CBD and Parkinson's Disease

22/07/2020

World Brain Day - 22 July 2020 

In 2014, the World Federation of Neurology instituted this date to celebrate World Brain Day. 

Purpose? An appeal to the great questions of the Brain and the importance of its discussion in the quality of human life. 

This year the topic is "move together to end Parkinson's Disease". 

It is intended, therefore, to make notice of the need - for all of us - to make efforts to diagnose earlier, treat more effectively and improve the lives of those who have this disease, as well as their caregivers. 

Given that today is the official day of the launch of the CBD Bloom project and taking into account that medical cannabis offers positive scientific evidence (see throughout the text) for Parkinson's Disease, this paper may assist in decision making.


What is Parkinson's disease? 

Parkinson's disease is a progressive neurological disorder that affects movement. It usually appears after the age of 60. It is commonly known for tremors, but people may also experience stiffness and slow movement. Symptoms usually appear gradually and may be missed at first. 



Epidemiology shows that Parkinson's disease is the second most common neurodegenerative disorder, being only surpassed by Alzheimer's disease. Between 7 and 10 million people worldwide live with this disease. Parkinson's symptoms can include: 

Tremor - usually starts on arms or legs , hand or fingers. In addition, tremors happen even when the body is at rest. 

Slow movement and rigid muscles - over time, Parkinson's disease can slow down movement, making it difficult and time consuming to perform simple tasks. The steps can be made shorter when patients walk, and they can drag their feet while walking. Muscle stiffness can occur anywhere on the body. Rigid muscles can cause pain and limit range of motion. 

Posture and balance - posture can be bent and balance can become a problem. 

Loss of automatic movements - people may have a reduced ability to perform unconscious movements, including blinking, smiling or waving their arms when walking.

Changes in verbal and written language - the patient can speak softly, quickly, involuntarily offend his family, friends or acquaintances, suffer many hesitations before speaking. Speech can become slurred and monotonous, erratic speech. Writing can also change due to changes in fine motor skills. Additional symptoms include decreased facial expressions, dementia or confusion, fatigue, sleep disturbance, depression, cognitive changes, fear, anxiety and urinary problems. Source


Traditional Treatment and Medicines for Parkinson's Disease 


There is currently no cure for Parkinson's disease. Symptoms are treated with lifestyle changes, psychotherapy, medication and, in some cases, surgery. 

Treatments include a balanced and healthy diet, as well as regular exercise. Therapies typically include: physical therapy, occupational therapy and speech therapy, as these methodologies have the potential to increase functionality and, therefore, can improve the overall quality of the patient's life.

Drugs commonly used are those that affect the patient's dopamine levels. They are effective due to the fact that Parkinson's disease is caused by a reduction in dopamine levels. 

When dopamine levels are significantly reduced (60-80%), the cells where dopamine is produced begin to die and symptoms appear. 

As with any medication, there are side effects that can be challenging, especially when used for the long term, as is the case with Parkinson's disease. Some side effects include: nausea, dizziness, loss of appetite, low blood pressure, confusion, uncontrollable movements of the face, arms, legs or trunk (dyskinesia). 

One of the many reasons why Science became interested in CBD as a treatment for Parkinson's disease is this: this treatment helps to relieve symptoms associated with medication. 

Cannabis and Parkinson's Disease 

As with many other medical conditions, there is not enough clinical research to conclusively claim that cannabis is an effective treatment for Parkinson's disease, but there is research going on and the results look promising. 

Regardless of clinical data, many people choose to use cannabis to treat their symptoms and to manage the long-term side effects of using drugs. Some research suggests that CBD may improve the overall quality of life for people with Parkinson's disease. 

In a study published in the Journal of Psychopharmacology in 2014, for a sample of 21 patients, those who were treated with 75 mg to 300 mg of CBD per day reported a significant increase in quality of life. 


Dyskinesia and Cannabis 

Dyskinesia is one of the most common long-term effects developed in some people with Parkinson's disease. It is described as an uncontrollable movement. It can occur in one part of the body, such as an arm or leg, or it can affect the whole body, and manifestations can be as shaking the head or shaking the body. 

Some people are able to manage symptoms without much difficulty, while others find that it causes a significant amount of pain. 

For those who experience painful or difficult to manage symptoms, it can be a challenge to perform the simple physical activities of daily living. In addition, patients generally see that their social lives are profoundly affected. 

The typical treatment for dyskinesia is to change the medication to a slightly different type of medication. 

CBD can be an alternative treatment that has the potential to allow people to take a lower dose of medication and still manage to manage their symptoms. Even if it does not directly affect tremors, it helps to control pain and improve quality of life in general.


CBD oil for Parkinson's disease 

Because Parkinson's disease affects brain's ability to produce dopamine, researchers at the University of Louisville (Kentucky, United States) found that CBD acts as a "reverse agonist" at CPR6 receptors. These receptors are found predominantly in the basal ganglia region of the brain, which affects the body's movement functions. This means that CBD potentially responds within the receptors to provide therapeutic effects against Parkinson's disease symptoms. Any increase in dopamine levels would counteract the steady decrease in dopaminergic neurons experienced by those suffering from Parkinson's disease. Source


THC or CBD for Parkinson's Disease: which is better? 

Due to the fact that THC and CBD affect the body and brain differently, it is often recommended that THC and CBD be used together. Juan Sanchez-Ramos, MD, PhD, a leader in the field of movement disorders and director of the Parkinson Research Foundation, says he encourages his patients to start with a 1: 1 THC / CBD product, if they can. 

He also mentioned that it was necessary to find pure and high quality products.


What is the best dose for Parkinson's disease? 


Doctors who support cannabis use realized that the dosage for patients with Parkinson's disease is not in line with a single approach. 

In his book Cannabis Revealed (2016), Dr. Bonni Goldstein discussed how varied the response of a patient with Parkinson's Disease to cannabis and cannabis therapy is: 

"Several of my Parkinson's disease patients reported the benefits of using different methods and different cannabinoid profiles. Some patients found relief from tremors with inhaled THC and others did not. Some patients found relief from high doses of CBD-rich cannabis taken sublingually. Some patients are using a combination of CBD and THC ... Trials and errors are needed to find out which profile and method of cannabinoids will work best. In the beginning, a low dose and titration is recommended, especially with rich cannabis in THC. (...) " 

If you are concerned about the high association with THC, remember that CBD helps to neutralize the psychoactive substance that THC produces, but it is recommended to start with a lower portion and adjust slowly to find the one that is right for you. (Source) 

For more support, you can request technical information.


Other sources:

Goldstein, B. (2016). Parkinson's Disease. In B. Goldstein, Cannabis Revealed (pp. 206-208). Bonni Goldstein.

Chagas MH, Zuardi AW, Tumas V, et al. Effects of cannabidiol in the treatment of patients with Parkinson's disease: an exploratory double-blind trial. J Psychopharmacol (Oxford). 2014;28(11):1088-98. doi:10.1177/0269881114550355