Is Cannabis Effective in Treating Parkinson’s Disease?
What is Parkinson’s Disease?
Its symptoms are so subtle and develop so slowly that it usually takes 5 to 10 years before you even know there’s a problem. Even then, this disease can almost be managed, often for decades, with specialized medications, good self-care, but now, there’s exciting news about the potential benefits of CBD.
More than 100,000 Canadians have Parkinson’s disease, and about 5,000 new cases are discovered every year. Currently there are more than 10 million people worldwide who suffer from the disease. If you’ve recently been diagnosed, you are probably already displaying some symptoms, maybe a slight trembling (tremor) in your hands, legs, or face, or possibly muscle stiffness, coordination problems, or a slowness of movement (bradykinesia). These and other Parkinson’s symptoms indicate that nerve cells (neurons) in a relatively tiny part of your brain called the substantia nigra have started to die off. This results in a drop in dopamine, a nerve chemical that carries the signals that allow your muscles to move quickly and smoothly.
Parkinson’s disease usually occurs between the ages of 55 and 70, and men get it slightly more often than women. Up to 10% of those afflicted, however are under age 40—and have what’s called “young onset” Parkinson’s. But whether your symptoms start when you’re young or old, what causes Parkinson’s remains a mystery.
One theory is that naturally occurring oxygen molecules called free radicals damage nerve cells in the brain. Research has shown that some Parkinson’s patients have a 30% to 40% decrease in an enzyme called complex I, which normally controls its free radical onslaught. Genetic factors are occasionally involved as well. If you have a close relative with Parkinson’s disease, your chances of getting it are three times greater than someone without a family link. It’s also possible that exposure to herbicides and pesticides plays a role.
Whether you’ve had Parkinson’s for years or have just found out your diagnosis, the outlook is good. Among the degenerative disease of the nervous system, Parkinson’s is one of the most treatable. Symptoms do get worse over time as dopamine steadily decreases, but many individuals go on to live full, active lives.
Although there isn’t a definitive test for Parkinson’s disease, neurologists have little trouble recognizing it once symptoms have progressed beyond the earliest stages. Often symptoms are so mild at first, people don’t bother to call their doctors. It’s unfortunate because early treatment can make a difference in how you function.
The goals of Parkinson’s treatment are to relieve your symptoms and effectively balance the challenge of the disease with the often-troubling side effects of the medications. Treatment is extremely individualized, and as the disease progresses you’ll need to work closely with a neurologist to customize a program for you. So far, Parkinson’s can’t be prevented or cured.
The main treatment for Parkinson’s is a drug called levodopa, which is converted in the brain to muscle-controlling dopamine. It’s most effective against rigidity and slowness. Most levodopa preparations include the drug carbidopa. It helps levodopa work more efficiently, and it also helps reduce nausea or other side effects. The drawback to levodopa is that the “honeymoon” usually only lasts five years on average. After that, it may gradually stop working.
Another drug, catechol-O-methyltransferase (COMT) inhibitors, are taken along with levodopa to block a liver enzyme that breaks down levodopa before it reaches your brain. These drugs, which include entacapone not only prolong the effects of levodopa but also allow you to manage on smaller doses of it.
Because levodopa works for only a short time, your doctor may look for ways to delay starting you on it. So, as an initial treatment, some doctors try another class of drugs, the dopamine agonists, which include bromocriptine, pergolide and pramipexole. These mimic the effects of dopamine, and activate certain chemical receptor sites in brain cells to reduce Parkinson’s symptoms.
Your doctor can also choose among a variety of other drugs to control specific Parkinson’s symptoms. For muscle tremors in the early stages, for example, you might need to take an anti-cholinergic drug. To reduce tremor, muscle rigidity and slowness an antiviral drug called amantadine, that’s often prescribed for treating bouts of the flu, may be recommended (it also increases the amount of dopamine in the brain).
CBD and Parkinson’s Disease
Both physicians and people with Parkinson’s are eager to discover how well medical cannabis, a more-natural alternative to traditional medications, can help manage Parkinson’s symptoms. Research has really just begun when it comes to its potential benefits for people with Parkinson’s.
Thus far, many research studies have shown that CBD may help to relieve some of the more debilitating symptoms of Parkinson’s which is extremely good news in view of the fact that traditional medications usually prescribed for Parkinson’s may become less effective over time.
Endorphins are substances that naturally occur in the brain that help to reduce pain. These substances can be boosted naturally by exercise and are often referred to as the brain’s natural opiates, because opioid drugs bind to the same cell receptors as endorphins. Similarly, cannabinoids naturally occur in the brain while the cannabinoids in cannabis have an effect by binding to the receptors for these natural molecules. The chemicals in the brain that are similar to the active agents in cannabis are called endocannabinoids and scientists have studied their role in the nervous system.
Do endocannabinoids play a role in Parkinson’s? Researchers know that they are involved in the brain area called the basal ganglia, which is affected. In studies with laboratory animals, cannabinoids that bind to receptors in the central nervous system have been reported to improve dyskinesias, the involuntary movements that Parkinson’s patients develop. Cannabinoids also have antioxidant and anti-inflammatory effects, which could point to neuroprotective activity. Other studies support this idea, but more research is needed.
