Does cbd oil work for parkinson& 39

Cannabis and Parkinson’s disease

This is the kind of post that can really get someone in quite a bit of trouble.

Both the legal kind of trouble and the social media type of trouble.

Given the online excitement surrounding a particular video that appeared on the internet last week, however, we thought that it would be useful to have a look at the research that has been done on the medicinal use of Cannabis and Parkinson’s disease.

In addition, we will assess the legal status regarding the medicinal use of Cannabis (in the UK at least).

Cannabis being grown for medicinal use. Source: BusinessWire

This week a video appeared online that caused a bit of interest (and hopefully not too many arrests) in the Parkinson’s community.

Here is the video in question:

The video was posted by Ian Frizell, a 55 year old man with early onset Parkinson’s disease. He has recently had deep brain stimulation (DBS) surgery to help control his tremors and he has also posted a video regarding that DBS surgery which people might find useful (Click here to see this).

In the video, Ian turns off his DBS stimulator and his tremors quickly become apparent. He then ‘self medicates’ with cannabis off camera and begins filming again some 20-30 minutes later to show the difference. The change with regards to his tremor are very clear and quite striking.

Here at the SoPD, we find the video very interesting, but we have two immediate questions:

  1. How is this reduction in tremors working?
  2. Would everyone experience the same effect?

We have previously seen many miraculous treatments online (such as coloured glasses controlling dyskinesias video from a few years ago) which have failed when tested under controlled conditions (the coloured glasses did not elicit any effect in the clinical setting – click here to read more). Some of these amazing results can simply be put down to the notorious placebo effect (we have previously discussed this in relation to Parkinson’s disease – click here to read the post), while others may vary on a person to person basis.

Thus, while we applaud Mr Frizell for sharing his finding with the Parkinson’s community, we are weary that the effect may not be applicable to everyone. For this reason, we have made a review of the scientific literature surrounding Cannabis and Parkinson’s disease.

What exactly is Cannabis?

Drawings of the Hemp plant, from Franz Eugen Köhler’s ‘Medizinal-Pflantzen’. Source: Wikipedia

Cannabis (also known as marijuana) is a family of flowering plants that can be found in three types: sativa, indica, and ruderalis. Cannabis is widely used as a recreational drug, behind only alcohol, caffeine and tobacco in its usage. It typically consumed as dried flower buds (marijuana), as a resin (hashish), or as various extracts which are collectively known as hashish oil.

While the three varieties of cannabis (sativa, indica, and ruderalis) may look very similar, pharmacologically they have very different properties. Cannabis sativa is often reported to cause a “spacey” or heady feeling, while Cannabis indica causes more of a “body high”. Cannabis ruderalis, by contrast, is less well used due to its low Tetrahydrocannabinol levels.

What is Tetrahydrocannabinol?

Tetrahydrocannabinol (or THC) is one of the principle psychoactive components in Cannabis. It a chemical that is believed to be a plant defensive mechanism against herbivores. THC is a cannabinoid, a type of chemical that attaches to the cannabinoid receptors in the body, and it is this pathway that many scientists are exploring for future neuroprotective therapies for Parkinson’s disease (For a good review on the potential cannabinoid-based therapies for Parkinson’s disease, click here).

A second type of cannabinoid is Cannabidiol (or CBD). CBD is considered to have a wider scope for potential medical applications. This is largely due to clinical reports suggesting reduced side effects compared to THC, in particular a lack of psychoactivity.

So what research has been done regarding Cannabis and Parkinson’s disease?

In 2004, a group of scientists in Prague (Czech Republic) were curious to determine cannabis use in people with Parkinson’s disease, so they conducted a study and published their results:

Title: Survey on cannabis use in Parkinson’s disease: subjective improvement of motor symptoms.
Authors: Venderová K, Růzicka E, Vorísek V, Visnovský P.
Journal: Mov Disord. 2004 Sep;19(9):1102-6.
PMID: 15372606

The researchers posted out 630 questionnaires to people with Parkinson’s disease in Prague. In total, 339 (53.8%) completed questionnaires were returned to them. Of these, 85 people reported Cannabis use (25.1% of returned questionnaires). They usually consumed it with meals (43.5%), and most of them were taking it once a day (52.9%).

After consuming cannabis, 39 responders (45.9%) described mild or substantial alleviation of their Parkinson’s symptoms in general, 26 (30.6%) improvement of rest tremor, 38 (44.7%) alleviation of rigidity (bradykinesia), 32 (37.7%) alleviation of muscle rigidity, and 12 (14.1%) improvement of L-dopa-induced dyskinesias.

Importantly, half of the people who consumed cannabis experience no effect on their Parkinson’s disease features, and four responders (4.7%) reported that cannabis actually worsened their symptoms. So while this survey suggested some positive effects of cannabis in the treatment of Parkinson’s disease, it is apparent that the effect is different between people.

