Over 7 million people worldwide are living with Parkinson’s disease. What is the clinical evidence for cannabis therapy in Parkinson’s disease?
The administration of cannabis-based medicine to a patient with Parkinson’s disease can result in the amelioration of motor and non-motor symptoms. The majority of the clinical trials focus on the effect of cannabis on dyskinesias in PD, and the most commonly improved symptoms are: bradykinesia, muscle rigidity, tremors, and a trend towards improved posture. Patients have reported that the benefits associated with a single dose were short lasting (2-3 hours).
Palliative care teams are often interdisciplinary and can include doctors, nurses, social workers, chaplains, pharmacists, therapists (physical/occupational/speech/massage), and volunteers, amongst others.
What is cannabinoid hyperemesis syndrome? When was it first described?
In 2004, Allen et al. described a condition of cyclical hyperemesis that was associated with chronic long-term use of cannabis and that was relieved by bathing or showering in hot water. The cessation of cannabis use led to a resolution of symptoms. This condition was coined cannabinoid hyperemesis syndrome.
Could cannabinoid therapy modulate the wasting and cachexia associated with ALS?
A survey in ALS patients reported that cannabis was effective at reducing symptoms of appetite loss. The physiological control of appetite, feeding behavior and satiety is extremely complex, involving numerous neurotransmitters and neuropeptides. The current understanding suggests that there are many interactions between the ECS and multiple systems to modulate appetite stimulation. For example, endocannabinoids might interact with leptin, a hormone released from adipocytes, to modulate food intake. Studies suggest that people actively using cannabis have higher intakes of energy and nutrients than non-users and that exposure to cannabis correlates positively with an increase in food consumption, caloric intake, and body weight.
According to the National Multiple Sclerosis Society, more than 2.3 million people are affected by MS worldwide. What is the clinical evidence for cannabis therapy in multiple sclerosis?
There is evidence that cannabis-based medicine can significantly reduce spasticity, pain, and cause a subjective improvement in sleep quality compared to placebo in clinical trials. Cannabis-based medicine can also result in an objective improvement in mobility and bladder dysfunction. The undesirable side effects observed are often mild and well tolerated.
Could cannabinoid therapy modulate the spasticity and muscle cramps associated with ALS?
Clinical studies have suggested that cannabinoids may provide at least a subjective reduction of spasticity in patients with a motor neuron disease, although virtually all of the studies have been done in MS patients. A RCT using nabiximols in 189 MS patients reported a significant decrease of spasticity). A systematic review published for the American Academy of Neurology concluded that oral cannabis extracts are effective, and nabiximols and THC are probably effective in improving patient reported outcomes in those with MS, but not in changing short-term objective measures of spasticity.
What are the effects of THC and CBD consumption on the reproductive system?
THC and CBD alter hypothalamic and/or pituitary function and cause a decrease in the circulating levels of hormones, including testosterone, progesterone, LH, FSH and prolactin. In repeat-dosing animal studies, it has been shown that both THC and CBD decrease the weights of reproductive organs, including uterus and testes. Also, these cannabinoids can lengthen the menstrual cycle and inhibit spermatogenesis.
Cannabis use is not associated with respiratory depression. Why not?
In the brainstem, cannabinoid receptor expression is low, accounting for the lack of respiratory depression and the absence of a risk of respiratory arrest with the use of cannabis and cannabinoid drugs.
Cancer pain is often caused by:|1. Tumor pressing on surrounding tissue -Compression of peripheral nerves, the spinal cord or other organs can lead to significant pain. |2. Cancer therapies – Chemotherapy, radiation therapy and surgical therapy are all associated with painful side effects.|3. Diagnostic testing – Diagnostic tests, such as surgical biopsies, spinal taps and bone marrow biopsies may cause pain.
THC and the analogues of THC derived from the cannabis plant that interact with endocannabinoid receptors or otherwise affect the endocannabinoid system are called phytocannabinoids. Phytocannabinoids have pharmacological activity due to their receptor-based effects on the endocannabinoid system. Additional pharmacological effects, such as anti-inflammatory mechanisms may be non-receptor mediated.