine agonists (such as pramipexole, ropinirole and apomorphine)
• antidepressants (such as amitriptyline, fluoxetine and venlafaxine)
• antiepileptic drugs (such as gabapentin)

Given the complexity of the condition, a patient’s medication plan may include more than one of the above medications. The downside is that these drugs are associated with numerous side effects, including worsening motor complications.

For those who experience the more debilitating effects of PD, surgery may be an option. Deep brain stimulation (DBS) uses electrical impulses to control abnormal nerve signals in the brain. Cranial nerve stimulators can also be used to treat tremors associated with PD by stimulating specific areas of the brain with electric currents.

Medical cannabis: properties, pharmacology, and more

Given the numerous side effects PD medications can cause and the fear of surgery, some patients may choose to forgo treatment altogether. However, this can be a risky move as the disease progresses and symptoms worsen. A new alternative option for treating PD is the use of medical cannabis.

Properties of medical cannabis

Cannabis is a plant that contains more than 100 chemical compounds known as cannabinoids. The two most common are Tetrahydrocannabinol (THC) and cannabidiol (CBD):

• THC is the psychoactive component of cannabis that produces a feeling of being “high” or euphoric. For the purposes of PD treatment, THC is often avoided as it can cause a worsening of symptoms.
• CBD does not produce any mind-altering effects and has been proven to have medical benefits such as reducing pain, inflammation, anxiety and depression. It is also believed that CBD can help with motor symptoms such as tremors and dyskinesia, which are common in PD.

How CBD and the endocannabinoid system works

To understand how medical cannabis can help PD patients, it is important to understand how the body naturally produces its cannabinoid compounds. The endocannabinoid system (ECS) is a network of receptors located throughout the body that are responsible for regulating many physiological processes like sleep, appetite and pain sensation.

CBD interacts with receptors called CB1 and CB2. When these receptors are stimulated, they send signals to the brain that can help reduce anxiety and alleviate pain. CBD is also believed to stimulate the production of dopamine and serotonin, two neurotransmitters that regulate mood and motor function.

Medical cannabis for Parkinson’s – what we know so far

While cannabis for Parkinson’s is still in its infancy, studies are starting to shed light on how medical cannabis may help PD symptoms. Research shows that CBD can lead to positive outcomes for some people with Parkinson’s.

Medical cannabis oil for Parkinson’s may help with psychosis

Psychosis is a common symptom of Parkinson’s disease, and patients may experience hallucinations, delusions or paranoia. Nearly one-third of all PD patients develop psychosis. Though the nature of psychosis is still highly debated, one common culprit is believed to be Parkinson’s medications like Levodopa.

A 2018 open-label study published in the Journal of Psychopharmacology suggests that CBD oil can significantly decrease psychosis. In the study, the researchers administered 150mg of CBD daily to six patients (four men and two men) over four weeks. This was done in addition to standard therapy.

At the end of the clinical trial, the patients all reported decreased instances of psychosis. No side effects were reported, suggesting that CBD may be well-tolerated even among PD patients.

The results of this 2018 study follow suit to previous preclinical data suggesting CBD does indeed have antipsychotic effects.

When CBD stimulates the CB1 receptors of the endocannabinoid system, it induces the activation of dopamine transmission. Dopamine release is a byproduct of CB1 activation. This can inhibit the effects of psychosis, which are often related to disturbed dopamine activity.

Medical CBD may help with non-motor symptoms of PD

Aside from motor complications, PD patients face countless non-motor symptoms that can negatively influence their well-being. As with other symptoms, both preclinical and clinical data suggest that CBD also encourages positive outcomes for these symptoms.

Anxiety and depression

Anxiety and depression exist in more than 30-40% of PD patients. Several studies have found that CBD can reduce anxiety, depression, and apathy. Though not fully understood, the mechanism behind this is likely related to the balancing of neurotransmitters like serotonin and dopamine.

Sleep disturbances

Aside from mood disorders, PD patients often get poor sleep. Recent studies suggest that CBD may induce sedative-like effects or encourage wakefulness depending on the dose. A 2011 lab study published in the Journal of Psychopharmacology reported that high CBD doses improve sleep in rats, while low doses decrease sleep latency.

Cognitive dysfunction

Cognitive dysfunction refers to a set of symptoms associated with PD that include poor attention, working memory and executive function. Furthermore, nearly 40% of PD patients have dementia, which causes memory loss and impaired thinking.

CBD has been shown to have a neuroprotective function in PD models. In animal models, CBD may also improve cognition and memory. Clinical trials will need to be conducted to confirm these findings on actual patients.

Medical CBD may help improve the quality of life of PD patients

In a 2016 placebo study published in Frontiers Pharmacology, researchers found that administering CBD helped improve patients’ overall well-being. The groups that received 75 or 300 mg CBD noted improvements in their scores for depression, anxiety, and well-being. Patients who received the placebo did not experience any of these benefits.

Risks associated with cannabis for Parkinson’s

Aside from the common risks associated with cannabis use (e.g., dry mouth, dizziness), PD patients who seek cannabis are vulnerable to the following:

• Increased risk of falls – Cannabis oil containing THC can cause dizziness and impaired motor function, leading to falls.
• Risk of psychosis – Cannabinoids like THC can cause psychotic episodes that are severe enough to make a patient lose touch with reality or even result in death (rare). As such, it is important to avoid THC, especially when dealing with PD.
• Increased paranoia – Cannabis oil containing THC can cause paranoia that may lead to increased anxiety, which is an issue for many PD patients.

Is medical cannabis the way to go?

It’s important to note that medical cannabis is not a cure for Parkinson’s disease. Moreover, when it comes to treating motor conditions, the data is still conflicting.

One study found that CBD improved motor function and reduced symptoms of tremors in mice with PD. Another showed that it was effective in reducing the severity and number of seizures in rats with a similar condition called hemiparkinsonism. However, current clinical studies suggest that CBD does have a significant impact on motor function.

The problem is that current research on cannabis’s impacts on Parkinson’s is limited. Most studies have a small number of participants and a short follow-up period.

Many physicians and experts are still sceptical about the use of medical cannabis in PD, a 2016 survey suggests. The lack of consensus on CBD for PD results from various factors, such as the lack of more clinical data, knowledge gaps, and more. There needs to be more research and a larger pool of participants to make CBD a more standardised treatment.

Medical cannabis may help with some symptoms of Parkinson’s, but it could have side effects and interact with other medications you take. You should talk to your doctor about the pros and cons of using medical cannabis before deciding whether you want to try it out. If you’re interested in trying to use medical cannabis for Parkinson’s disease, you can schedule an online consultation with a specialist doctor at Lyphe now.

Conclusion

In conclusion, there is evidence to suggest that cannabis may help people with PD. Medical CBD for Parkinson’s shows conflicting effects on motor symptoms, but it may help with non-motor complications. More research is needed to determine how effective CBD is in the long term.

As with all medications, there are risks associated with using medical cannabis for PD treatment. However, the potential benefits of using cannabis may outweigh these risks in many cases because the current treatments have serious side effects.

If a person has tried all other medications and still experiences severe symptoms of Parkinson’s disease (such as tremors), then medical cannabis could be worth considering as an option for managing those symptoms.

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