Additional surveys have been conducted around the world, with similar results (Click here to read more on this).

Have there been any clinical trials?

In the 1990s, there was a very small clinical study of cannabis use as a treatment option for Parkinson’s disease, and this study failed to demonstrate any positive outcome. In the study, none of the 5 people with Parkinson’s disease experienced any effect on their Parkinson’s motor features after a week of smoking cannabis (click here for more on this).

This study was followed up by a larger study:

Title: Cannabis for dyskinesia in Parkinson disease: a randomized double-blind crossover study.
Authors: Carroll CB, Bain PG, Teare L, Liu X, Joint C, Wroath C, Parkin SG, Fox P, Wright D, Hobart J, Zajicek JP.
Journal: Neurology. 2004 Oct 12;63(7):1245-50.
PMID: 15477546

In this randomized, double-blind, placebo-controlled study, 19 people with Parkinson’s disease randomly received either oral cannabis extract or a placebo (twice daily) for 4 weeks. They then took no treatment for an intervening 2-week ‘washout’ period, before they were given the opposite treatment for 4 weeks (so if they received the cannabis extract during the first 4 weeks, they would be given the placebo during the second 4 weeks). In all cases, the participants and the researchers were ‘blind’ to (unaware of) which treatment was being given.

The results indicated that cannabis was well tolerated by all of the participants in the study, but that it had no pro- or anti-Parkinsonian actions. The researchers found no evidence for a treatment effect on levodopa-induced dyskinesia.

In addition to this study, there has been a recent double-blind clinical study of cannabidiol (CBD, mentioned above) in the treatment of Parkinson’s disease:

Title: Effects of cannabidiol in the treatment of patients with Parkinson’s disease: an exploratory double-blind trial.
Authors: Chagas MH, Zuardi AW, Tumas V, Pena-Pereira MA, Sobreira ET, Bergamaschi MM, dos Santos AC, Teixeira AL, Hallak JE, Crippa JA.
Journal: J Psychopharmacol. 2014 Nov;28(11):1088-98.
PMID: 25237116

The Brazilian researchers who conducted the study took 21 people with Parkinson’s disease and assigned them to one of three groups which were treated with placebo, small dose of CBD (75 mg/day) or high dose of CBD (300 mg/day). They found that there was no positive effects by administering CBD to people with Parkinson’s disease, except in their self-reported measures on ‘quality of life’.

So what does all of this mean?

Firstly, let us be clear that we are not trying to discredit Mr Frizell or suggest that what he is experiencing is not a real effect. The video he has uploaded suggests that he is experiencing very positive benefits by consuming cannabis to help treat his tremors.

Having said that, based on the studies we have reviewed above we (here at the SoPD) have to conclude that the clinical evidence supporting the idea of cannabis as a treatment for Parkinson’s disease is inconclusive. There does appear to be some individuals (like Mr Frizell) who may experience some positive outcomes by consuming the drug, but there are also individuals for whom cannabis has no effect.

One of the reasons that cannabis may not be having an effect on everyone with Parkinson’s disease is that many people with Parkinson’s disease actually have a reduction in the cannabis receptors in the brain (click here for more on this). This reduction is believed to be due to the course of the disease. If there are less receptors for cannabis to bind to, there will be less effect of the drug.

Ok, but how might cannabis be having a positive effect on the guy in the video?

Cannabis is known to cause the release of dopamine in the brain – the chemical classically associated with Parkinson’s disease (Click here and here for more on this). Thus the positive effects that Mr Frizell is experiencing may simply be the result of more dopamine in his brain, similar to taking an L-dopa tablet. Whether enough dopamine is being released to explain the full effect is questionable, but this is still one possible explanation.

There could be questions regarding the long term benefits of Mr Frizell’s cannabis use, as long term users of cannabis generally have reduced levels of dopamine being released in the brain (Click here for more on this). Although the drug initially causes higher levels of dopamine to be released, over time (with long term use) the levels of dopamine in the brain gradually reduce.

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I live in the UK. Is it legal for me to try using Cannabis for my Parkinson’s disease?

National status on Cannabis possession for medical purposes. Source: Wikipedia

The map above is incorrect, with regards to the UK at least (and may be incorrect for other regions as well).

According to the Home Office, it is illegal for UK residents to possess cannabis in any form (including medicinal).

Cannabis is illegal to possess, grow, distribute or sell in the UK without the appropriate licences. It is a Class B drug, which carries penalties for unlicensed dealing, unlicensed production and unlicensed trafficking of up to 14 years in prison (Source: Wikipedia; and if you don’t trust Wikipedia, here is the official UK Government website).

