CBD for Parkinson’s disease: Research on its therapeutic potential

On the occasion of World Parkinson’s Day, we review current research on CBD in this disease. It is important to note that, for the time being, CBD is not a drug for Parkinson’s and that further research is needed to establish its efficacy. We recommend that you consult with your physician before using CBD.

Parkinson’s disease is a neurodegenerative condition whose treatment has begun to include cannabis products. Cannabis oil is the main derivative that has shown good results in clinical practice. These oils are mostly preparations of cannabidiol (CBD) o CBD drops drops for Parkinson’s disease.

Potential therapeutic use of CBD in the treatment of Parkinson’s disease

What is Parkinson’s disease?

Parkinson’s disease is a progressive disease that originates due to decreased dopamine concentrations in the brain, resulting from the loss of dopamine-producing neurons (dopaminergic neurons), as well as the accumulation of certain proteins (Lewy bodies) in the neurons (1).

Parkinson’s disease is characterized by motor and non-motor symptoms (2). Motor symptoms are, for example, tremor, slowness of movement or bradykinesia and body rigidity (3, 4, 5); and non-motor symptoms are hallucinations, depression (6), impaired verbal fluency (7) and cognitive impairment, the latter being associated with a progression to dementia (8).

Because Parkinson’s is a disease of high incidence (9, 10), and for which there is still no cure, continued research into palliative medications such as cannabinoids is critical to its treatment.

Cannabis for the treatment of Parkinson’s disease

With the increasing legalization of cannabis products, many patients with Parkinson’s disease started using cannabis as a treatment. These patients have reported significant improvements in their health status and even a decrease in the use of medications they were taking as treatment for Parkinson’s disease (11).

However, the use of products containing tetrahydrocannabinol (THC) ( Δ-9 tetrahydrocannabinol, the psychoactive cannabinoid in marijuana) is not recommended , as it can lead to psychosis (12), anxiety, euphoria (13), memory impairment and cognitive problems (14).

CBD or cannabidiol, since it has proven to be a good neuroprotectant, represents a great potential treatment for neurodegenerative diseases such as Parkinson’s disease.

How does CBD help Parkinson’s disease?

CBD for the treatment of Parkinson’s disease, either consumed orally through drops of CBD oil drops or airborne, through vaporizer inhalations, could prevent dopamine depletion by protecting dopaminergic neurons from dying (15).

CBD oil has also been shown to have sedative (16) and anti-inflammatory (17) effects , which can help improve the quality of life of patients with this disease.

CBD dosage for Parkinson’s disease used in current studies

The various current studies help to give us an idea about the use of CBD for this disease. A clinical study conducted in Parkinson’s patients showed that CBD improves mobility, communication and decreases body discomfort in Parkinson’s patients treated daily with 300 mg of CBD (18).

Another study reported a decrease in psychotic symptoms when 150 to 400 mg of CBD was added daily to antiparkinsonian therapy without serious side effects in Parkinson’s patients (19).

Finally, in 2020, a research group in the United States set about the task of testing different doses of CBD in patients who were taking different medications that are normally prescribed to treat Parkinson’s disease. Evidence that daily doses of 5 to 20 mg/kg of purified CBD (20) are well tolerated even when patients are taking various antiparkinsonian drugs.

Regarding the frequency of administration, studies conducted with CBD in Parkinson’s patients indicate the amount of CBD daily, but do not specify whether the dose is spread over several doses during the day, or whether the daily dose is taken all at once. Only one of the studies indicates that CBD oil was administered at night.

Parkinson’s medications and CBD

Of all the antiparkinsonian drugs, Levodopa or L-DOPA is the most widely used as it is a precursor of dopamine. Once the drug crosses the blood-brain barrier, it is converted into dopamine to restore the brain’s imbalance of this neurotransmitter.

This drug and some others commonly used for the treatment of this disease were evaluated with the concomitant administration of purified CBD oil. The results showed that CBD is effective and safe at doses less than 20 mg/kg per day. Patients who took 25 mg/kg CBD had adverse effects such as liver enzyme alterations, diarrhea, abdominal pain, fatigue and nausea (20).

