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Medical Cannabis in Parkinson Disease: Real-Life Patients' Experience

Balash, Yacov*†; Bar-Lev Schleider, Lihi; Korczyn, Amos D.; Shabtai, Herzel*; Knaani, Judith*; Rosenberg, Alina§; Baruch, Yehuda; Djaldetti, Ruth†¶; Giladi, Nir*†#; Gurevich, Tanya MD*†#

doi: 10.1097/WNF.0000000000000246
Original Articles

Background The use of medical cannabis (MC) is controversial. Support for its benefits is based on small clinical series.

Objective The aim of this study was to report the results of a standardized interview study that retrospectively assessed the effects of MC on symptoms of Parkinson disease (PD) and its adverse effects in patients treated for at least 3 months.

Methods The survey used telephone interviews using a structured questionnaire based on subjective global impressions of change for various parkinsonian symptoms and yes/no questions on adverse effects.

Results Forty-seven nondemented patients with PD (40 men) participated. Their mean age was 64.2 ± 10.8 years, mean disease duration was 10.8 ± 8.3 years, median Hoehn and Yahr (H&Y) was stage III. The duration of MC use was 19.1 ± 17.0 months, and the mean daily dose was 0.9 ± 0.5 g. The delivery of MC was mainly by smoking cigarettes (38 cases, 80.9%). Effect size (r2) improvement for falls was 0.89, 0.73 for pain relief, 0.64 for depression, 0.64 for tremor, 0.62 for muscle stiffness, and 0.60 for sleep. The most frequently reported adverse effects from MC were cough (34.9%) in those who used MC by smoking and confusion and hallucinations (reported by 17% each) causing 5 patients (10.6%) to stop treatment.

Conclusions Medical cannabis was found to improve symptoms of PD in the initial stages of treatment and did not cause major adverse effects in this pilot, 2-center, retrospective survey. The extent of use and the reported effects lend support to further development of safer and more effective drugs derived from Cannabis sativa.

*Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv; †Sackler School of Medicine, Tel Aviv University, Tel Aviv; ‡Tikun Olam, Research Department, Tel Aviv; §School of Public Health, Epidemiology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv; ∥OneWorld Cannabis Ltd, Petah-Tikva; ¶Movement Disorders Center, Rabin Medical Center, Petah-Tikva; and #Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.

Address correspondence and reprint requests to Tanya Gurevich, MD, Movement Disorders Unit, Tel Aviv Sourasky Medical Center, 6 Weizmann St, Tel Aviv 6423906, Israel; E-mail: tanyag@tlvmc.gov.il

Both Movement Disorders Units were responsible for patient with PD selection and providing the patient's telephone numbers. Tikun Olam Co was responsible for designing and administering the questionnaire, setting up the datasheet, and entering the data. The extraction and analysis of data and the report were performed by the first author (Y.B.). This article represents a final report on these data with the collaboration of all the authors.

Conflicts of Interest and Source of Funding: Lihi Bar-Lev Schleider is an employee of Tikun Olam Co, an Israel pharmaceutical company, which is developing cannabis-based medicinal extracts. Yehuda Baruch was a head of the Israeli Ministry of Health program for Medical Use of Cannabis in 2003 to 2012; at present, Yehuda Baruch is CSO of One World Cannabis Israel, which is a company dedicated to the research of cannabis and cannabinoids and their medical properties. All the other authors have nothing to declare.

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