Cannabis For Parkinsons Patients With Anxiety And Depression
Along with the struggles of PD also comes a high prevalence of anxiety and depression .
At least half of all Parkinsons patients may suffer from clinical depression at some point during the course of their disease, estimates from the Michael J. Fox Foundation point out, and sometimes depression manifests even before motor symptoms .
Depression in PD is thought to be connected to the neurotransmitter disturbances in that area of the brain, and most specifically with monoamine neurotransmitters.
But low dopamine levels, which are characteristic of PD, also contribute to depression in the form of apathy and a loss of motivation.
Yet in self-reported data collected by the app Strainprint, which helps users of medical marijuana track their symptoms after using different strains, medical cannabis users perceived :
- 50% less depression
- 58% less anxiety and stress
After reviewing the data, there was an association between high CBD /low THC strains and the largest changes in depression ratings.
This information may be used to help those with PD find relief without adding another prescription pill to their daily cocktail.
Another symptom of PD affecting a patients quality of life is their sleep cycle.
Other Treatments For Parkinsons
The primary goals in treating PD are to alleviate symptoms and improve quality of life. Treatment may also prevent disease progression.
If taking marijuana isnt feasible, there are other options available. Numerous types and combinations of conventional medications may also be used. Examples include:
- amantadine , which is used in early stages
Our Position On The Use Of Medical Marijuana And Medicinal Cannabis In Parkinsons
There are many endorsements of cannabinoids for Parkinsons symptoms in the social media. However, the science tells a different story.
Statement of Position
Further research into the efficacy and safety of medicinal cannabis in the treatment of symptoms in Parkinsons disease is necessary before Fight Parkinsons will advocate its use for people with Parkinsons disease.
Medicinal Use of Cannabis
The two main active ingredients used for medical care are tetrahydrocannabinoids or THC and cannabidiol or CBD. Both are referred to as cannabinoids. THC is the part that produces the high favoured by recreational users of cannabis and may have benefits in reducing nausea. CBD produces no highand may be used to treat pain inflammatory conditions and seizures. Generally, the use of either form of medicinal cannabis is for symptom relief and is not a cure.
The Evidence Base for Medicinal Cannabis
Many people with a range of serious conditions such as cancer have reported symptom benefits from cannabis or medical marijuana. A review of current scientific research suggested there was reasonable evidence that cannabinoids can help symptoms of chronic pain and spasticity including that experienced in Multiple Sclerosis. In other conditions, such as in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome use of cannabinoids remains unproven.
Changing Legal Framework
Prescribing of Medicinal Cannabis
References
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Research On The Effects Of Cannabinoids On Parkinsons
A number of studies have been conducted on the effects of CBD on Parkinsons disease. A 2015 study showed that CBD enhances the viability of cells, differentiation, and expression of synaptic proteins and axonal proteins.
Subjects that participated in the study took CBD. It was observed that the CBD helped protect against a decrease in NGF. NGF helps regulate growth and survival of target neurons.
CBD also assists with neuritogenesis. This is the formation of neurites which repairs damaged cells. The loss of neurites kick-starts neurodegenerative diseases. This research was an eye-opener to the possibility CBD in fighting Parkinsons.
A 2014 study tested the efficacy of cannabis in controlling the symptoms of Parkinsons. Twenty-two patients afflicted with Parkinsons were given marijuana. The researchers evaluated the patients 30 minutes after consumption of the medical marijuana. Upon evaluation, it was discovered that the mean score of the Unified Parkinson Disease Rating Scale had a dramatic improvement from 33.1 to 23.2! Motor symptoms, pain, and sleep scores were also significantly improved in the patients. Also, there were no side effects.
References
Neife et al. . The neuroprotection of cannabidiol against MPP+ – induced toxicity in PC12 cells involves trkA receptors, upregulation of axonal and synaptic proteins, neuritogenesis, and might be relevant to Parkinsons disease. Toxicology in vitro 30: 231-240.
Why You Dont Know And What You Should Know About Parkinsons And Cannabinoids
The mythology of marijuana still clouds the science of cannabinoids. Legislation has been passed since 2014 to support the growth, development, sales, and use of industrial hemp, and yet many people are still unaware of the health benefits of cannabinoids.