In 1999, a major House of Lords inquiry made the recommendation that cannabis should be made available with a doctor’s prescription. The government of the U.K., however, has not accepted the recommendations. Cannabis is not recognised as having any therapeutic value under the law in England and Wales.

Having said all of this, there has recently been an all-party group calls for the legalisation regarding cannabis for medicinal uses to be changed (click here for more on this). Whether this will happen is yet to be seen.

So the answer is “No, you are not allowed to use cannabis to treat your Parkinson’s disease”.

(And here is where things get a really grey)

There is a cannabis-based product – Sativex – which can be legally prescribed and supplied under special circumstances. Sativex is a mouth spray developed and manufactured by GW Pharmaceuticals in the UK. It is derived from two strains of cannabis leaf and flower, cultivated for their controlled proportions of the active compounds
THC and CBD.

In 2006, the Home Office licensed Sativex so that:

  • Doctors could privately prescribe it (at their own risk)
  • Pharmacists could possess and dispense it
  • Named patients with a prescription could possess

In June 2010 the Medicines Healthcare Regulatory products Agency (MHRA) authorised Sativex as an extra treatment for patients with spasticity due to Multiple Sclerosis (MS). Importantly, doctors can also prescribe it for other things outside of the authorisation, but (again) this is at their own risk.

EDITORIAL NOTE: Given that possessing cannabis is illegal and that more research into the medicinal benefits of cannabis for Parkinson’s disease is required, we here are the SoPD can not endorse the use of cannabis for treating Parkinson’s disease.

While we are deeply sympathetic to the needs of many individuals within the Parkinson’s community and agree with a reconsideration of the laws surrounding the medicinal use of cannabis, we are also aware of the negative consequences of cannabis use (which can differ from person to person).

If a person with Parkinson’s disease is considering a change in their treatment regime for any reason, we must insist that they first discuss the matter with their trained medical physician before undertaking any changes.

The information provided here is strictly for educational purposes only.

The banner for today’s post was sourced from the IBTimes.

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Published by Simon

I am the Deputy Director of Research at the Cure Parkinson’s Trust. Before that I was working as a Parkinson’s research scientist at the University of Cambridge where I conducted both clinical- and lab-based research on Parkinson’s. I have worked in the Parkinson’s research field for over 15 years – both academically and in biotech ventures. In addition, I am the president of my local Parkinson’s UK support branch in North Hertfordshire. All of my views/opinions expressed here are solely my own, and may not reflect the views of my employer or associated parties. View all posts by Simon

14 thoughts on “ Cannabis and Parkinson’s disease ”

There is vastly more research on cannabis for Parkinson’s than you suggest.

My apologies for the length of this comment but I hope it is helpful.

Cannabinoid–Dopamine Interaction in the Pathophysiology and Treatment of CNS
Disorders (full – 2010)
Enhancement of endocannabinoid signaling by fatty acid amide hydrolase inhibition: a
neuroprotective therapeutic modality. (full – 2010)
Loss of cannabinoid CB1 receptor expression in the 6-hydroxydopamine-induced
nigrostriatal terminal lesion model of Parkinson’s disease in the rat. (full – 2010)
Cannabinoids and Dementia: A Review of Clinical and Preclinical Data
(link to PDF – 2010)
The effects of cannabinoid drugs on abnormal involuntary movements in dyskinetic and
non-dyskinetic 6-hydroxydopamine lesioned rats. (abst – 2010)
In vivo type 1 cannabinoid receptor mapping in the 6-hydroxydopamine lesion rat model
of Parkinson’s disease. (abst – 2010)
Cannabinoid receptor agonist protects cultured dopaminergic neurons from the death by
the proteasomal dysfunction. (full – 2011)
Is lipid signaling through cannabinoid 2 receptors part of a protective system?
(full – 2011)
Prospects for cannabinoid therapies in basal ganglia disorders. (full – 2011)
Symptom-relieving and neuroprotective effects of the phytocannabinoid D(9) -THCV in
animal models of Parkinson’s disease (full – 2011)

