Medical cannabis as an alternative therapeutics for Parkinsons’ disease: Systematic review

Bougea, Anastasia; Koros, Christos; Simitsi, Athina‐Maria; Chrysovitsanou, Chrysa; Leonardos, Athanasios; Stefanis, Leonidas

doi:10.1016/j.ctcp.2020.101154

Cited by 22 publications

(17 citation statements)

References 28 publications

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“…Here, discontinued use was primarily reported due to a lack of symptom improvement. These findings are in line with the inconsistent efficacy observed in the limited clinical trials conducted on cannabis and PD 12,28,29 .…”

Section: Discussionsupporting

confidence: 70%

Weeding through the haze: a survey on cannabis use among people living with Parkinson’s disease in the US

Feeney

Bega

Kluger

et al. 2021

npj Parkinsons Dis.

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Symptomatic management of Parkinson’s disease (PD) is complex and many symptoms, especially non-motor symptoms, are not effectively addressed with current medications. In the US, cannabis has become more widely available for medical and recreational use, permitting those in the PD community to try alternative means of symptom control. However, little is known about the attitudes towards, and experiences with, cannabis use among those living with PD. To address this shortcoming, we distributed an anonymous survey to 7,607 people with PD in January 2020 and received 1339 responses (17.6%). 1064 complete responses were available for analysis. Respondents represented 49 states with a mean age of 71.2 years (±8.3) and mean PD duration of 7.4 years (±6.2). About a quarter of respondents (24.5%) reported cannabis use within the previous six months. Age and gender were found to be predictors of cannabis use in this sample (Age OR = 0.95, 95% CI 0.93 to 0.97; Male OR = 1.44, 95% CI 1.03 to 2.03). Users reported learning about cannabis use from the internet/news (30.5%) and friends or other people with PD (26.0%). Cannabis users were more likely to report insufficient control of their non-motor symptoms with prescription medications than non-users (p = 0.03). Cannabis was primarily used for PD (63.6%) and was most often used to treat nonmotor symptoms of anxiety (45.5%), pain (44.0%), and sleep disorders (44.0%). However, nearly a quarter of users (23.0%) also reported they had stopped cannabis use in the previous six months, primarily due to a lack of symptom improvement (35.5%). Three quarters of respondents (75.5%) did not use cannabis, primarily because there was a lack of scientific evidence supporting efficacy (59.9%). Our results suggest that the lack of formal guidance or research evidence about cannabis for PD may in part underlie inconsistencies in both use and reported effectiveness.

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Section: Discussionsupporting

confidence: 70%

Weeding through the haze: a survey on cannabis use among people living with Parkinson’s disease in the US

Feeney

Bega

Kluger

et al. 2021

npj Parkinsons Dis.

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“…Previous systematic reviews either covered cannabinoids for PD among other neurodegenerative and movement disorders 18 , 44 , 45 or evaluated efficacy across more broad domains without combining outcome data. 46 As such, this review enhances our knowledge by evaluating and collating particular efficacy and safety endpoints among all available RCTs and real-world observational studies in the PD population. This systematic review establishes that the current evidence for the use of cannabis and its derivatives for the alleviation of motor symptoms in PD is heterogeneous and that there is a dearth of robust placebo-controlled studies.…”

Section: Discussionmentioning

confidence: 94%

Cannabis and its derivatives for the use of motor symptoms in Parkinson’s disease: a systematic review and meta-analysis

