Over the past two decades, medical cannabis has become an alternative treatment option for many medical patients across the globe.
While medical studies in this area are by no means complete, there have been many promising findings both in the medical lab and outside of it, which may be indicators of future treatments that could be based on medical cannabis. A disease called Parkinson’s disease has recently moved to the forefront of medical investigation involving medical cannabis treatments.
What is Parkinson’s Disease?
Parkinson’s disease is a neurodegenerative brain disorder that occurs when there is a slow reduction in the amount of dopamine produced in the human brain’s nerve cells. Dopamine is the brain chemical that allows coordinated and smooth muscle movements in the body.
Because the disease affects a person’s movements and begins gradually, and because there is no laboratory test for the disease, it can be difficult to spot early on. Through a thorough examination of a patient’s medical history and repeated neurological exams, most cases can be diagnosed. Parkinson’s disease is not generally diagnosed in younger people; age 60 is the age when it usually begins to affect a patient. For the disease to affect a patient noticeably, 60-80 percent of a patient’s nerve cells must be affected. Early warning signs of Parkinson’s disease include:
- Tremors or shaking
- Small handwriting
- Loss of sense of smell
- Difficulty sleeping
- Moving or walking issues
- Soft or low voice
- Masked face
While Parkinson’s disease is not fatal, complications from it can be, and there is no cure. The goal of treatment is to provide the most high-quality life possible once the disease has been diagnosed.
What are the Symptoms of Parkinson’s Disease?
There are four main stages of Parkinson’s disease, all accompanied by their own symptoms. Stage one involves mild symptoms that do not interfere with normal, everyday activities of patients – tremor and other movement symptoms occur, but only on one side of the body. Changes in posture, walking, and facial expressions may become apparent to friends or family at this stage.
In stage two, tremors and rigidity may appear on both sides of the body, and walking and posture issues are obvious. Daily tasks may become more difficult or take longer, but the patient should still be self-sufficient. Stage three often includes loss of balance and slower movements, possibly with frequent falls. Independence is still possible, but dressing and eating may become more and more difficult at this stage.
In stage four, symptoms of Parkinson’s disease may require help from a walker and help with daily tasks – this usually results in a loss of independence. Help from family, a friend, or a nurse that either visits daily or lives with the patient may now be required. In stage five, leg stiffness may prevent the patient from walking, and require 24-hour nursing care. Although most symptoms of Parkinson’s disease are commonly associated with physical issues, the following non-motor symptoms are also common, particularly in stage five:
- Depression and anxiety
- Issues with focused attention, planning, slow thoughts, language and memory
- Personality changes
- Dementia, hallucinations, or delusions
- Orthostatic hypotension
- Sleep disorders
- Lack of appetite
- Pain and fatigue
- Vision problems
- Excessive sweating
- Sexual issues
- Weight loss or gain
- Impulsive control disorders
What Medical Treatments are Available for Parkinson’s Disease?
Among the types of medical treatment that have been shown to decrease symptoms of Parkinson’s disease are surgery, deep brain stimulation (DBS), and various prescribed medications (most common are carbidopa/levodopa, Sinemet, Azilect, Mirapex, ropinirole, and Requip). In DBS, surgically implanted electrodes in the brain block electrical pulses from nerve cells that cause unwanted movements, stopping tremors and other Parkinson’s disease symptoms.
A doctor may use magnetic resonance imaging (MRI) or computed tomography (CT) scans to identify parts of the brain producing unwanted movements prior to surgery. DBS uses surgical insertion of a neurostimulator (similar in size to a stopwatch or heart pacemaker) which delivers to electrical stimulation to targeted brain areas. DBS usually involves the thalamus, subthalamic nucleus, and the globus pallidus. DBS is used only for patients who do not respond to other medications and treatments, and is an invasive procedure. Medical cannabis could help prevent such a procedure, and provide an option that Parkinson’s disease patients could use in the privacy of their own homes.
How Can Medical Cannabis Help Parkinson’s Disease Patients?
The National Parkinson’s Foundation acknowledges the current medical cannabis investigations occurring for Parkinson’s disease patients, noting that several anecdotal reports show reduced tremors in Parkinson’s patients. “Ride with Larry” is a three-part documentary involving Larry, a man with severe Parkinson’s disease who chose to consume medical cannabis to help with his tremors and other symptoms. Because medical cannabis can interact with neurological cannabinoid receptors (CB1 and CB2), it affects the brain and can calm tremors in some patients.
In general, people with Parkinson’s disease have fewer CB1 receptors than people without it; boosting CB1 receptors with medical cannabis seems to alleviate dyskinesia and reduce tremors. The difficulty of conducting medical cannabis trials for Parkinson’s disease has been and is still affected by national and international laws regarding the use of medical cannabis, as well as the difficulty of conducting a double-blind, placebo controlled trial with medical cannabis. However, some patients are positive that medical cannabis helps their tremors, and have posted videos of the treatment working on websites such as YouTube. In one pilot study, nabilone (a cannabinoid receptor agonist) significantly reduced dyskinesia in seven patients with Parkinson’s disease. Several other studies have shown different results, including tic benefits but no dyskinesia benefits.
A more recent study conducted in Europe has demonstrated that some Parkinson’s patients enjoy both pain relief and improved motor function following medical cannabis treatments. Parkinson’s disease patients in areas of the world where medical cannabis is legal have the option to discuss this form of treatment with their doctors or healthcare professionals if they are not responding to medications or DBS, but more clinical trials are needed to find reliable results for this treatment.