Can I take CBD if I take medication for Parkinson’s disease?

You should not use CBD without consulting your doctor, who is the person who will be able to give you a reliable answer to this question, based on the study of your particular case. Generally speaking, it will depend on the medications you are taking.

Cannabinoids may present interactions when consumed simultaneously with certain medications. Although, as mentioned above, according to available studies, coadministration of low doses of CBD with antiparkinsonian drugs does not pose a significant health risk (20). However, it is possible that Parkinson’s patients may be taking other medications with which cannabidiol could interact. For more information you should consult the post about possible interactions between CBD and drugs .

Ultimately, it is recommended to consult a medical specialist to obtain the relevant advice on the convenience of taking cannabidiol, the appropriate doses and the best form of administration.

Remember that not all of us react in the same way to CBD and therefore the dosage is also totally personal. Therefore, when starting a treatment with cannabidiol, start with low doses, and gradually increase the concentration if the professional deems necessary to readjust the dose.

According to available data, in case of taking Parkinson’s medication, it is not recommended to exceed 20 mg/kg of CBD per day.

We strongly recommend that you consult your medical specialist for more information and personalized advice on the treatment and management of Parkinson’s disease before using CBD.

We remind you that this is an informative article that is not intended to prevent, diagnose or treat any disease. Consult your doctor before using CBD. Its content can complement, but never replace, the diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines.

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Referencias

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2. Leite Silva, A. B. R., Gonçalves de Oliveira, R. W., Diógenes, G. P., de Castro Aguiar, M. F., Sallem, C. C., Lima, M. P. P. P., de Albuquerque Filho, L. B., Peixoto de Medeiros, S. D., Penido de Mendonça, L. L., de Santiago Filho, P. C., Nones, D. P., da Silva Cardoso, P. M. M. M., Ribas, M. Z., Galvão, S. L., Gomes, G. F., Bezerra de Menezes, A. R., Dos Santos, N. L., Mororó, V. M., Duarte, F. S., & Dos Santos, J. C. C. (2022). Premotor, nonmotor and motor symptoms of Parkinson’s Disease: A new clinical state of the art. Ageing research reviews, 84, 101834. Advance online publication. https://doi.org/10.1016/j.arr.2022.101834

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Gelb, D. J., Oliver, E., & Gilman, S. (1999). Diagnostic criteria for Parkinson’s disease. Archives of neurology, 56(1), 33-39. https://doi.org/10.1001/archneur.56.1.33

5. Almgren, H., Hanganu, A., Camacho, M., Kibreab, M., Camicioli, R., Ismail, Z., Forkert, N. D., & Monchi, O. (2022). Motor symptoms in Parkinson’s disease are related to the interplay between cortical curvature and thickness. NeuroImage. Clinical, 37, 103300. Advance online publication. https://doi.org/10.1016/j.nicl.2022.103300

6. Macías-García, P., Rashid-López, R., Cruz-Gómez, Á. J., Lozano-Soto, E., Sanmartino, F., Espinosa-Rosso, R., & González-Rosa, J. J. (2022). Neuropsychiatric Symptoms in Clinically Defined Parkinson’s Disease: An Updated Review of Literature. Behavioural neurology, 2022, 1213393. https://doi.org/10.1155/2022/1213393

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9. Titova, N., & Chaudhuri, K. R. (2018). Non-motor Parkinson disease: new concepts and personalised management. The Medical journal of Australia, 208(9), 404-409. https://doi.org/10.5694/mja17.00993

Öksüz, N., Öztürk, Ş., & Doğu, O. (2022). Future Prospects in Parkinson’s Disease Diagnosis and Treatment. Noro psikiyatri arsivi, 59(Suppl 1), S36-S41. https://doi.org/10.29399/npa.28169

11. Kindred, J. H., Li, K., Ketelhut, N. B., Proessl, F., Fling, B. W., Honce, J. M., Shaffer, W. R., & Rudroff, T. (2017). Cannabis use in people with Parkinson’s disease and Multiple Sclerosis: A web-based investigation. Complementary therapies in medicine, 33, 99-104. https://doi.org/10.1016/j.ctim.2017.07.002

