CBD oil can be effective to manage symptoms of Parkinson’s disease. This article covers current research and highlights the best CBD products according to our team at CFAH. The benefits and research around using CBD and medical marijuana to help treat the symptoms associated with Parkinson’s disease. Medical Marijuana With medical marijuana now legalized in 38 states and the District of Columbia, there is strong interest in its therapeutic properties. Researchers are testing marijuana, which
CBD Oil for Parkinson’s Disease: Can Hemp Oil Help Parkinson’s Patients?
CBD can be a healthy, natural alternative to traditional treatments for Parkinson’s Disease.
Studies show that CBD, or cannabidiol, also referred to as CBD-rich cannabis, may help with managing debilitating symptoms of this condition, including the non-motor ones.
It’s actually possible to live a productive and happy life despite being diagnosed with Parkinson’s. When you take CBD oil, you won’t experience the adverse side effects of prescription medications; you also won’t get the high effect associated with using marijuana. And while traditional treatments may become less effective over time, CBD users are reporting long-lasting benefits.
Of course, we’re not saying CBD is a miracle drug — it’s not even a drug in the first place — but a high-quality CBD oil can improve your daily life as a Parkinson’s patient.
CBD is gaining momentum as a versatile supplement for a wide range of other conditions, including anxiety, epilepsy, pain, sleeping difficulty, or neurodegenerative disorders.
Everybody wants to capitalize on the booming market now, so how do you choose the right product from so many different brands?
This article will help you understand the potential benefits of using CBD oil for Parkinson’s Disease on top of highlighting the best companies whose products actually work.
Parkinson’s Disease Symptoms
Parkinson’s disease (PD) is a neurological condition that impacts a person’s nervous system, usually appearing at the age of 60. In simple words, brain cells that release the neurotransmitter dopamine — which sends messages to the body about the movement — become damaged and start to degenerate.
This causes a variety of motor issues, including but not limited to tremors, lack of facial expression, problems with balance, and stiffness in joints and muscles.
Moreover, Parkinson’s Disease may also lead to the development of Parkinson’s disease dementia (PDD), which compromises one’s cognitive performance, such as the ability to remember things, pay attention, or make decisions.
Some people confuse PDD with Lewy Bodies Dementia (DLB). However, with DLB, cognitive problems appear prior to motor issues. Both diseases are progressive, meaning the symptoms will deteriorate over time, and unfortunately, there’s no treatment that could cure people out of PD.
Initial symptoms of Parkinson’s Disease are mild and may include:
- Lack of facial expression
- Balance issues
- Difficulty sitting or standing
- Slowness of movement (Bradykinesia)
People with Parkinson’s Disease struggle with walking as the disease progresses. There’s even a phenomenon called Parkinsonian gait, which refers to a stooped posture, shuffling of the feet, and limited arm movement.
Other health problems in people with PD include:
- Slurred speech
- Memory loss
- Difficulty maintaining focus
- Impaired judgment
- Visual hallucinations
- Loss of smell
- Trouble swallowing
People with Parkinson’s Disease may also suffer from anxiety, apathy, irritability, depression, pain, and insomnia. As mentioned, many PD patients develop Parkinson’s dementia over time.
Prescription medications to alleviate the symptoms of the disease may be effective, but they tend to lose efficacy over time, requiring larger doses to provide relief — which often leads to adverse side effects such as drowsiness, blurred vision, lightheadedness, nausea, vomiting, diarrhea, dry mouth, heartburn, loss of appetite, and more.
Not to mention the risk of lethal overdose.
It’s no wonder that people with Parkinson’s disease often seek alternative forms of treatment.
Let’s see how CBD could be used for Parkinson’s disease.
How Could CBD Oil Help with Parkinson’s?
While doctors haven’t been using CBD oil for Parkinson’s disease long-term, and research into the benefits of CBD for this condition only began a few decades ago, current findings are very exciting. Studies suggest that CBD may have some positive effects on certain symptoms of Parkinson’s disease, especially when it comes to anxiety, depression, and sleep difficulties.