Cannabinoid Receptor Type 1 Protects Nigrostriatal Dopaminergic Neurons against
MPTP Neurotoxicity by Inhibiting Microglial Activation. (full – 2011)
Cannabinoid receptor signalling in neurodegenerative diseases: a potential role for
membrane fluidity disturbance. (full – 2011)
Endocannabinoid hydrolysis generates brain prostaglandins that promote
neuroinflammation (full – 2011)
Therapeutic Potential of Cannabinoids in the Treatment of Neuroinflammation
Associated with Parkinson’s Disease (abst – 2011)
Regional changes in type 1 cannabinoid receptor availability in Parkinson’s disease in
vivo (abst – 2011)
Neuropathology of sporadic Parkinson disease before the appearance of parkinsonism:
preclinical Parkinson disease. (abst – 2011)
Homeostatic changes of the endocannabinoid system in Parkinson’s disease.
(abst – 2011)
Increased vulnerability to 6-hydroxydopamine lesion and reduced development of
dyskinesias in mice lacking CB1 cannabinoid receptors (abst – 2011)
The dynamic nature of type 1 cannabinoid receptor (CB1) gene transcription
(full – 2012)
The Therapeutic Potential of Cannabis and Cannabinoids (full – 2012)
Cannabinoid modulation of neuroinflammatory disorders. (full – 2012)
Review article: The endocannabinoid system in normal and pathological brain ageing
(full – 2012)
The cannabinoid agonist WIN55212-2 decreases l-DOPA-induced PKA activation and
dyskinetic behavior in 6-OHDA-treated rats. (full – 2012)
Cannabinoids and value-based decision making: implications for neurodegenerative
disorders. (full – 2012)
The decrease of dopamine D(2)/D(3) receptor densities in the putamen and nucleus
caudatus goes parallel with maintained levels of CB(1) cannabinoid receptors in
Parkinson’s disease: A preliminary autoradiographic study with the selective dopamine
D(2)/D(3) antagonist [(3)H]raclopride and the novel CB(1) inverse agonist
[(125)I]SD7015. (full – 2012)
Targeting the endocannabinoid system with cannabinoid receptor agonists:
pharmacological strategies and therapeutic possibilities (full – 2012)
Δ(9) -THC exerts a direct neuroprotective effect in a human cell culture model of
Parkinson’s disease. (abst – 2012)
Contribution of genetic variants to pain susceptibility in Parkinson disease.
(abst – 2012)
Evaluation of the role of striatal cannabinoid CB1 receptors on movement activity of
parkinsonian rats induced by reserpine. (full – 2013)
Striatal Molecular Signature of Subchronic Subthalamic Nucleus High Frequency
Stimulation in Parkinsonian Rat. (full – 2013)
Temporal changes of CB1 cannabinoid receptor in the basal ganglia as a possible
structure-specific plasticity process in 6-OHDA lesioned rats. (full – 2013)
The Influence of Cannabinoids on Generic Traits of Neurodegeneration. (full – 2013)
Cannabidiol attenuates catalepsy induced by distinct pharmacological mechanisms via 5-
HT1A receptors activation in mice. (full – 2013)
A spontaneous deletion of α-Synuclein is associated with an increase in CB1 mRNA
transcript and receptor expression in the hippocampus and amygdala: Effects on alcohol
consumption (full – 2013)
Natural Cannabinoids Improve Dopamine Neurotransmission and Tau and Amyloid
Pathology in a Mouse Model of Tauopathy. (link to PDF – 2013)
Therapeutic Potential of Cannabinoids in Neurodegenerative Disorders: A Selective
Review. (abst – 2013)
Δ9-Tetrahydrocannabinol is protective through PPARγ dependent mitochondrial
biogenesis in a cell culture model of Parkinson’s Disease
(abst – 2013)
Oleoylethanolamide reduces L-DOPA-induced dyskinesia via TRPV1 receptor in a
mouse model of Parkinson´s disease. (abst – 2013)
The combination of oral L-DOPA/rimonabant for effective dyskinesia treatment and
cytological preservation in a rat model of Parkinson’s disease and L-DOPA-induced
dyskinesia. (abst – 2013)
L-DOPA-treatment in primates disrupts the expression of A(2A) adenosine-CB(1)
cannabinoid-D(2) dopamine receptor heteromers in the caudate nucleus.
(abst – 2013)
The endocannabinoid system: a putative role in neurodegenerative diseases.
(full – 2014)
The CB1 cannabinoid receptor agonist reduces L-DOPA-induced motor fluctuation and
ERK1/2 phosphorylation in 6-OHDA-lesioned rats. (full – 2014)
Endocannabinoid signalling and the deteriorating brain. (full – 2014)
Cannabinoids: New Promising Agents in the Treatment of Neurological Diseases
(full – 2014)
Activation of PPAR gamma receptors reduces levodopa-induced dyskinesias in 6-OHDAlesioned
rats. (full – 2014)
Medical Cannabis Research, What the Science Says (article – 2014)
L-DOPA disrupts adenosine A2A-cannabinoid CB1-dopamine D2 receptor heteromer
cross-talk in the striatum of hemiparkinsonian rats: Biochemical and behavioral studies.
(abst – 2014)
Cannabidiol Normalizes Capase 3, Synatophsin, and Mitochondrial Fission Protein
DNM1L Expression Levels in Rats with Brain Iron Overload: Implications for
Neuroprotection (abst – 2014)
Genome-wide microarray analysis identifies a potential role for striatal retrograde
endocannabinoid signaling in the pathogenesis of experimental l-DOPA-induced
dyskinesia (abst – 2014)
Cannabis (Medical Marijuana) Treatment for Motor and Non-Motor Symptoms of
Parkinson Disease: An Open-Label Observational Study. (abst – 2014)
Cannabidiol can improve complex sleep-related behaviours associated with rapid eye
movement sleep behaviour disorder in Parkinson’s disease patients: a case series.
(abst – 2014)
The monoacylglycerol lipase inhibitor JZL184 is neuroprotective and alters glial cell
phenotype in the chronic MPTP mouse model. (abst – 2014)
Effects of cannabidiol in the treatment of patients with Parkinson’s disease: An
exploratory double-blind trial. (abst – 2014)
Identification of CB2 receptors in human nigral neurons that degenerate in Parkinson’s
disease. (abst – 2014)
Self-Reported Efficacy of Cannabis and Other Complementary Medicine Modalities by
Parkinson’s Disease Patients in Colorado (full – 2015)
Promising cannabinoid-based therapies for Parkinson’s disease: motor symptoms to
neuroprotection. (full – 2015)