Thanabalasingam

Ranjith

Jackson

et al. 2021

Ther Adv Neurol Disord

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Background: Recent changes to the legal status of cannabis across various countries have renewed interest in exploring its use in Parkinson’s disease (PD). The use of cannabinoids for alleviation of motor symptoms has been extensively explored in pre-clinical studies. Objective: We aim to systematically review and meta-analyze literature on the use of medical cannabis or its derivatives (MC) in PD patients to determine its effect on motor function and its safety profile. Methods: We reviewed and analyzed original, full-text randomized controlled trials (RCTs) and observational studies. Primary outcomes were change in motor function and dyskinesia. Secondary outcomes included adverse events and side effects. All studies were analyzed for risk of bias. Results: Fifteen studies, including six RCTs, were analyzed. Of these, 12/15 (80%) mention concomitant treatment with antiparkinsonian medications, most commonly levodopa. Primary outcomes were most often measured using the Unified Parkinson Disease Rating Scale (UPDRS) among RCTs and patient self-report of symptom improvement was widely used among observational studies. Most of the observational data lacking appropriate controls had effect estimates favoring the intervention. However, the controlled studies demonstrated no significant motor symptom improvement overall. The meta-analysis of three RCTs, including a total of 83 patients, did not demonstrate a statistically significant improvement in UPDRS III score variation (MD −0.21, 95% CI −4.15 to 3.72; p = 0.92) with MC use. Only one study reported statistically significant improvement in dyskinesia ( p < 0.05). The intervention was generally well tolerated. All RCTs had a high risk of bias. Conclusion: Although observational studies establish subjective symptom alleviation and interest in MC among PD patients, there is insufficient evidence to support its integration into clinical practice for motor symptom treatment. This is primarily due to lack of good quality data.

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“…These findings are in line with the inconsistent efficacy observed in the limited clinical trials conducted on cannabis and PD. 12,26,27 We found that a majority of people living with PD and using cannabis, were doing so without having been provided information or provider recommendations. This was not entirely surprising; a previous study found a significant cannabis knowledge gap among specialized Parkinson's disease clinicians that paralleled our observed knowledge gap in people with PD.…”

Section: Discussionmentioning

confidence: 93%

“…These findings are in line with the inconsistent efficacy observed in the limited clinical trials conducted on cannabis and PD. 12,28,29…”

Section: Discussionmentioning

confidence: 99%

Weeding Through the Haze: A Survey on Cannabis Use Among People Living with Parkinson’s Disease in the US

Feeney¹,

Bega²,

Kluger

et al. 2020

Preprint

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Symptomatic management of Parkinson′s disease (PD) is complex and many symptoms, especially non-motor symptoms, are not effectively addressed with current medications. In the US, cannabis has become more widely available for medical and recreational use, permitting those in the PD community to try alternative means of symptom control. However, little is known about the attitudes towards, and experiences with, cannabis use among those living with PD. To address this shortcoming, we distributed an anonymous survey to 7,607 people with PD in January 2020 and received 1,064 complete responses for analysis (14%). Respondents represented 49 states with a mean age of 71.2 years (± 8.3) and mean PD duration of 7.4 years (± 6.2). About a quarter of respondents (24.5%) reported cannabis use within the previous six months. Users reported learning about cannabis use from the internet/news (30.5%) and friends or other people with PD (26.0%). Cannabis users were more likely to report insufficient control of their non-motor symptoms with prescription medications than non-users (p < 0.005). Cannabis was primarily used for PD (63.6%) and was most often used to treat nonmotor symptoms of anxiety (45.5%), pain (44.0%) and sleep disorders (44.0%). However, nearly a quarter of users (23.0%) also reported they had stopped cannabis use in the previous six months, primarily due to a lack of symptom improvement (35.5%). Three quarters of respondents (75.5%) did not use cannabis, primarily because there was a lack of scientific evidence supporting efficacy (59.9%). Our results suggest that the lack of formal guidance or research evidence about cannabis for PD may in part underlie inconsistencies in both use and reported effectiveness.

show abstract

Medical cannabis as an alternative therapeutics for Parkinsons’ disease: Systematic review

Cited by 22 publications

References 28 publications

Weeding through the haze: a survey on cannabis use among people living with Parkinson’s disease in the US

Weeding through the haze: a survey on cannabis use among people living with Parkinson’s disease in the US

Cannabis and its derivatives for the use of motor symptoms in Parkinson’s disease: a systematic review and meta-analysis

Weeding Through the Haze: A Survey on Cannabis Use Among People Living with Parkinson’s Disease in the US

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