Common treatments for Parkinson’s Disease can result in medicine-triggered tremors or uncontrolled muscle movements. Continuous use of such medicine could make this symptom even worse. One older and smaller study suggested that CBD may be a possible solution due to its ability to help ease these muscle movements .
A recently published study conducted by Brazilian researchers showed that CBD lowered tremors and anxiety that occurred during a public speaking test for people over 60 with Parkinson’s disease. Participants who took 300 mg of CBD before giving a speech, which is a classic anxiety-inducer, experienced milder symptoms than a control group who took a placebo.
Another study from researchers Alyssa S. Laun and Zhao-Hui Song from the University of Louisville, Kentucky, made a significant discovery a few years ago when they found that CBD is an inverse agonist of the CPR6 receptor found primarily in the basal ganglia area of the brain, which connects to the brainstem and cerebral cortex . This receptor is responsible for many important functions in our bodies, such as movement, emotion processing, and learning. This means that CBD has a strong affinity to this receptor, providing beneficial effects against the symptoms of cerebral palsy and Parkinson’s. Any rise in dopamine levels would counteract the slow decrease of dopaminergic neurons experienced by PD patients.
A small study of 22 people with Parkinson’s found that taking cannabis helped improve pain . However, this study involved medical marijuana, which contains both CBD and THC in various ratios.
However, animal studies have suggested that CBD alone may be effective in reducing pain and inflammation, two symptoms that affect people with PD frequently .
Psychosis is a sort of collateral damage caused by Parkinson’s disease. It can lead to hallucinations, delusions, and delirium. It is more likely to occur during the later stages of the disease and affects up to 50 percent of people with PD .
While antipsychotic medications are available to treat this symptom, some people have wondered if CBD might help too.
According to a 2009 study, the severity of psychosis and its symptoms were reduced in individuals with Parkinson’s disease . More interestingly, CBD also didn’t cause any side effects.
A lack of quality sleep caused by sleep disruption is a serious problem for people with Parkinson’s disease. Vivid dreams or nightmares, as well as an abrupt movement during sleep, can heavily impact your sleep cycles. Studies have found that both cannabis and CBD alone might help with sleep deprivation .
Overall Quality of Life
Researchers have suggested that the many potential benefits of CBD can translate to improved quality of one’s life. This is a major concern for people diagnosed with Parkinson’s Disease, as the condition affects various both physical and mental health.
One study found that people with Parkinson’s disease and no psychiatric symptoms or conditions experienced an improved quality of life while taking CBD . However, this study was conducted in a very small group of people, so further research is needed to draw further conclusions on these findings.
What Does the FDA Say About Using CBD Oil for Parkinson’s?
CBD oil hasn’t been approved by the FDA as a treatment for Parkinson’s disease. In fact, there are no FDA-approved cannabis treatments for this condition as of today. However, the FDA did acknowledge a CBD-based medication, Epidiolex, to treat two types of drug-resistant epilepsy.
Researchers from the University of Colorado are using Epidiolex to analyze its benefits on people with Parkinson’s-triggered tremors. The study is currently in its second stage.
Can You Use CBD Oil as a Prevention for Parkinson’s?
Studies have suggested that CBD may be able to help prevent Parkinson’s disease, but the current data comes only from animal models.
The research also suggests that CBD can do nothing to help treat PD after its onset. Based on this, it may only be useful as a preventive supplement.
However, most clinical trials only use CBD after a person is diagnosed with Parkinson’s disease. This is important because about 60 percent of the dopamine-receptive neurons in the brain are already destroyed by the time a person begins showing the symptoms of their condition.
It’s also difficult to predict who will develop Parkinson’s and who will be more resistant to this disease. There are only a few preventive strategies, and thus far, we don’t know if CBD can help everyone.
How to Administer CBD for Parkinson’s Disease?
If you’re about to use CBD for the first time, you may be wondering how to take it the right way to maximize the benefits for Parkinson’s disease.
