Physicians’ reports, patient surveys and clinical studies have indicated that Cannabis may help alleviate the motor and non-motor symptoms in chronic Parkinson’s Disease as we have discussed in a previous post.However the lack of properly designed clinical trials for Cannabis, and its derivatives like CBD, has limited its acceptance by the medical community.

Two big studies presented in the “21st International Congress of Parkinson’s Disease and Movement Disorders” evaluated the effects of oral cannabidiol (CBD) and inhaled Cannabis in patients that had Parkinson’s Disease.

Dr. Maureen A. Leehey et al. from the University of Colorado in Aurora carried on a phase II, open-label, dose –escalation study to determine the safety and efficacy of Epidiolex (a commercial form of CBD) in humans. The study included 13 volunteers—without a history of drug or alcohol dependence or took cannabinoids in the previous 30 days—who were treated with 5, 7.5, 10, 15 and 20 mg/kg/day doses of CBD for 31 days; they ere evaluated at triage, baseline and 31-days treatment. The adverse effects were usually mild to moderate: fatigue, diarrhea, somnolence, rising liver enzymes and dizziness. Only seven patients finally completed the treatment.

The “Unified Parkinson’s Disease rating scale” (whose acronym is UPDRS) is a comprehensive rating scale for patients with PD that includes:

  1. alterations of intellectual function
  2. alrerations of cognitive function
  3. depression
  4. motivation-initiative
  5. language
  6. salivary function
  7. swallowing
  8. writing
  9. cut the food and handling cutlery
  10. personal grooming
  11. personal hygiene
  12. behavior in bed
  13. falls
  14. gait
  15. tremor
  16. sensory symptoms

For each item the rating scale goes from 0 (no abnormalities) to 4 (presence of abnormalities) The mean total UPDRS score decreased from 45.9 at baseline to 36.4 at the last visit; the UPDRS motor score decreased from 27.3 to 20.3. Mean rigidity subscore significantly decreased from 9.14 to 6.29. Some patients stated that their pain and irritability have also decreased.

Dr. Laurie K. Mischley et al, from the Bastyr University Research Institute, studied the effects of inhaled cannabis (Epidiolex) on the tremors of PD patients by using motion sensors and interviewing the patients themselves. The participating patients wore a device to monitor their movements for two weeks and they logged their impressions in a daily journal. The sensors registered the frequency and amplitude of the parkinsonian tremor during the wakeful state; the patients pressed a button each time they took the drug.

In this study the duration and the magnitude of the tremor was compared one hour before and hour after the inhalation of Epidiolex; after the study ended the patients responded a few questions about their impressions of the effects. Four patients that took more than 10 doses and had a tremor more than 2% of the time in the hour before the use of Epidiolex, showed decreased tremor in the hour after they took the drug. The monitored data showed that the effect might have lasted up to three hours after the use of Epidiolex. In the follow-up, 9 out of the 10 participants said their symptoms had ameliorated. The side effects included: sleepiness, short-term memory loss and dry throat. An unexpected but useful collateral effect was the improvement of sleep.

What do you think? Please tell us.

Don’t leave me alone.

3 thoughts on “Cannabis in Parkinson’s Disease – Part II

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