You may have heard of marijuana being used to combat early signs of Parkinsons and similar diseases. But the popular perception persists that there is something controversial about using marijuana medicinally. This is because people are either not aware of or have not fully grasped the science behind it.
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Fighting Depression And Anxiety Symptoms Caused By Parkinsons Disease
In addition to the typical symptoms of movement disorders, patients with PD often experience psychiatric symptoms such as depression and anxiety. FAAH-related inhibitors can improve depressive symptoms by modulating monoaminergic signaling and improving the function of the hypothalamicpituitaryadrenal axis . For example, some FAAH inhibitors, such as URB597, URB694, and ST4070, can improve blood corticosterone levels under stressful conditions, thus alleviating depression or anxiety . However, the MAGL inhibitor JZL184 increased corticosterone levels, although the MAGL inhibitor had a significant antidepressant effect. The mechanism could be attributed to the removal of the inhibition of synaptic function by astrocytes and restoration of the glutamatergic or GABAergic synapses to normal activity, while MAGL inhibitors also activate mTOR signaling and can promote neurogenesis in brain as well as maintenance of intersynaptic LTD . These mechanisms can alleviate psychiatric symptoms. In addition, since the main effect of MAGL inhibitors is to increase the levels of 2-AG, which mainly activates CB2 receptors and regulates neuroinflammation, they seem to contribute to the improvement of depressive symptoms associated with neuroinflammation. JZL184 has been shown to decrease the levels of inflammatory factors such as IL-6 and TNF- in a lipopolysaccharide-induced neuroinflammation model .
Is Cbd Oil Prescribed For Parkinsons Disease
As mentioned, CBD oil or any other form of medicinal cannabis is not approved by the TGA as a medicine. Doctors can only prescribe it under the TGA Special Access Scheme for certain conditions, and for patients who meet strict criteria. Doctors must also receive approval from the TGA before the patient can receive treatment.
Whether CBD oil is a viable option for patients with Parkinsons is at the discretion of a doctors professionals assessment of a patients symptoms and needs. Researchers believe CBD oil may help reduce anxiety, tremor and brain inflammation that promotes worsening of the disease, but results are mixed on whether CBD oil alone has consistently positive or lasting effects for Parkinsons disease and further clinical trials are needed.
Other ways medicinal cannabis treatments help Parkinsons patients
Some studies indicate that medical cannabis treatments like CBD oil or products combining THC and CBD may help to insomnia, anxiety and depressive symptoms in human and animal trials. Anxiety can appear with Parkinsons disease as a result of the disease itself, or due to the physical and mental hardship of experiencing a chronic and incurable condition.
Nausea and appetite are two other major concerns for Parkinsons patients where medical cannabis may provide benefit. By reducing nausea and promoting appetite the negative impact of the disease on quality of life and other fundamental body functions can be reduced.
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Effects Of Other Cannabinoid Receptors On Parkinsons Disease
TRPV-1 receptors play different roles in different neurons. TRPV-1 receptors, present in striatal dopaminergic neurons in the substantia nigra, are activated to reduce the synthesis and secretion of dopamine in striatal dopaminergic neuron terminals . In contrast, TRPV-1 receptors present in glutamatergic neuronal cells in the substantia nigra, when activated, can instead stimulate dopamine release . CB1 receptor antagonists may also elevate dopamine levels by blocking TRPV-1 receptors on dopaminergic neurons in the nigrostriatal, producing an effect against bradykinesia in PD. Thus, blocking TRPV-1 receptors at the terminals of dopaminergic neurons may have a therapeutic effect in the treatment of PD, but this effect decreases gradually with neuronal death and loss of TRPV-1 receptors due to disease progression .
TRPV-1 receptors can also regulate neuronal function . It was found that capsaicin-activated TRPV-1 inhibits oxidative stress and exerts neuroprotective effects in a 6-OHDA-induced animal model of PD . However, excessive activation of TRPV-1 leads to elevated intracellular Ca2+ levels and disrupts mitochondrial function, which in turn promotes neurotoxicity . Moreover, the TRPV-1 antagonist rimonabant has been shown to promote neuronal cell proliferation in the brain of mice. However, this was not observed in TRPV-1-knockout mice . Therefore, further investigation is needed to clarify whether the effect of TRPV-1 on neuronal cell function is two sided.