You can buy CBD in various forms, including:
- CBD oil (sublingual drops). CBD can be swallowed or absorbed sublingually (beneath the tongue). This is a good option if you don’t like to take capsules and want to precisely measure out your dose. The calming effects of CBD usually take hold around 15-30 minutes after ingestion and may last for up to 6 hours.
- Capsules. This form of CBD is a good option if you’re looking for a premeasured dose of CBD in your supplement. You just take as many capsules as recommended by your physician. The downside of taking CBD capsules is their delayed onset and lower bioavailability since they have to pass through the digestive system before reaching the bloodstream.
- Edibles.CBD-infused is becoming more popular these days. Gummies are by far the most common option. They work in a similar manner to capsules. They usually kick in after 40–120 minutes and last for up to 10 hours. Edibles are a discreet way to deliver a dose of CBD.
- Topicals. Products like lotions and creams may be effective for localized problems because they deliver the CBD to the cannabinoid receptors located in the deeper layer of the skin. From there, CBD can produce its soothing effects on the body, reducing inflammation, stiffness, and pain.
- Vape pens. CBD oils can be mixed with thinners such as vegetable glycerin to be vaporized and inhaled. The effects take hold quickly if you use this route of administration and can deliver more CBD to your system than any of the above methods. However, vaporized CBD will last shorter than it does when you take CBD oil or edibles, usually up to 2-4 hours.
Possible Side Effects of CBD Oil
Most studies have concluded that CBD is a safe and well-tolerated substance. The WHO issued a complete report on the safety and efficacy of cannabidiol, supporting the earlier findings. CBD rarely causes any side effects, and if they do happen, they tend to be mild.
The side effects of CBD oil include:
- Dry mouth
- Changes in appetite
CBD can also interact with prescription and non-prescription medications, so make sure to always consult your doctor before taking CBD, especially if you’re on medications that are metabolized by the Cytochrome P450 system. If your doctor tells you not to eat grapefruit along with your meds, the same rule applies to CBD because they use an identical mechanism, blocking the p450 system from metabolizing the active ingredients in those medications.
Best CBD Oil for Parkinson’s Disease: Our Top Picks in 2022
1. Royal CBD (Best CBD Oil for Parkinson’s Disease)
Get 15% off all Royal CBD products. Use code “CFAH” at checkout.
|Potency||250 mg – 2500 mg|
|Available Flavors||Natural, Berry, Mint, Vanilla|
|CBD per serving||8.3 mg – 83.3 mg|
Why Royal CBD Oil is the Best CBD Oil for Parkinson’s Disease
Royal CBD is a premium brand from Nevada that sells full-spectrum CBD oil from organic hemp. The company was started by a group of cannabis activists to leverage the quality standards for making CBD products in the industry. On top of its best-selling CBD oil, Royal CBD also offers full-spectrum softgels, THC-free gummies, and two types of broad-spectrum topicals.
Royal CBD oil comes in four strengths. Users can choose between 250 mg, 500 mg, 100 mg, and 2500 mg of total CBD. If you have problems holding the natural CBD oil in your mouth, you can pick one of the four flavored options. The 2500 mg is only available in the unflavored variant because adding flavorings would compromise its cannabinoid profile and the efficacy of the entourage effect from other cannabinoids.
The oil contains the full-spectrum of phytochemicals, including CBD, trace cannabinoids, terpenes, and flavonoids that boost the efficacy of cannabidiol. To further enhance the bioavailability of this hemp extract, the guys at Royal CBD have suspended it in food-grade MCT oil from coconut. The addition of MCT oil also brings other benefits to the table, including a stable source of energy for the brain and the presence of heart-healthy essential fatty acids.
I found the 2500 mg potency particularly helpful for non-motor problems like anxiety, irritation, and fatigue. This CBD is also decent at easing pain and inflammation, not to mention that it can last for up to a few months if you benefit from lower doses in your routine.
The entire Royal CBD collection is made from US-grown organic hemp, extracted with supercritical CO2, and rigorously tested in a certified laboratory for potency and purity.
