Is Cannabis Effective in Treating Parkinson’s Disease?

With medical marijuana getting legalized across the nation, it is evident that there is strong potential in its therapeutic properties. Researchers are testing marijuana, which is also referred to as cannabis, as a treatment for many illnesses and diseases, with Parkinson’s disease (PD) high on the list. 

If you are a Florida resident interested in seeing if you are a candidate for a Florida Medical Marijuana Card, this survey will tell you in just a few short minutes if you might qualify for a cannabis recommendation. DocMJ’s team of Qualified Florida Medical Marijuana Doctors are located conveniently across the state in over twenty-five locations with both weekday, night, and weekend appointments available. Their risk-free appointment policy allows you to chat with a cannabis doctor to determine if a medical marijuana card is right for you.

Parkinson’s disease (PD) is the second most common neurodegenerative disorder of adult-onset in the United States. [1] It is a debilitating condition and has both motor and non-motor symptoms. There are not many current treatments for PD, and they include replacement of dopamine deficiency with levodopa. While this helps, it only targets the disorder’s motor symptoms, does not stop its progression, and is associated with side effects of its own. 

Since medical marijuana is available to qualified patients in Florida, we examined the pros and cons of marijuana in treating Parkinson’s disease.

How Cannabis Can Help

Marijuana consists of many different phytocannabinoids, from which cannabidiol (CBD) and tetrahydrocannabinol (THC) are the two most popular. CBD is non-psychoactive and is known to have hypnotic, anxiolytic, antipsychotic, and neuroprotective effects. 

THC is the prominent cannabinoid responsible for the “high” effects of cannabis, and it acts via two kinds of G protein-coupled receptors, referred to as cannabinoid type 1 (CB1) and type 2 (CB2). CB1 receptors are located mainly in the central nervous system (CNS), and CB2 receptors reside in the immune system’s organs and cells. The significant presence of cannabinoid receptors in the basal ganglia is why the significance of cannabis or cannabinoids as possible pharmacotherapy for treating PD and dyskinetic movement disorders. 

On the other hand, CBD is indirectly antagonistic to cannabinoid receptors and modulates the side effects of THC by increasing the CB1-receptor density or some other CB1-mechanism. So CBD inhibits the high of THC and improves its tolerability and therapeutic window without causing intoxicating effects. Studies also suggest that cannabinoid antagonists exert anti-parkinsonism effects, while agonists help with motor control.

Medical marijuana has been shown to improve motor and non-motor symptoms of Parkinson’s disease, including bradykinesia, tremors, sleep, and pain [3]. A study that included 85 individuals with PD demonstrated the effects of cannabis on 85 individuals with PD. Most consumed half a teaspoon of cannabis leaves, along with their prescribed pharmacotherapy for PD. Around 46% reported relief of PD symptoms, occurring at an average of 1.7 months after the first use of marijuana. This study suggested chronic use of marijuana may be required for improvement in symptoms. 

Bradykinesia was the most common symptom alleviated among cannabis users, followed by muscle rigidity and tremor. Additionally, 14% of patients reported improvement of levodopa-induced dyskinesia with the use of cannabis [2]

A study investigated the use of marijuana and compared it to non-marijuana users in individuals with Parkinson’s Disease. There was a lower level of disability in marijuana users than non-users, and other factors such as memory, mood, and fatigue were also improved with cannabis. About 85% of the patients reported effectiveness as moderate or higher due to improvement in symptoms and no worsening with the use of cannabis [3].

PD-Related Medicinal Marijuana Trials

The use of cannabinoids as medicine has been shown to help manage both neurological and non-neurological conditions. But due to the federal scheduling of cannabis as a Schedule 1 Substance, marijuana cannot go through testing completely for clinical trials, limiting the amount of completed research. While some studies have not clearly supported the use of marijuana for PD, there have been clinical trials that demonstrate the potential benefits. 

Below are several PD-related medical marijuana studies that have been conducted to evaluate the use of cannabinoids:

• The Therapeutic Potential of Cannabinoids for Movement Disorders: These clinical observations and trials of cannabinoid-based therapies suggest a possible benefit to tics and probably no help for tremor in dyskinesias or PD motor symptoms. 
• Cannabinoids Reduce Levodopa-induced Dyskinesia in Parkinson’s Disease: A Pilot Study: this study shows that nabilone, the prescription cannabinoid receptor agonist, significantly reduces levodopa-induced dyskinesia in PD.

What is Parkinson’s Disease?

Parkinson’s disease is a neurodegenerative disorder that affects predominantly dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. Both men and women can have Parkinson’s; however, the disease affects about 50 percent more men than women. [4]

Parkinson’s symptoms usually begin gradually and worsen over time. As it progresses, people may experience difficulty walking and talking. They can also have mental and behavioral changes, depression, memory issues, sleep problems, and fatigue.