Is There Ongoing Or Recent Cannabis Research That Excites You
It is exciting to see all of the cannabis research that is currently being conducted, as in the past the funding was only available to study harms of cannabis. It looks like the time has come for greater understanding and evidence for the applicability of cannabis, along with other botanical medicines, for treating what are generally difficult-to-treat chronic diseases and to provide potential improvements in quality of life!
Expert Voices is a monthly series involving a Q& A with an expert in the Parkinsons space about a specific topic. These topics and questions are curated from a survey in which we ask readers what they want to learn more about from experts. If youd like to submit topics or questions for consideration in a future installment of the series, click here to take the survey.
Parkinsons News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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Parkinsons Foundation Centers Of Excellence And Medicinal Marijuana
The Parkinsons Foundation, in partnership with Northwestern University researchers, studied attitudes about cannabis at 40 Centers of Excellence members of our Global Care Network. To the best of our knowledge, this is the first study to provide data on the practices, beliefs and attitudes of expert PD physicians concerning cannabis use.
The results were interesting: most experts said they knew what cannabis did but disagreed on the details. While there is no general agreement on what the benefits might be for people with PD, the survey confirmed that cannabis is a popular subject within Parkinsons Foundation centers, as 95 percent of neurologists reported people have asked them to prescribe it.
These cannabis study results also included:
- Only 23% of physicians had any formal education on the subject of cannabis , thus 93% of physicians want cannabis taught in medical school.
- Physicians reported that 80% of their people with PD have used cannabis.
- Only 10% of physicians have recommended the use of cannabis to people with PD.
- In terms of memory: 75% of physicians felt that cannabis would have negative effects on short-term memory and 55% felt that cannabis could have negative effects on long-term memory.
- Only 11% of physicians have recommended use of cannabis in the last year.
What Products Are People Using
The most common cannabis-derived product people with Parkinson’s used was CBD oil. People interested in using a cannabis-derived product in the future said this is what they’d consider using.
If the side effects are less than traditional Parkinson’s drugs, then I would want to try cannabis. Person with Parkinson’s who has never used a cannabis-derived product
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Cannabinoids And Parkinsons Disease
Volume 8, Issue 6, 2009
Page: Pages: 8
Abstract
CNS & Neurological Disorders – Drug Targets
Title: Cannabinoids and Parkinsons Disease
Volume: 8Issue: 6
Moises Garcia-Arencibia, Concepcion Garcia and Javier Fernandez-Ruiz
Affiliation:
- Departamento de Bioquimica y Biologia Molecular III, Facultad de Medicina, Universidad Complutense, Ciudad Universitaria s/n, 28040-Madrid, Spain.,Spain
Keywords:Cannabinoids, cannabinoid signaling system, CB1 receptors, CB2 receptors, basal ganglia, motor inhibition, neurodegeneration, neuroprotection, Parkinson’s disease
Cannabis Shown To Relieve Parkinson Disease Symptoms
A recent survey found that patients experienced relief of certain motor and nonmotor symptoms of Parkinson disease from using cannabis.
A recent survey on community perceptions of cannabis use in patients with Parkinson disease found that patients reported cannabis to be effective at reducing symptom severity.
Results also show a lack of knowledge on the different types and administration routes among patients. Researchers said that this is the largest study analyzing the view of patients on cannabis therapy in PD.
The study, published in Journal of Parkinsons Disease, took place in Germany, which in 2017 approved medical cannabis as a therapy for patients with severe symptoms of PD when other therapies were unsuccessful or not tolerable. MC is eligible for reimbursement in these cases.
Although many cannabis products and formulations are available to patients, there is a lack of controlled clinical studies addressing MC effectiveness on PD symptoms. Its also unclear which PD symptoms would be best treated with MC, whether certain cannabis formulations are more effective, or which routes of administration patients would prefer most. Further, the prevalence of MC use and patient opinion on its use for PD symptoms relief are unknowns.
Cannabis users made up 15% of participants, of which 13.9% were regular users, 32.2% were occasional users, and 42.6% had tried it once 11.4% did not answer. Users were on average 5.6 years younger than nonusers.