- Made from locally grown organic hemp
- Extracted with supercritical CO2
- Infused with full-spectrum CBD
- Available in 4 strengths and flavors
- Up to 2500 mg of CBD per bottle
- 3rd-party tested for potency and purity
- Great natural flavor
- Not available in local CBD stores (this may soon change)
2. Gold Bee (Best Organic Formula)
|Potency||300 – 1200 mg|
|Available Flavors||Natural, Honey|
|CBD per serving||8.3 mg – 33.3 mg|
About Gold Bee
The “runner up” title in our ranking of the best CBD oils for Parkinson’s Disease belongs to Gold Bee, which is another premium manufacturer from Nevada. This company makes unique CBD oils that are infused with a natural honey flavor, hence the Bee name. The guys at Gold Bee have partnered with their local growers from Colorado to create their own blend of high-CBD strains.
Gold Bee CBD oil comes in four different concentrations, from 300 mg to 1200 mg CBD per bottle. And just like Royal CBD, this brand also uses full-spectrum CBD in its product, so you’re getting the whole hemp goodness from the original plant. When it comes to symptoms like anxiety and problems with focus, I’ve noticed similar results to Royal CBD oil, but I think Gold Bee products are less affordable in the long-run.
Still, these are the best CBD oils for Parkinson’s disease in the mid-potency range.
- Sourced from US-grown organic hemp
- Contains full-spectrum CBD
- Up to 33 mg CBD/mL
- Great potency range for beginners
- Third-party tested for potency and purity
- Great honey flavor
- No high-strength CBD oils
3. CBDPure (Top Transparency)
|Potency||100 – 1000 mg|
|CBD per serving||3.3 – 33 mg/mL|
I highly recommend CBDPure for those who are just starting out with CBD. The strengths of the oils offered by this company are great for beginners. The lowest strength contains 100 mg of CBD, which is perfect if you want to see how taking CBD affects your body. It delivers 3.3 per half a dropper of the oil, so it should be good for managing mild symptoms.
For moderate problems, you can use the higher potencies. These include 300 mg, 600 mg, and 1000 mg of CBD per bottle. The last potency is a standard option for users who already have some experience and their daily dose doesn’t exceed 30 mg.
This brand is a textbook example of transparency. You can easily access the lab reports of their CBD oils and softgels through the company’s website.
- Sourced from organic Colorado-grown hemp
- Extracted with supercritical CO2
- Lab-tested for potency and purity
- 90-day return policy
- Only two forms of CBD available
- Low potency
- Premium pricing
4. Hemp Bombs (Best CBD Isolate)
|Potency||125 – 4000 mg|
|Available Flavors||Natural, Acai Berry, Orange Creamsicle, Peppermint, Watermelon|
|CBD per serving||4 – 133 mg/mL|
About Hemp Bombs
If you’re looking for a company that offers CBD oil made with a broad-spectrum of cannabinoids or based on CBD isolate, Hemp Bombs is by far the best manufacturer on the market. The company specializes in making pure CBD oils in a wide range of potencies, with up to 4000 mg of CBD per bottle.
This CBD oil is a good alternative for people with Parkinson’s disease who don’t want to include any THC into their regime for some reason. Broad-spectrum or isolated CBD can work for you if you’re tested for THC at work, as large doses of full-spectrum CBD oil taken regularly can result in a false-positive result on the screening.
However, those using CBD oils with zero THC should be aware that the synergy from other cannabinoids and terpenes will be either incomplete, or there will be no synergy at all (if using isolate).
- Sourced from organic hemp
- Extracted with CO2
- 0% THC
- Available as broad-spectrum or isolate
- Third-party tested for CBD and contaminants
- Up to 4000 mg of CBD per bottle
- 5 strengths to choose from
- Infused with synthetic flavorings
- No “entourage effect” from other cannabinoids and terpenes
- Most people don’t need such high doses of CBD oil in their routine
5. CBDistillery (Best Price)
|Potency||250 – 5000 mg|
|Potency||8.3 – 166 mg/mL|
As one of the industry’s trailblazers, CBDistillery definitely deserves a mention on our list of the best CBD oils for Parkinson’s disease considering how the company has managed to maintain its stellar reputation throughout the years. Not only did CBDistillery not rest on its laurels, but it also became one of the biggest suppliers in North America.