Most people with Parkinson’s first develop the condition around the age 60. Still, about 5 to 10 percent of people with Parkinson’s have “early-onset” disease meaning it can develop before that period of their life. Early-onset forms of Parkinson’s are often inherited, and some forms have been linked to specific gene mutations.

Symptoms of Parkinson’s

Parkinson’s disease has four primary symptoms:

• Trembling in the hands, arms, legs, jaw, or head
• Stiffness of the limbs and trunk
• Slowness of movement
• Impaired balance and coordination

Other symptoms can include depression and other emotional changes; difficulty swallowing, chewing, speaking; urinary problems or constipation; skin problems; and sleep disruptions. [7] The symptoms and the progression rate can be different among individuals making it easy to dismiss early signs of Parkinson’s. In most cases, however, there are no tests that can definitively detect it, making accurate diagnosing difficult. 

Many people with Parkinson’s notice that before they experience stiffness and tremors, they have sleep issues, restless legs, constipation, and a decreased ability to smell. [4] Symptoms usually begin on one side of the body and as it progresses it eventually affects both sides; however, the symptoms can still be more severe on one side than on the other.

People with Parkinson’s oftentimes develop a parkinsonian gait. They tend to lean forward, have to take small quick steps, and can not swing their arms the average amount. They could also develop trouble initiating or continuing movement.

Traditional Treatment for PD

While there is no cure for Parkinson’s disease, medicines, surgical treatment, and other therapies are traditionally used for managing the symptoms mentioned above.

Pharmaceuticals prescribed for Parkinson’s include:

• Drugs that increase the amount of dopamine in the brain
• Drugs that affect other chemicals in the brain and body
• Medicines that help control nonmotor symptoms

The main route used for Parkinson’s is levodopa, also known as L-dopa. Our nerve cells use levodopa to create dopamine to replenish the brain’s decreasing supply. In most cases, people take levodopa, and the medication called carbidopa prevents or reduces some of the side effects of levodopa therapy and reduces the amount of levodopa needed to improve symptoms.

Other traditional medicines used to treat Parkinson’s symptoms include: [7]

• Dopamine agonists mimic the role of dopamine in the brain
• MAO-B inhibitors slow down an enzyme that breaks down dopamine in the brain
• COMT inhibitors to help break down dopamine
• Amantadine, an old antiviral drug, to reduce involuntary movements
• Anticholinergic drugs to reduce tremors and muscle rigidity

All of the abovementioned medications come along with a range of side effects to include, but not limited to:

• vomiting
• nausea
• lightheadedness
• appetite loss
• low blood pressure
• confusion
• hallucinations
• confusion
• Dyskinesia
• trouble sleeping
• confusion
• diarrhea
• reddish-brown urine
• memory problems
• hallucinations

As you can see, traditional medications come with many unwanted side effects compared to cannabis. While medical marijuana is not a cure-all for Parkinson’s disease, it does have the ability to help those suffering manage their symptoms without having to manage additional side effects.

How to Qualify for a Florida Medical Marijuana Card

If after reading this article you believe you or a loved one could benefit from the medicinal potential of cannabis and are ready to take the first step in becoming a qualified Medical Marijuana Patient in Florida, you must meet the following requirements per state guidelines: [8]

• Be a permanent or seasonal Florida resident
• Be diagnosed with a qualifying medical condition by a qualified physician
• Be entered into the Medical Marijuana Use Registry
• Obtain a Medical Marijuana Use Registry Identification Card

In addition to Parkinson’s Disease, the following conditions have been approved for the use of medical marijuana in Florida:

• Cancer
• Epilepsy
• Glaucoma
• HIV/AIDS
• Post-traumatic stress disorder (PTSD)
• Amyotrophic lateral sclerosis (ALS)
• Crohn’s disease
• Multiple sclerosis (MS)
• Medical conditions of the same kind or class as or comparable to the others listed.
• A terminal illness diagnosed by a physician other than the qualified physician issuing the physician certification.
• Chronic nonmalignant pain is caused by a qualifying medical condition or that originates from a qualifying medical condition and persists beyond the usual course of that qualifying medical condition.

Ready to book an appointment? Still unsure if you qualify? This questionnaire can tell you in just a few minutes!

[1] https://www.cureus.com/articles/20020-pros-and-cons-of-marijuana-in-treatment-of-parkinsons-disease

[2] https://www.hindawi.com/journals/pd/2016/1279042/

[3] https://movementdisorders.onlinelibrary.wiley.com/doi/abs/10.1002/mds.20111

[4] https://www.sciencedirect.com/science/article/abs/pii/S0965229917302340?via%3Dihub

[4]  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003756/

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003756/

[6] https://www.nia.nih.gov/health/smell-and-taste

[7] https://www.nia.nih.gov/health/parkinsons-disease

[8] https://knowthefactsmmj.com/patients/