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Coordinated Regulation of Synaptic Plasticity at Striatopallidal and Striatonigral Neurons
Orchestrates Motor Control (full – 2015)
Increasing levels of the endocannabinoid 2-AG is neuroprotective in the 1-methyl-4-
phenyl-1,2,3,6-tetrahydropyridine mouse model of Parkinson’s disease.
(full – 2015)
The therapeutic potential of cannabinoids for movement disorders. (full – 2015)
Endocannabinoid Signaling in Motivation, Reward, and Addiction: Influences on
Mesocorticolimbic Dopamine Function. (full – 2015)
Cannabinoid-dopamine interactions in the physiology and physiopathology of the basal
ganglia. (full – 2015)
Cannabinoids and Tremor Induced by Motor-related Disorders: Friend or Foe?
(full – 2015)
Detection of cannabinoid receptors CB1 and CB2 within basal ganglia output neurons in
macaques: changes following experimental parkinsonism (link to PDF – 2015)
Potential of the cannabinoid CB2 receptor as a pharmacological target against
inflammation in Parkinson’s disease. (abst – 2015)
The role of cannabinoids and leptin in neurological diseases. (abst – 2015)
Differential upregulation of the cannabinoid CB2 receptor in neurotoxic and
inflammation-driven rat models of Parkinson’s disease. (abst – 2015)
Neuroprotective Effect of JZL184 in MPP+-Treated SH-SY5Y Cells Through CB 2
Receptors. (abst – 2015)
N-Palmitoylethanolamine and Neuroinflammation: a Novel Therapeutic Strategy of
Resolution. (abst – 2015)
Cannabinoids for the Treatment of Movement Disorders. (abst – 2015)
Cannabinoids in Neurodegenerative Disorders and Stroke/Brain Trauma: From
Preclinical Models to Clinical Applications. (abst – 2015)
Endocannabinoids and Neurodegenerative Disorders: Parkinson’s Disease, Huntington’s
Chorea, Alzheimer’s Disease, and Others. (abst – 2015)
Dopamine-dependent CB1 receptor dysfunction at corticostriatal synapses in
homozygous PINK1 knockout mice. (abst – 2015)
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 Parkinson’s disease (abst – 2015)
THC exerts neuroprotective effect in glutamate affected murine primary mesencephalic
cultures and neuroblastoma N18TG2 cells (abst – 2015)
Modulation of cellular redox homeostasis by the endocannabinoid system.
(full – 2016)
Delta-9-tetrahydrocannabinol protects against MPP+ toxicity in SH-SY5Y cells by
restoring proteins involved in mitochondrial biogenesis. (full – 2016)
Targeting the cannabinoid CB2 receptor to attenuate the progression of motor deficits in
LRRK2-transgenic mice. (abst – 2016)
Reversal effect of simvastatin on the decrease in cannabinoid receptor 1 density in 6-
hydroxydopamine lesioned rat brains. (abst – 2016)
Upregulation of the cannabinoid CB2 receptor in environmental and viral inflammationdriven
rat models of Parkinson’s disease. (abst – 2016)
Fatty acid amide hydrolase inhibition for the symptomatic relief of Parkinsons disease.
(abst – 2016)
Endocannabionoid System in Neurological Disorders. (abst – 2016)
The bright side of psychoactive substances: cannabinoid-based drugs in motor diseases.
(abst – 2016)
Co-administration of cannabidiol and capsazepine reduces L-DOPA-induced dyskinesia
in mice: Possible mechanism of action (abst – 2016)
Type-2 cannabinoid receptors in neurodegeneration. (abst – 2016)
Cannabinoid Type 2 (CB2) Receptors Activation Protects against Oxidative Stress and
Neuroinflammation Associated Dopaminergic Neurodegeneration in Rotenone Model of
Parkinson’s Disease. (abst – 2016)
CB2 receptor activation prevents glial-derived neurotoxic mediator production, BBB
leakage and peripheral immune cell infiltration and rescues dopamine neurons in the
MPTP model of Parkinson’s disease. (abst – 2016)