CBDistillery’s mission is to provide high-quality CBD oils affordable for everyone. The company sells hemp extracts in full-spectrum and broad-spectrum variants. The latter is referred to as “pure oil” and contains all the non-psychoactive cannabinoids and terpenes from hemp, but without any THC in the final product.
This company covers the entire potency range for CBD oils, from 250 mg to a whopping 5000 mg of CBD per bottle. At 166 mg of CBD in each mL, the strongest version is enough to get yourself stocked with CBD for months to come.
The only downside of CBDistillery’s products is that they’re not made with organic hemp. Nevertheless, it’s still one of the best companies in this price range, so if you’re shopping for CBD on a budget, this is a rock-solid supplier.
Comparing CBD with Levodopa for Parkinson’s
Levodopa is an established treatment for Parkinson’s disease. Although it’s not perfect, it’s currently the most effective treatment for PD. It helps boost the level of dopamine in the brain.
Levodopa is effective at targeting the motor symptoms of the condition, such as tremors or muscle stiffness.
However, this medicine does little to combat the nonmotor symptoms of Parkinson’s disease. These are the problems that can significantly affect a person’s daily life. They include anxiety, sleep disturbance, fatigue, irritation, and depression.
Furthermore, prolonged use of levodopa may result in side effects like elevated anxiety, agitation, confusion, and nausea. It may also trigger tremors that result from the medication itself, not PD.
CBD appears to help with those nonmotor symptoms and potential side effects, rather than physical problems. A study with more than 200 participants found that regular use of cannabis was highly effective on non-motor symptoms of Parkinson’s Disease. However, this study included a combination of THC with CBD, not CBD oil alone.
Final Thoughts on Using CBD Oil for Parkinson’s
There is no cure for Parkinson’s disease. Once diagnosed, patients can only slow their progression.
However, there are ways to manage its pesky symptoms. One of them is using CBD oil. If you’re planning to try it out, remember to make an appointment with your doctor first. This is to make sure that you don’t experience any side effects of potential drug interactions. In addition, your doctor can also give you professional advice on finding the right dose.
Although more research is needed to confirm the benefits of CBD oil for Parkinson’s disease, the best product that may support official treatment is Royal CBD oil. Made from organic hemp and using supercritical CO2, this product is pure, safe, and available in a wide range of potencies to suit different CBD needs.
Do you know anyone who takes CBD oil to cope with the symptoms of Parkinson’s disease? Does it help? Let us know in the comment section below!
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
Using CBD to Treat Parkinson’s Disease Symptoms
The benefits and research around CBD are still emerging
Colleen Travers writes about health, fitness, travel, parenting, and women’s lifestyle for various publications and brands.
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.
Diana Apetauerova, MD, is board-certified in neurology with a subspecialty in movement disorders. She is an associate clinical professor of neurology at Tufts School of Medicine.
With the legalization of medical marijuana, many states are approving the use of it in a non-traditional way to treat the symptoms of certain conditions, including Parkinson’s disease. Marijuana has two major components to it—tetrahydrocannabinol (THC) and cannabidiol (CBD). Both may help with nausea and muscle pain or spasms, but unlike THC, CBD doesn’t give you the “high” feeling marijuana is most commonly known for. This makes it an enticing, natural way for many to help treat their Parkinson’s disease symptoms. What’s more, is that because CBD is a natural compound from the Cannabis sativa plant, using it may also leave you side effect-free, unlike many prescription medications.
The body of research on using CBD for Parkinson’s disease symptoms is rapidly growing, as Parkinson’s disease affects 1% of the population over 60 years old. Parkinson’s disease is a neurological condition, affecting the nervous system. Parts of the brain that produce dopamine, which is responsible for sending messages to the body in order to direct movement, become damaged or die. This results in tremors, muscle stiffness, the inability to use facial expressions, and trouble balancing.