Reference
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The Challenge Of Regulating Cbd Products
Practically, CBD products can be obtained relatively easily at health food stores and online. They are not considered drugs , and therefore are not regulated by the Food and Drug Administration . This can be very problematic because without FDA oversight:
- There is no assurance that what is stated on the package is what is being sold. For example, even if the bottle says it is pure CBD, the product may contain other chemicals from the cannabis plant, or a higher amount of THC than advertised
- The manufacturing process, which is also not regulated, may introduce contaminants
- There is no assurance that the dosage written on the bottle is correct
- Medication interactions between CBD products and other drugs are not clear to consumers
The FDA is aware of the health claims that are made by manufacturers about various products and issues warnings to companies who market CBD products with unsubstantiated health claims.
Role Of Cannabinoid Receptor 2 Receptors In Parkinsons Disease
CB2 receptor is the second cannabinoid receptor that is discovered in humans . Studies have shown that CB2 receptors are distributed in neurons in the cortex, striatum, amygdala, hippocampus, and VTA . Therefore, activation of CB2 receptors could influence the progression of PD by regulating neurotransmission and neuronal function. Furthermore, some findings have shown that in the brain, CB2 receptors are abundantly distributed in activated astrocytes and microglia . Thus, they have a crucial role in regulating neuroinflammation .
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Cannabinoid Receptor 1 Receptors Activation Influence Parkinsons Disease Progression
In addition to modulating PD through neurotransmission signaling, CB1 receptor activation can also modulate the neurological levels of cytokines to influence the progression of PD.
Modulation of Neuroinflammation by Cannabinoid Receptor 1 Receptors Stimulation
Neuroinflammation is a key pathological factor contributing to PD . Glial cells in the brain and various pro- or anti-inflammatory cytokines are the main factors that regulate neuroinflammation.
Effect of Cannabinoid Receptor 1 Receptors Stimulation on Oxidative Stress in Parkinsons Disease
Oxidative stress levels are maintained at higher levels in the SNpc of the brains of patients with PD . Oxidative stress levels were later assessed by further testing oxidized proteins and lipids in the brain tissue of patients with PD, and it was found that oxidative stress levels may have an impact on the progression of PD . The current findings suggest that oxidative stress can lead to degeneration of nigrostriatal dopamine neurons in the basal ganglia of patients with PD and that a number of factors that contribute to changes in oxidative stress levels are responsible for neuronal damage, such as mitochondrial dysfunction, nitric oxide toxicity, excitotoxicity, and inflammatory responses .
Modulation of Excitotoxicity by Cannabinoid Receptor 1 Receptors Stimulation
Cannabinoid Receptor 1 Receptor Activation Promotes Neurogenesis
The Potential Risks Of Taking Cannabis
Until unambiguous trial results are available, cannabis should be used with great caution in Parkinsons because of its associated risks, including addiction. Cannabis affects thinking and executive function, which are already frequently impaired in those with the condition. It should not be taken as a substitute for dopaminergic and other approved Parkinsons treatments. You should always seek medical advice before taking cannabis in any form.
In many countries, taking cannabis is illegal and may result in imprisonment if you are caught with the drug. It can also impair judgement which presents a real danger when driving or carrying out other hazardous activities.
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Relief For Less Characteristic Symptoms Of Parkinsons Disease
While there is limited evidence that has been gathered evaluating cannabinoid medicine and medical cannabis use as treatment for Parkinsons Disease, there is a wealth of information on the effects of these options on symptoms often experienced by patients with Parkinsons Disease, such as pain and sleep disturbance. According to a post on the Parkinsons Disease Foundation website by Blair Ford, M.D., Descriptions of Parkinsons Disease do not generally include the mention of pain. And yet, when carefully questioned, more than half of all people with Parkinsons disease say that they have experienced painful symptoms and various forms of physical discomfort. There is mounting evidence that cannabis may be useful for some patients in managing chronicpain. Additionally, evidence for relief from symptoms experienced by patients with Parkinsons Disease, such as depression and anxiety, has been discovered with the use of cannabinoid therapy. Cannabis use may also provide relief to patients experiencing nausea and vomiting, potential side effects of certain standard PD medications.