Cannabis bei Parkinson – Hype oder Heilmittel?

Abstract

Cannabis buds and extracts as well as synthetic cannabinoids have been available on prescription to patients with severe diseases since March 2017, with the costs covered by health insurance companies.The prescription of medical marihuana is not restricted to specific symptoms and is therefore also valid for patients with Parkinson's disease. From a legal perspective, patients who are seriously ill even have the right to be treated with cannabis if standard treatment methods are unsuccessful or result in unbearable side effects. This also applies even if only a slight chance of noticeable improvement is predicted as a result of the cannabis treatment.Bearing this in mind and due to an intense media coverage of this topic, more and more patients with Parkinson's disease are requesting cannabis prescription, which is a challenging situation to their neurologists.This article provides an overview of the various cannabis products that can be prescribed, the different modes of administration and the available literature regarding motor- and non-motor symptoms in Parkinson's disease. Furthermore, the authors state their opinion on which indications cannabinoids could be useful in treating patients with Parkinson's disease or in which situation the patient could or even should be prescribed cannabinoids. Additionally, this article presents practical recommendations for the prescription of cannabinoids and patient counseling, e. g., on the effects of medical marijuana on driving capacity.

Das idiopathische Parkinsonsyndrom und Schmerz – diagnostische und therapeutische Ansätze für ein herausforderndes nicht-motorisches Symptom

“…Von den beiden im Cannabis enthaltenden Hauptwirkstoffen, dem Delta-9-Tetrahydrocannabinol (THC) und dem Cannabidiol (CBD), ist nur das psychotrope THC BtM-pflichtig, während das nicht-psychoaktive CBD auf dem Markt frei und legal erhältlich ist. Ein Überblick über die verschreibungsfähigen Cannabisprodukte und Applikationsformen, die Datenlage für Cannabis bei motorischen-und nicht-motorischen Parkinson Symptomen sowie praxisrelevante Empfehlungen, wann im Einzelfall Cannabis in welcher Applikationsform bei Parkinson-Patienten hilfreich sein könnte, findet sich in der Arbeit von Mainka et al [52].…”

Distinctive Evidence Involved in the Role of Endocannabinoid Signalling in Parkinson’s Disease: A Perspective on Associated Therapeutic Interventions

“…The considerable rise in the scientific interest of promising therapeutic benefits of cannabinoids have displayed a remarkable improvement in parkinsonian symptoms like dyskinesia or tremors [ 7 , 8 ]. Moreover, it has led to an increasing interest in research exploring the potential of these CBs and ECS as possible medical interventions for the treatment of various diseases, including neurodegenerative disorders [ 8 ].…”

“…The considerable rise in the scientific interest of promising therapeutic benefits of cannabinoids have displayed a remarkable improvement in parkinsonian symptoms like dyskinesia or tremors [ 7 , 8 ]. Moreover, it has led to an increasing interest in research exploring the potential of these CBs and ECS as possible medical interventions for the treatment of various diseases, including neurodegenerative disorders [ 8 ]. The involvement of the cannabinoid 1 (CB1) receptor in ECS is a well expressed phenomenon in basal ganglia, which is reported to be affected in case of different motor dysfunctions and other neurodegenerative disorders including PD [ 9 ].…”

Link between personality and response to THC exposure

“…Several factors have contributed recently to an improved epidemiological profile of cannabis use. Increase of cannabis use for medical purposes [2][3][4][5][6][7][8], higher public levels of interest in cannabis as a research topic [9], and increased research accumulation of scientific data have shifted the public perception of the drug from negative to relatively positive viewpoint. Collectively, this has resulted in growth in the number of recreational users and greater volume of legally reportable, real-world data.…”