Highlights
- •Cannabis use in PD was not associated with increased self-reported depressive/cognitive symptoms.
- •No link between cannabis use in PD patients and higher reported psychotic events.
- •Cannabis use did not enhance annual Hoehn and Yahr progression in PD patients.
- •Cannabis use did not accelerate the annual levodopa equivalent daily dose increase.
- •The median cannabis dose for PD was 20 g/month with a 10/4 THC/CBD% ratio.
Abstract
Background
Whole-plant medical cannabis (MC) products are widely used for controlling symptoms
associated with Parkinson's disease (PD). Despite its widespread use, few studies
have investigated the long-term impact of MC on the progression of PD or its safety
profile. This study examined the effects of MC on PD in a real-life setting.
Methods
A retrospective case-control study of 152 idiopathic PD patients (mean age 69.1 ± 9.0
years), followed at the Sheba Medical Center Movement Disorders Institute (SMDI) from
2008 to 2022 was conducted. Seventy-six patients who used licensed whole-plant medical
cannabis (MC) for at least a year were compared to a matched group who did not receive
MC in terms of their Levodopa Equivalent Daily Dose (LEDD), Hoehn and Yahr (H&Y) stage,
and cognitive, depressive, and psychotic symptoms.
Results
The median monthly dose of MC was 20 g (IQR: 20–30), with a median Tetrahydrocannabinol
(THC) percentage of 10 (IQR: 9.5–14.15) and a median Cannabidiol (CBD) percentage
of 4 (IQR: 2–10). There were no significant differences between the MC and the control
groups for LEDD or H&Y stage progression (p = 0.90, 0.77, respectively). A Kaplan-Meier
analysis showed no evidence of relative worsening of psychotic, depressive, or cognitive
symptoms reported by patients to their treating physicians over time in the MC group
(p = 0.16–0.50).
Conclusion
Over the 1–3 years of follow-ups, the MC treatment regimens appeared to be safe. MC
did not exacerbate neuropsychiatric symptoms and had no detrimental effects on disease
progression.
Graphical abstract
Graphical Abstract
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Parkinsonism & Related DisordersAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The medical cannabis unit circular no. 106 licenses for cannabis use, Israeli medical cannabis unit (IMCU), Israel ministry of health (MoH).https://www.gov.il/BlobFolder/policy/cn-106-2019/he/files_circulars_cn_CN_106_2019.pdf(March 2013, last updated on January 2022. URL:)Date accessed: January 31, 2022
- Cannabis in Parkinson's disease: the patients' view.J. Parkinsons Dis. 2021; 11: 309-321https://doi.org/10.3233/JPD-202260
- Weeding through the haze: a survey on cannabis use among people living with Parkinson's disease in the US.NPJ Parkinsons Dis. 2021; 7 (Published 2021 Mar 3): 21https://doi.org/10.1038/s41531-021-00165-y
- Cannabis in Parkinson's Disease - the patient's perspective versus clinical trials: a systematic literature review.Neurol. Neurochir. Pol. 2022; 56: 21-27https://doi.org/10.5603/PJNNS.a2022.0004
- Marijuana for Parkinson's disease?.Innov Clin Neurosci. 2019 Jan 1; 16: 33-34
- Does marijuana use cause long-term cognitive deficits?.JAMA. 2002; 287: 2653-2654
- Effects of cannabis use on human behavior, including cognition, motivation, and psychosis: a review.JAMA Psychiatr. 2016; 73: 292-297https://doi.org/10.1001/jamapsychiatry.2015.3278
- Movement disorder society UPDRS revision task force. Movement disorder society-sponsored revision of the unified Parkinson's disease rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results.Mov. Disord. 2008 Nov 15; 23: 2129-2170https://doi.org/10.1002/mds.22340
- A comparison of the two one-sided tests procedure and the power approach for assessing the equivalence of average bioavailability.J. Pharmacokinet. Biopharm. 1987; 15: 657-680https://doi.org/10.1007/BF01068419
- Effects of cannabidiol in the treatment of patients with Parkinson's disease: an exploratory double-blind trial.J. Psychopharmacol. 2014; 28: 1088-1098https://doi.org/10.1177/0269881114550355
- Pros and cons of marijuana in treatment of Parkinson's disease.Cureus. 2019 Jun 3; 11e4813https://doi.org/10.7759/cureus.4813
- Practical considerations in medical cannabis administration and dosing.Eur. J. Intern. Med. 2018; 49: 12-19https://doi.org/10.1016/j.ejim.2018.01.004
Article info
Publication history
Published online: May 04, 2023
Accepted:
April 16,
2023
Received in revised form:
April 9,
2023
Received:
March 3,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