12. Murray, R. M., Englund, A., Abi-Dargham, A., Lewis, D. A., Di Forti, M., Davies, C., Sherif, M., McGuire, P., & D’Souza, D. C. (2017). Cannabis-associated psychosis: Neural substrate and clinical impact. Neuropharmacology, 124, 89-104. https://doi.org/10.1016/j.neuropharm.2017.06.018

13. D’Souza, D. C., Perry, E., MacDougall, L., Ammerman, Y., Cooper, T., Wu, Y. T., Braley, G., Gueorguieva, R., & Krystal, J. H. (2004). The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 29(8), 1558-1572. https://doi.org/10.1038/sj.npp.1300496

14. Curran, H. V., Brignell, C., Fletcher, S., Middleton, P., & Henry, J. (2002). Cognitive and subjective dose-response effects of acute oral Delta 9-tetrahydrocannabinol (THC) in infrequent cannabis users. Psychopharmacology, 164(1), 61-70. https://doi.org/10.1007/s00213-002-1169-0

15. Ferreira-Junior, N. C., Campos, A. C., Guimarães, F. S., Del-Bel, E., Zimmermann, P. M. D. R., Brum Junior, L., Hallak, J. E., Crippa, J. A., & Zuardi, A. W. (2020). Biological bases for a possible effect of cannabidiol in Parkinson’s disease. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 42(2), 218-224. https://doi.org/10.1590/1516-4446-2019-0460

16. Zuardi, A. W., Shirakawa, I., Finkelfarb, E., & Karniol, I. G. (1982). Action of cannabidiol on the anxiety and other effects produced by delta 9-THC in normal subjects. Psychopharmacology, 76(3), 245-250. https://doi.org/10.1007/BF00432554

17. Rajesh, M., Mukhopadhyay, P., Bátkai, S., Patel, V., Saito, K., Matsumoto, S., Kashiwaya, Y., Horváth, B., Mukhopadhyay, B., Becker, L., Haskó, G., Liaudet, L., Wink, D. A., Veves, A., Mechoulam, R., & Pacher, P. (2010). Cannabidiol attenuates cardiac dysfunction, oxidative stress, fibrosis, and inflammatory and cell death signalling pathways in diabetic cardiomyopathy. Journal of the American College of Cardiology, 56(25), 2115-2125. https://doi.org/10.1016/j.jacc.2010.07.033

18. Chagas, M. H., Zuardi, A. W., Tumas, V., Pena-Pereira, M. A., Sobreira, E. T., Bergamaschi, M. M., dos Santos, A. C., Teixeira, A. L., Hallak, J. E., & Crippa, J. A. (2014). Effects of cannabidiol in the treatment of patients with Parkinson’s disease: an exploratory double-blind trial. Journal of psychopharmacology (Oxford, England), 28(11), 1088-1098. https://doi.org/10.1177/0269881114550355

19. Zuardi, A. W., Crippa, J. A., Hallak, J. E., Pinto, J. P., Chagas, M. H., Rodrigues, G. G., Dursun, S. M., & Tumas, V. (2009). Cannabidiol for the treatment of psychosis in Parkinson’s disease. Journal of psychopharmacology (Oxford, England), 23(8), 979-983. https://doi.org/10.1177/026988110809651920. Leehey, M. A., Liu, Y., Hart, F., Epstein, C., Cook, M., Sillau, S., Klawitter, J., Newman, H., Sempio, C., Forman, L., Seeberger, L., Klepitskaya, O., Baud, Z., & Bainbridge, J. (2020). Safety and Tolerability of Cannabidiol in Parkinson Disease: An Open Label, Dose-Escalation Study. Cannabis and cannabinoid research, 5(4), 326-336. https://doi.org/10.1089/can.2019.0068

Masha Burelo
Investigadora en cannabinoides | Doctoranda en Neurociencia

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