Effects of cannabidiol in the treatment of patients with Parkinson’s disease: An exploratory double-blind trial

Chagas, Marcos Hortes Nisihara; Zuardi, Antônio Waldo; Tumas, Vítor; Pena-Pereira, Márcio Alexandre; Sobreira, Emmanuelle Tavares Alves; Bergamaschi, Mateus M.; Santos, Antônio Carlos dos; Teixeira, Antônio Lúcio; Hallak, Jaime Eduardo Cecílio; Crippa, José Alexandre de Souza

doi:10.1177/0269881114550355

Cited by 295 publications

(252 citation statements)

References 24 publications

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“…The study by Carrol et al [17] was the only one considered class I for the purposes of evidence-based recommendations. Various doses of cannabidiol were given to 21 patients over 6 weeks; no change was found in the total motor score, despite improvement in the quality of life section of the Unified Parkinson's disease rating scale if the target dose of 300 mg daily was reached, which was possible in only 35 % of the patients [18]. Finally, an open-Blabel^study of smoked marijuana in 22 Israeli patients showed improvement in the number of dyskinesias observed after dopa challenge, 30 min after smoking the cigarette [19].…”

Section: Dyskinesias From Levodopa (In Advanced Pd)mentioning

confidence: 99%

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

Koppel

2015

Neurotherapeutics

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Cannabis has been used for many medicinal purposes, including management of spasms, dystonia, and dyskinesias, with variable success. Its use for tetanus was described in the second century BCE, but the literature continues to include more case reports and surveys of its beneficial effects in managing symptoms of hyperkinetic movement disorders than randomized controlled trials, making evidence-based recommendations difficult. This paper reviews clinical research using various formulations of cannabis (botanical products, oral preparations containing Δ 9 -tetrahydrocannabinol and/or cannabidiol) and currently available preparations in the USA (nabilone and dronabinol). This has been expanded from a recent systematic review of cannabis use in several neurologic conditions to include case reports and case series and results of anonymous surveys of patients using cannabis outside of medical settings, with the original evidence classifications marked for those papers that followed research protocols. Despite overlap in some patients, dyskinesias will be treated separately from dystonia and chorea; benefit was not established beyond individual patients for these conditions. Tics, usually due to Tourettes, did respond to cannabis preparations. Side effects reported in the trials will be reviewed but those due to recreational use, including the dystonia that can be secondary to synthetic marijuana preparations, are outside the scope of this paper.

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Section: Dyskinesias From Levodopa (In Advanced Pd)mentioning

confidence: 99%

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

Koppel

2015

Neurotherapeutics

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“…It acts via various mechanisms, such as inhibition of primary afferent nerve activity, decrease in neuronal response to a noxious stimulus, and inhibition of mast cell degranulation (Richardson, 2000). The effect of cannabinoid-related drugs on PD symptoms is still controversial (Sieradzan et al, 2001;Carroll et al, 2004;Venderov a et al, 2004;Chagas et al, 2014). A study from our Movement Disorders Clinic showed that treatment with medical cannabis was associated with a decrease in motor and pain scores as well as an improvement in sleep quality (Lotan et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

Shohet

Khlebtovsky

Roizen

et al. 2016

European Journal of Pain

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Background: Cannabis can alleviate pain of various etiologies. This study assessed the effect of cannabis on motor symptoms and pain parameters in patients with Parkinson's disease (PD). Methods: Twenty patients with PD who were licensed to use cannabis underwent evaluation before and 30 min after cannabis consumption and again after long-term use. Motor function was assessed with the Unified PD Rating scale (UPDRS) by two raters, one blinded. Pain was assessed with the Pain Rating Index (PRI) and Visual Analogue Scale (VAS) of the short-form McGill Pain Questionnaire. Thermal quantitative sensory testing (QST) was performed in 18 patients. The two consecutive QST measurements were validated in 12 cannabis-na€ ıve patients with PD. Results: There was a significant decrease from baseline to 30 min after cannabis consumption in mean motor UPDRS score (38.1 AE 18 to 30.4 AE 15.6, p < 0.0001), total PRI (27 AE 13.5 to 9.7 AE 11, p = 0.001), and VAS score (6.4 AE 2.8 to 3.6 AE 3.1, p = 0.0005). Mean cold pain threshold decreased significantly in the more affected limb, but only after exclusion of two patients who consumed cannabis by vaporizer rather than smoking (19.5 AE 5.2 to 15.6 AE 8.7°C, p = 0.02). After longterm (median 14 weeks) exposure, mean heat pain threshold decreased significantly in the more affected limb in all treated patients (43.6 AE 3.5 to 40.9 AE 3.3°C, p = 0.05) and in cannabis smokers (43.7 AE 3.6 to 40.3 AE 2.5°C, p = 0.008). Conclusions: Cannabis improved motor scores and pain symptoms in PD patients, together with a dissociate effect on heat and cold pain thresholds. Peripheral and central pathways are probably modulated by cannabis. Significance: Quantitative sensory test results are significantly altered following cannabis consumption in patients with PD. Cannabis probably acts on pain in PD via peripheral and central pathways.