Enhanced levels of endogenous cannabinoids in the globus pallidus are associated with a
reduction in movement in an animal model of Parkinson’s disease (abst – 2000)
Control of the cell survival/death decision by cannabinoids. (abst – 2001)
Experimental parkinsonism alters endocannabinoid degradation: implications for striatal
glutamatergic transmission. (full – 2002)
US Patent 6630507 – Cannabinoids as antioxidants and neuroprotectants (full – 2003)
(Assignee (owner)- the US GOVERNMENT!)
Future of Cannabis and Cannabinoids in Therapeutics (link to PDF – 2003)
Therapeutic potential of cannabinoids in CNS disease. (abst – 2003)
Cannabis trial on Parkinson’s (news – 2003)
Survey on cannabis use in Parkinson’s disease: subjective improvement of motor
symptoms. (abst – 2004)
Marijuana Compounds May Aid Parkinson’s Disease (news – 2004)
Depression in Parkinson’s disease is related to a genetic polymorphism of the
cannabinoid receptor gene (CNR1) (full – 2005)
Cannabinoids provide neuroprotection against 6-hydroxydopamine toxicity in vivo and in
vitro: relevance to Parkinson’s disease. (abst – 2005)
Cannabinoid control of motor function at the basal ganglia. (abst – 2005)
Cannabinoids In Medicine: A Review Of Their Therapeutic Potential (full – 2006)

Anti-dyskinetic effects of cannabinoids in a rat model of Parkinson’s disease: role of CB1
and TRPV1 receptors (full – 2007)
The endocannabinoid system in targeting inflammatory neurodegenerative diseases
(full – forum repost – 2007)
Clinical research Cannabinoids in health and disease (link to PDF – 2007)
Evaluation of the neuroprotective effect of cannabinoids in a rat model of Parkinson’s
disease: importance of antioxidant and cannabinoid receptor-independent properties.
(abst – 2007)
Endocannabinoid-mediated rescue of striatal LTD and motor deficits in Parkinson’s
disease models. (abst – 2007)
Cannabinoids and neuroprotection in motor-related disorders. (abst – 2007)
Comparison Analysis of Gene Expression Patterns between Sporadic Alzheimer’s and
Parkinson’s Disease (abst – 2007)
Marijuana-Like Chemicals Helps Treat Parkinson’s (news – 2007)
Parkinsons’ Helped By Marijuana-Like Chemicals In Brain (news – 2007)
Enhancing Activity Of Marijuana-Like Chemicals In Brain Helps Treat Parkinson’s
Symptoms In Mice (news – 2007)
The importance of the endocannabinoid-system (news – 2007)
Paraquat induces apoptosis in human lymphocytes: protective and rescue effects of
glucose, cannabinoids and insulin-like growth factor-1. (abst – 2008)
The cannabinoid CP55,940 prolongs survival and improves locomotor activity in
Drosophila melanogaster against paraquat: implications in Parkinson’s disease.
(abst – 2008)
LSUHSC research reports new method to protect brain cells from diseases like
Alzheimer’s (news – 2008)
WIN55,212-2, a Cannabinoid Receptor Agonist, Protects Against Nigrostriatal Cell Loss
in the MPTP Mouse Model of Parkinson’s Disease (full – 2009)
Cannabidiol: a promising drug for neurodegenerative disorders? (full – 2009)
The endocannabinoid system as a target for the treatment of motor dysfunction.
(full – 2009)
Cannabidiol for the treatment of psychosis in Parkinson’s disease (abst – 2009)
Medical Marijuana and Parkinson’s Disease (news/ad – 2009)

Hi Peter, thanks for the messages (and all of the links!) and yes, we completely agree: there has been mountains of work in this area. There does appear to be major future potential for derivatives of Cannabinoids in neurodegenerative conditions (not just PD).

In our post, however, we were primarily focusing on the clinical side of things. The bulk of the links you have kindly provided deal mostly with preclinical experiments (on cells in culture or animal models of PD). While we certainly hope that novel future therapies will result from those efforts, in the post we were simply providing a short review of what has been tested on subjects in the clinic. And as we say, the published results appear to be mixed with some people having positive benefits while other experience limited effects.

Thanks very much for contributing! Much appreciated.

Yep, there’s a terrible lack of clinical work on all aspects of medicinal cannabis and cannabinoids, mainly because of its schedule 1 status. That is beginning to change and there are clinical trials going on in Israel, Canada and California. Probably the most promising area for PD is cannabidiol (CBD) which is non-psychoactive, completely safe on all available evidence and easily available in the UK.