A recently published study from Brazil indicated that CBD reduced anxiety and tremors in patients during a simulated public speaking test. Participants who took 300mgs of CBD before giving a speech (public speaking is known to cause anxiety), had less symptoms than a control group who were given a placebo.
Another research investigation into Parkinson’s affects upon the brain’s ability to produce dopamine, researchers Alyssa Laun and Zharo-Hui Sone, at the University of Louisville, Kentucky, discovered that CBD acts as an “inverse agonist” on CPR6 receptors, located predominantly in the basal ganglia region of the brain. This region connects to the cerebral cortex and brainstem and drives body functions such as movement, learning and emotion. Their discovery implies that CBD potentially responds within the receptors and has a therapeutic effect on the symptoms of Parkinson’s. Any increase in dopamine levels would certainly help counteract the steady decline caused by Parkinson’s.
Cannabinoid receptors exist throughout the human body as part of the endocannabinoid system. This system regulates physiological functions such as hunger, mood, memory and sensitivity to pain. These receptors are affected in patients with Parkinson’s disease. In study after study, CBD is providing relief for tremors, insomnia, psychosis, depression, anxiety and pain. For example, another study from the Colorado School of Medicine revealed that CBD provided relief of tremors and insomnia in Parkinson’s patients.
There are numerous medical studies that echo the benefits of CBD and many can be found on the internet with reputable sources. Recently, the Parkinson’s Foundation published a statement to help guide the Parkinson’s community in making informed decisions about using cannabis. Please click “statement” for more specifics.
If you decide that you would like to try treating your Parkinson’s symptoms with cannabis, first please speak with your doctor. Medications for Parkinson’s might interact with cannabis. Also, remember that not all cannabis products are created equal. Even if two products are the same strain, the cannabinoids in them may be different, and have different effects. To get the most consistent dose, stick with the same product. Talk to the experts at Medicanna Express.
Start with a low dose.
As with all medications, start with a low dose and observe the effects. The first step to ascertaining an effective dose is to establish your baseline dosage. Since many Parkinson’s patients report good results with CBD at low doses, start with a minimal dose of approximately 5mg, twice or three times daily. Maintain this baseline dosage for a test period of at least one week noting how you feel and how you think CBD is interacting with your body. After this test period, if you are still not receiving the benefit you expected, then increase your daily dosage minimally every several days until you find a dosage that works optimally for you. However, people with Parkinson’s should especially be aware of side effects such as confusion and low blood pressure that may exacerbate Parkinson’s symptoms.
Because Parkinson’s affects muscle movement, it’s important to stay as strong and fit as you can. Regular exercise is essential because it improves your mobility, balance, and range of motion and keep up your strength. Any physical activity, such as stretching, walking, swimming, or even weight-lifting will not only help you move better but also help build up your endurance. If you’re new to exercise or could simply use some extra motivation, begin by working with a physical therapist who can custom design an exercise plan that will be the most effective for you.
To prevent falls, safety-proof your home. Install handrails along stairways, and grab rails in the shower and next to the toilet. It’s also a good idea to keep electrical cords out of the way. As the disease progresses, carry a cell phone or an emergency call system device with you at all times in case you fall and can’t get up again.
Diet is another self-care cornerstone. If you’re taking L-dopa medications, limit protein to about 12% of total daily calories. More protein than this makes it harder for the levodopa to reach your brain. It’s also important to eat plenty of fibre-rich foods, such as vegetables, fruits and legumes. Fibre prevents constipation, a common symptom of Parkinson’s. Plant foods are also rich in vitamin C and other antioxidant nutrients, which may help curtail nerve-cell damage caused by free radicals. Consider working with a nutritionist.
And don’t forget that a good mental attitude can be just as important as keeping yourself physically healthy. One good way to avoid dwelling on your condition is to take up a hobby. Tasks that involve both the mind and the hands, such as carpentry, knitting, or playing cards, may slow the progression of the disease. Joining a Parkinson’s support group can also be beneficial, not only for you, but also for family members and caregivers.
National Library of Medicine, “Effects of acute cannabidiol administration on anxiety and tremors induced by a Simulated Public Speaking Test in patients with Parkinson’s disease,” by Martins de Faria, Morais Fabricio, Tumas, Castro, Ponti, Hallak, Zuardi, Crippa and Chagas. https://pubmed.ncbi.nlm.nih.gov/31909680/
Biochemical and Biophysical Research Communications, “GPR3 and GPR6, novel molecular targets for cannabidiol,” by Alyssa Laun and Zhao-Hui Song, University of Louisville
The Parkinson’s Foundation, https://www.parkinson.org/living-with-parkinsons
Dementia Care Central, “CBD: A Natural Remedy that Decreases Symptomatic Behaviors of Parkinson’s Disease?” https://www.dementiacarecentral.com/parkinsons/treating/cbd/#:~:text=Studies%20show%20that%20CBD%2C%20a,effect%20from%20THC%20in%20marijuana