In connection with Parkinson’s disease as well as other movement-related disorders, CBD may help improve motor skills. In one study published in Frontiers in Pharmacology CBD was shown to have a more preventative role in delaying abnormal movement symptoms in animal models of Parkinson’s.
Since Parkinson’s disease can take some time to properly diagnose when the symptoms are already prevalent, using CBD once diagnosed may not offer much benefit. With early detection combined with the use of CBD together the possibility of reducing movement-related symptoms increases.
Those dealing with Parkinson’s disease may also have trouble sleeping due to REM sleep behavior disorder (RBD), a condition in which patients ‘act out’ their dreams while asleep. A study published in the Journal of Clinical Pharmacy and Therapeutics found that four patients with Parkinson’s disease who also suffered from RBD had a decrease of RBD symptoms during sleep with the use of CBD.
In some cases, people suffering from Parkinson’s disease may also have symptoms of psychosis, ranging in hallucinations to vivid dreams and illusions. Research has found that CBD may be able to help. In research out of University of São Paulo in Brazil, patients were given a dose of CBD starting out at 150 milligrams (mg) per day in addition to their current treatment plan of therapy for four weeks. The use of CBD showed no adverse effects, no impact on worsening motor function, and a decrease in their reported psychosis symptoms, meaning that not only can it help with the physical setbacks of Parkinson’s disease, it can also play a part in the cognitive challenges as well. This was however an older study and current clinical trial evidence to support the use of CBD is minimal.
More research out of Brazil suggests CBD can improve the overall quality of life of those with Parkinson’s disease. In a sample of 21 patients, those who were treated with 75 mg to 300 mg of CBD per day reported a significant increase in quality of life, though no significant differences were noted in motor and general symptoms or neuroprotective effects. This goes to show how much results can vary when it comes to the effects of CBD, requiring larger studies to be done in order to get more definitive answers to this treatment option.
Uses and Safety
Parkinson’s disease can impact cognitive function and memory, particularly in those whose symptoms progress to Parkinson’s disease dementia. Because of this, medical marijuana with both THC and CBD may not be recommended, as it can impair thinking and brain function even more so. CBD by itself may be a safer route.
CBD has been discovered as an effective way to help treat Parkinson’s disease symptoms because it interacts with two cannabinoid receptors in the body found on certain cells called CB1 and CB2. By interacting with one or both of these receptors, CBD may delay tremor development as well as have protective neurological benefits. But as seen with the above studies, there is no uniform approach or conclusion on this treatment method. This means that patients may react differently to using CBD, some having tremendous success while others seeing little difference. But regardless of whether or not CBD is an effective treatment option for you, you always need to consult your treating physician to make sure this treatment will not cause side effects.
What can cause side effects is if a patient decides to mix medical marijuana with their treatment plan that consists of certain prescription medications. If you plan to use medical marijuana as opposed to CBD by itself, it’s smart to consult a healthcare provider or your pharmacist before you start mixing it in with other medications to make sure it’s safe for you.
Should You Use It?
While the research on CBD to treat Parkinson’s disease symptoms is largely inconclusive, its mild effect on patients as a whole makes it enticing to try in addition to an existing traditional treatment plan. Parkinson’s disease has no cure. But with prescription medication, therapy, and now perhaps the use of nontraditional options like CBD, patients may be able to experience less frequency and severity of symptoms that affect their motor skills.
If you’re interested in trying CBD for Parkinson’s disease, talk to your healthcare provider about it. They will be able to point you to the latest research and provide recommendations on how much you should take. They will also be able to monitor your progress with the rest of your care team in order to come to a conclusion if this is the right treatment plan for you.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Peres FF, Lima AC, Hallak JEC, Crippa JA, Silva RH, Abílio VC. Cannabidiol as a Promising Strategy to Treat and Prevent Movement Disorders?. Front Pharmacol. 2018;9:482. doi:10.3389/fphar.2018.00482
Davis Phinney Foundation for Parkinson’s website. New Research, Medications, and CBD for Parkinson’s. Updated November 14, 2018.