Hi there, great write up. I do have to correct your information on Sativex which is, in fact, a full plant extract. Extracts from different strains (High THC/Low CBD Eg: Skunk and High CBD/low THC Eg: Charlottes Web are mixed to produce a 1-1 Balanced THC/CBD ratio. The final product contains all cannabinoids and terpenes etc from the whole plant, plus a bit of alcohol to make it a tincture and peppermint for taste! Then they price it so high, our own NHS cant afford it so any patients who have been able to get it, pay about £8000 per year. The vast majority of our patients (at United Patients Alliance) find it is not strong enough to mange pain properly so have replaced it with herbal cannabis, cheaper and more effectively.

Opps. Thanks for pointing out the error Jon. And for highlighting some of the issues faced by affected folks that we didn’t cover in the post. Much appreciated.

What to Know About Marijuana and Parkinson’s Disease as CAM Therapy

Sarah Jividen, RN, BSN, is a freelance healthcare journalist and content marketing writer at Health Writing Solutions, LLC. She has over a decade of direct patient care experience working as a registered nurse specializing in neurotrauma, stroke, and the emergency room.

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Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey.

People with Parkinson’s disease are becoming more interested in learning how medical marijuana and cannabidiol (CBD) can relieve symptoms associated with the disease. Medical marijuana is a type of complementary and alternative medicine (CAM) that has not traditionally been used in the medical community.

But in recent years, more states have authorized the use of marijuana for both recreational and medicinal use. As a result, Parkinson’s patients are asking their physicians if medical cannabis is an effective treatment for their disease.

Parkinson’s disease is a neurodegenerative disease with no cure, but some studies have shown that medical marijuana helps relieve symptoms. Learn more about the benefits and considerations that come with using marijuana as a therapy for Parkinson’s disease.

Verywell / Michela Buttignol

What Is Medical Marijuana?

Medical marijuana is cannabis that’s prescribed by a physician to treat or provide relief for a medical condition.

There are around 400 chemicals in the cannabis plant, and more than 60 of them are referred to as “cannabinoids.” The “high” marijuana users get is primarily due to the most psychoactive cannabinoid in the plant called tetrahydrocannabinol, or THC.

Cannabinol, or CBD, is the other cannabinoid, which is used in medical marijuana. CBD does not cause a “high” when taken alone and, in fact, moderates the psychoactive effects. Research is being done to determine how medical marijuana can help treat or relieve symptoms of various diseases, including Parkinson’s disease.

How Does Medical Marijuana Affect the Body?

Marijuana affects the body through neurotransmitters, which are the chemical messengers of the nervous system.

Various factors can stimulate neurotransmitter activity, initiating a set of physiological responses. In cannabis, it is mainly THC or CBD binding to endocannabinoid receptors that produce new physiological reactions in the body.

The endocannabinoid system (ECS) is one of the most important neurotransmitter systems in the body. It utilizes cannabinoid receptors located throughout the central nervous system (CNS) and peripheral nervous system (PNS). Cannabis works to “turn on” endocannabinoid neurotransmitters through activity at these receptors.

The Endocannabinoid System

The endocannabinoid system is not fully understood. However, experts know that it helps to regulate various body functions such as mood, sleep, memory, appetite, and fertility. While everyone has an ECS, medical cannabis’s direct interactions with it may affect individuals differently.

There are two types of cannabinoids involved in cannabis use:

  • Endocannabinoids are chemical messengers that affect the cannabinoid receptors in humans and animals. “Endo” means produced in the body system.
  • Phytocannabinoids are chemical messengers found in cannabis and hemp plants. “Phyto” refers to plants.

Cannabis and hemp are legally classified based on THC content. Hemp is a plant that contains 0.3% or less THC. Cannabis plants contain more than 0.3% THC.

How THC and CBD Work

Cannabinoids from cannabis activate the ECS by binding to endocannabinoid receptors throughout the brain and body. The two most affected by cannabis are:

  • CB1 receptors: Found in the brain in high levels, they are responsible for marijuana’s psychoactive properties, or the “high” effect.
  • CB2 receptors: Found throughout the body, they affect pain levels and inflammation.

THC strongly activates CB1 receptors, triggering a feeling of euphoria. This activation also increases blood flow to the prefrontal cortex of the brain, which is the area that controls the ability to focus, as well as our motor skills, attention, memory, and decision-making abilities.

THC also interacts with CB2 receptors, providing added analgesic (pain relieving), muscle relaxing, and antiemetic effects (helping with nausea and vomiting).