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“…60 A sintomatologia da DP inclui tremores involuntários, braquidinesia, instabilidade postural e rigidez, evoluindo para incontinência, incapacidade funcional e morte. 61 A fisiopatologia da doença está relacionada à degeneração de neurônios dopaminérgicos, 62 possivelmente devido ao estresse oxidativo e à um complexo processo neuroinflamatório, especialmente na substância negra do cérebro.…”

Section: Doença De Parkinson (Dp)unclassified

The Contribution of Studies with Canabidiol and Synthetic Analogues in the Design of New Drug Candidates for Neuropsychiatric Disorders and Neurodegenerative Diseases

Viegas¹,

Franco²

2017

Rev. Virtual Quim.

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Abstract:The first documented use of Cannabis for therapeutic purposes is dated from 2300 BC, with indications for the treatment of constipation, gout, beriberi, malaria, rheumatism and menstrual impairment. The search for therapeutic effects of Cannabis has already been pursued by scientists for over 50 years, and in the last 10 years, a new phase studies has started about marijuana constituents, such as Δ 9 -tetrahydrocannabinol (THC, 1) and cannabidiol (CBD, 2) for medicinal application. CBD is present in about 40% in the crude extract of Cannabis sativa, besides other 60 types of cannabinoids and a number of noncannabinoid constituents, accounting for approximately three hundred secondary metabolites. In spite of CBD being a constituent of Cannabis, it is deprived of the typical effects of the plant, differently from THC that induces anxiety and psychotic effects, being its main psychoactive component. Recent studies suggest that CBD could acts as a THC modulator in the brain, exhibiting anxiolytic and/or antipsychotic effects, antagonizing some undesirable effects of THC, as well as contributing with analgesic, antiemetic and antineoplastic, also affecting synapsis plasticity and facilitating neurogenesis. In this context, the scientific literature reinforces the need of advances and more investments in this research field, aiming a better knowledge about endocannabinoid system and the search for new natural and synthetic cannabinoids, supporting their use in the clinics and improving the available therapeutic arsenal for psychiatric and neurodegenerative diseases. Current data from studies dedicated to an improved understanding of its pharmacology and potential therapeutic applications, suggest that CBD and its analogues could play a singular role in the modulation of molecular targets related to central nervous system disorders, making possible the development of innovative, safer and efficient drugs for the treatment of non-responsive patients to the conventional clinics, with significant improvement in life quality and, perhaps, their cure.Keywords: Cannabidiol; cannabinoids; neuropsychiatric disorders; neurodegenerative diseases. ResumoO primeiro uso documentado da Cannabis para fins terapêuticos é datado de aproximadamente 2300 a.C., para o tratamento de constipação, gota, beribéri, malária, reumatismo e problemas menstruais. A busca por efeitos terapêuticos da Cannabis já recebe atenção de cientistas há mais de 50 anos, sendo que nos últimos 10 anos, tem-se observado uma nova fase de estudos acerca dos o po e tes da a o ha, a e e plo do Δ 9 -tetraidrocanabinol (THC, 1) e do canabidiol (CBD, 2) para uso medicinal. O CBD ocorre em cerca de 40% no extrato bruto de Cannabis sativa, além de outros 60 tipos de canabinoides e inúmeros constituintes não-canabinoides, totalizando cerca de 300 metabólitos secundários. O CBD, apesar de ser um constituinte da Cannabis, é desprovido dos efeitos típicos da planta, diferentemente do THC que induz a ansiedade e efeitos psicóticos, sendo o principal ingrediente psico...

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Effects of cannabidiol in the treatment of patients with Parkinson’s disease: An exploratory double-blind trial

Abstract: Our findings point to a possible effect of CBD in improving quality of life measures in PD patients with no psychiatric comorbidities; however, studies with larger samples and specific objectives are required before definitive conclusions can be drawn.

Cited by 295 publications

References 24 publications

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

The Contribution of Studies with Canabidiol and Synthetic Analogues in the Design of New Drug Candidates for Neuropsychiatric Disorders and Neurodegenerative Diseases

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