Parkinson’s Foundation website. Medical Marijuana.
The Michael J. Fox Foundation for Parkinson’s Research website. Ask the MD: Medical Marijuana and Parkinson’s Disease. Update May 2, 2018.
By Colleen Travers
Colleen Travers writes about health, fitness, travel, parenting, and women’s lifestyle for various publications and brands.
With medical marijuana now legalized in 38 states and the District of Columbia, there is strong interest in its therapeutic properties. Researchers are testing marijuana, which is also called cannabis, as a treatment for many illnesses and diseases, including Parkinson’s disease (PD). However, despite this interest, there isn’t conclusive scientific evidence that marijuana is beneficial in PD.
The Science Behind Marijuana
What is the science and pharmacology behind marijuana, and can it be used to treat Parkinson’s symptoms?
The endocannabinoid system is located in the brain and made up of the endocannabinoids (molecules in our body that act on the cannabinoid receptors) and cannabinoid receptors (a molecular switch on the outside of a cell that makes something happen inside a cell when activated) on neurons (brain cells). The endocannabinoid system helps regulate many functions, including memory, pleasure, concentration, movement, appetite, and pain.
Researchers began to show enthusiasm to study cannabis in relation to PD after people with PD gave anecdotal reports and posted on social media as to how cannabis allegedly reduced their tremors. Some researchers think that cannabis might be neuroprotective (ie, that it saves neurons from damage caused by PD), though there have not yet been studies in humans that demonstrate this effect.
Cannabinoids (the drug molecules in marijuana) have also been studied for use in treating other symptoms, like bradykinesia (slowness caused by PD) and dyskinesia (excess movement caused by levodopa). Despite some promising preclinical findings, researchers have not found any meaningful or conclusive benefits of cannabis for people with PD.
The Pharmacology of Cannabis
The two primary components (ie, cannabinoids) of marijuana are delta-9-tetrahydrocannibinol (THC) and cannabidiol (CBD). THC and CBD act on the cannabinoid receptors type 1 (CB1) and type 2 (CB2), which are primarily found throughout the nervous system and on cells of the immune system. The way that THC and CBD acts on these two receptors is different and may help explain the different effects mediated by each of these compounds. For example, THC is the psychoactive component of marijuana and causes alterations in perception and mood. CBD, on the other hand, can reduce anxiety and may have anti-inflammatory properties.
The various compounds present in different marijuana plants and their variable effects on the CB1 and CB2 receptors make cannabis studies difficult to conduct. When researchers study the effects of a medication, dosages are controlled and often set to a specific number of milligrams. When testing medical marijuana, the dosage administered can vary dramatically depending on the plant and method of administration.
PD-Related Medicinal Marijuana Trials
The use of cannabinoids has been suggested to help with managing neurological and non-neurological conditions. Literature on medical marijuana is incredibly varied. Studies have not clearly supported the use of marijuana for PD. The clinical studies of cannabis as a PD treatment that have been conducted are generally small studies that are predisposed to biases. Most of studies have not followed the clinical trial gold standard of a double blind, placebo-controlled trial design. Some studies had as few as five subjects.
While some results have been positive, the effects of medical marijuana are probably not completely understood. This is why more studies, especially those with more subjects, are needed.
PD-related Medical Marijuana Studies
Clinical observations and trials of cannabinoid-based therapies suggest a possible benefit to tics and probably no benefit for tremor in dyskinesias or PD motor symptoms. Further preclinical and clinical research is needed to better characterize the pharmacological, physiological and therapeutic effects of this class of drugs in movement disorders.
The authors demonstrate that nabilone, the cannabinoid receptor agonist, significantly reduces levodopa-induced dyskinesia in PD.
This study is an evaluation of the effects of three antagonists on the NK3, neurotensin and cannabinoid receptors on the severity of motor symptoms and levodopa-induced dyskinesias after administration of a single dose of levodopa in 24 people with PD. The study concluded that the drugs tested were safe, but did not improve Parkinsonian motor disability.