CBD activates both CB1 and CB2 receptors, although less strongly than THC. Although its CB1 and CB2 receptor activation does not produce a “high,” it has been shown to interact with additional receptors in the body and have calming and anti-inflammatory effects. For this reason, CBD has been used to treat pain, anxiety, and seizures.

Medical Marijuana as a Treatment for Parkinson’s Symptoms

Parkinson’s disease is a disorder of the central nervous system that causes tremors, slow movement, stiffness, and loss of balance. Because marijuana directly affects the central and peripheral nervous systems, scientists have studied the effect of marijuana as a treatment for Parkinson’s symptoms.

A 2020 review of 14 different studies acknowledged evidence that medical marijuana provides a reduction in anxiety, tremors, and involuntary or erratic movements. However, the researchers concluded that there is insufficient evidence to recommend medical marijuana use as part of Parkinson’s treatment.

A 2017 study with patients who used medical marijuana over three months to manage Parkinson’s symptoms found that the treatment improved their symptoms and did not cause major adverse effects.

Other research has shown that medical marijuana may be able to help with some Parkinson’s disease symptoms, including:

    (decreased movement ability)
  • Sleep problems
  • Pain

Cannabis use for patients with Parkinson’s has also been shown to help improve mood, memory, and fatigue.

Talk to Your Physician

The use of medical marijuana remains controversial, and there is no official guidance on its use at present. Though there are studies suggesting potential benefits of medical marijuana for Parkinson’s disease, patients should discuss their treatment options with their physicians and whether medical marijuana is appropriate for them.

Possible Benefits

Medical marijuana use can provide additional benefits for patients with Parkinson’s, including symptom relief for:

  • Anxiety
  • Pain
  • Poor sleep
  • Nausea

Possible Side Effects

As with any medication, there are potential side effects of medical marijuana. Negative effects of medical marijuana use for Parkinson’s can include:

  • Cognitive impairment, such as issues with attention, focus, and memory
  • Increased appetite and weight gain
  • Depression
  • Lung damage (if smoking)
  • Increased heart rate or potential withdrawal symptoms

Drug Interactions

There may also be potential negative interactions that medical marijuana may have with other medications. Check with your physician before taking a medical marijuana product.

How to Use Cannabis for Parkinson’s

There are many ways to use medical marijuana. If you are considering using medical marijuana to treat Parkinson’s symptoms, speak with your physician about the best products and applications for your specific case.

Forms of medical marijuana include:

  • Tinctures
  • Capsules
  • Lozenges
  • Dermal patches
  • Dermal sprays
  • Edibles
  • Vaporizing
  • Smoking


There is no universal marijuana or CBD dosage. Studies are being done to determine how patients respond to the effects of marijuana differently. Longer clinical trials with more patient involvement are needed to establish dosage parameters, so speak to your physician about the right dosing options for you.


Medical marijuana is legal in 36 states and four territories as of May 2021. There are some restrictions regarding THC content in many states.

Recreational marijuana is legal in 18 states, two territories, and the District of Columbia as of July 2021.

Although CBD does not produce a psychedelic effect, it is not legal in all 50 states, even if it’s sourced from hemp containing less than 0.3% THC. The reason is that each state has its own Controlled Substances Act (CSA) that considers CBD to be marijuana in some states.

Considerations Before Buying Marijuana Products

Marijuana is a Schedule 1 drug, meaning that it is a drug with a high potential for abuse and no currently accepted medical use. For that reason, it is still illegal to use in much of the country.

If you are considering using marijuana for medical purposes, there are a few things you need to consider, such as:

  • THC and CBD content levels
  • Published and accessible Certificates of Analysis (CoA), which certify the test results of the product from the manufacturer
  • Organic vs. not
  • Where it’s sourced
  • Methods of consumption

A Word From Verywell

Living with Parkinson’s disease can be challenging and stressful. While there are treatments available to help you manage your symptoms, you may want to discuss the possibility of medical marijuana as part of your treatment plan. Before taking any medication for symptom management, discuss your options with your physician, and whether medical marijuana is appropriate for your disease case.

Frequently Asked Questions

Every state has its own rules and regulations for getting a medical marijuana card. If you live in areas where medical marijuana is legal, you may want to consider the following options:

  • Talk to your primary care physician
  • Find a certified medical marijuana professional in your state
  • Register with your state department if required in your state

Some studies show that CBD can help with tremors and other Parkinson’s disease symptoms. However, more studies are needed. Speak with your physician if you are considering medical cannabis for tremor relief.

Many companies produce CBD oil, and there are no studies available that favor one brand over another. If you are taking CBD oil, it is essential that you follow your physician’s prescription. CBD oil is most commonly taken as a sublingual drop (under the tongue). CBD oil is an alternative for patients who don’t like taking medication in a pill form.

The THC in medical marijuana stimulates neurons that signal the release of dopamine neurotransmitters at higher levels than usual.