This study reviews the endocannabinoid system and its regulatory functions in health and disease.
Risks and Benefits for People with PD
There are risks and benefits associated with the use of cannabis for people with PD. Benefits include a possible improvement in anxiety, pain, sleep dysfunction, weight loss and nausea. Potential adverse effects include impaired cognition (specifically in executive function, or planning and judgement), dizziness, blurred vision, mood and behavioral changes, loss of balance and hallucinations. Chronic use of marijuana can increase the risk of mood disorders, particularly among young users, and lung cancer.
Researchers issue caution for people with PD who use cannabis particularly because of its effect on thinking. PD can impair the executive function — the ability to make plans and limit risky behavior. People with a medical condition that impairs executive function should be cautious about using any medication that can compound this effect.
Medical Marijuana and Legislation by State
Thirty-eight states and Washington, DC have passed legislation allowing the use of marijuana-based products as a medical intervention.
In some states where medical marijuana is legalized, consumers must register to possess and use cannabis. Other states require consumers to acquire a document from a physician stating that the person has an approved condition. Under federal law doctors cannot prescribe cannabis, but many states authorize them to issue certifications that allow people to obtain medical marijuana.
PD is listed as a qualifying condition for medical marijuana in California, Connecticut, Florida, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Mississippi, Missouri, New Hampshire, New Mexico, New York, Ohio, Oklahoma, Pennsylvania, Vermont and West Virginia.
Medical marijuana is legal in Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia and Washington, DC.
Eighteen states and the District of Columbia have legalized the recreational use of marijuana, making it legal for adults over the age of 21 to legally consume marijuana without a doctor’s recommendation. Many of these states still differentiate recreational from medical marijuana. In some states, medical marijuana consumers may have access to specialized dispensaries, strains of marijuana and sales tax exemptions.
Recreational marijuana is legal in Alaska, Arizona, Connecticut, California, Colorado, Illinois, Maine, Massachusetts, Michigan, Montana, New Jersey, New Mexico, New York, Nevada, Oregon, Virginia, Vermont, Washington and Washington, DC.
Multiple states, counties or cities have decriminalized certain marijuana-related offenses. In these areas, the possession of marijuana can be met with a citation — forgoing an arrest or criminal record — or no penalty at all.
For state-by-state guidance on marijuana legalization, medical laws and discrimination visit Norml.org/laws.
Parkinson’s Foundation Centers of Excellence and Medicinal Marijuana
The Parkinson’s 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 Parkinson’s 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 (such as a course or lecture), 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.
This graph shows how physicians expect cannabis would improve, worsen or show no effect to PD-related symptoms given their expertise and observations of people with PD.
The study emphasized that physicians would be more apt to use medical marijuana as a treatment if it was approved through regulation instead of legislation. Nearly all medications are only approved after passing a science-based evaluation proving their effectiveness in a process overseen by the Food and Drug Administration. Since cannabis has been approved through legislation rather than regulation, there are no labels, dosage recommendations or timing instructions that physicians can reference.
Is medical marijuana an option for me?
What’s next for a person with PD who wants to know if medical marijuana is an option? “Marijuana should never be thought of as a replacement for dopaminergic and other approved therapies for PD,” said Dr. Michael S. Okun, the Parkinson’s Foundation National Medical Advisor.
Research is still needed to determine how medical marijuana should be administered and how its long-term use can affect symptoms of PD. To keep people safe, states that legalize medical marijuana will eventually need to develop training programs for doctors and medical teams that prescribe medical marijuana. Consult your doctor to see if medical marijuana is an option for you.
The Parkinson’s Foundation Consensus Statement on the Use of Medical Cannabis for Parkinson’s Disease is designed to help guide the PD community in making informed decisions about using cannabis for Parkinson’s. The statement is based on the input from 46 experts who attended the Foundation’s first-ever medical marijuana convening. Read it now.
Page reviewed by Dr. Chauncey Spears, Clinical Assistant Professor and Dr. Sydney M. Spagna, Clinical Fellow at the University of Michigan.