←Parkinson Disease
Study register · detail Systematic Review · Parkinson Disease · 2020

Medical cannabis as an alternative therapeutics for Parkinsons' disease: Systematic review.

Bougea et al. ·Complementary therapies in clinical practice Impact 2.8
No benefit demonstrated GRADE High 39 citations
Samplek = 14 Studien
Durationunclear
ControlPlacebo or uncontrolled
EndpointMotor/non-motor symptoms
Blindingunklar
DesignSystematic Review
Key finding

Positive effects on motor and non-motor symptoms in uncontrolled studies were not confirmed by a few small RCTs; only individual RCTs showed effects on levodopa-induced dyskinesias, anxiety and tremor.

Summary

Systematic review on medical cannabinoids in Parkinson's; k=14 studies (5 RCTs + 9 uncontrolled studies). Positive effects on motor (5 studies) and non-motor symptoms (4 studies) from uncontrolled studies were NOT confirmed in the few, small RCTs. Only 1 RCT showed reduction of levodopa-induced dyskinesias, 1 RCT reduction of anxiety and tremor amplitude in an anxiogenic situation; 3 RCTs without effect on motor/non-motor symptoms. Conclusion: insufficient evidence for cannabis use in PD.

P
PopulationParkinson's patients (clinical trials on medical cannabinoids)
I
InterventionMedical cannabinoids (various substances/administrations)
C
ControlPlacebo or uncontrolled (depending on primary study)
O
OutcomePositive effects on motor and non-motor symptoms in uncontrolled studies not confirmed by RCTs; one RCT showed reduction of levodopa-induced dyskinesias, another reduction of anxiety and tremor in anxiety-inducing situations; three RCTs without significant effect
Confidence in the evidence
High

The highest of four GRADE levels, the effect estimate is very reliable.

Quality profile
Sample size ★★★★★
Blinding —
Effect size No benefit
Citations / year ★★★★★
Authors
Bougea A, Koros C, Simitsi AM, Chrysovitsanou C, Leonardos A, Stefanis L
DOI 10.1016/j.ctcp.2020.101154↗
Design: Systematic Review
Share
Abstract
Objectives: 1) to evaluate the efficacy of medical cannabinoids (MC) by appraising the quality of evidence from clinical studies 2) to explore the factors hampering the MC use in clinical practice of Parkinson's disease (PD). Methods: We performed a systematic review through various databases. The quality of 14 studies was assessed by Cochrane risk bias (5 randomized controlled trials- RCT) and Newcastle-Ottawa scale (9 uncontrolled studies). Results: The positive effects on motor (5 studies) and non-motor symptoms (4 studies) described in uncontrolled studies have not been confirmed by the few and small RCTs. Only one RCT found a reduction of levodopa-induced dyskinesias, another a reduction in anxiety and tremor amplitude in an anxiogenic situation, while the remaining three without effect on motor/non-motor symptoms. Physical and psychological symptoms are among the most common side effects. Conclusions: There is insufficient evidence to reform international legislation regarding cannabis use in PD practice.
Indication
Further studies on Parkinson Disease
All studies →
A Figura et al. · 2022 · Neurologia i neurochirurgia polska
19 citations
Cannabis in Parkinson's Disease - the patient's perspective versus clinical trials: a systematic literature review.
No benefit demonstrated Systematic Review

Systematische Review zu Cannabis bei Parkinson; k=7 randomisierte Studien identifiziert. Ergebnisse unterstützen KEINE Wirksamkeit von Cannabinoiden bei motorischen Symptomen der Parkinson-Krankheit. Schlussfolgerung: derzeit unzureichende Datenlage für Cannabinoid-Einsatz bei PD-Patienten.

10.5603/pjnns.a2022.0004 View study →
A Liu et al. · 2024 · Movement disorders
19 citations
Short-Term Cannabidiol with Delta-9-Tetrahydrocannabinol in Parkinson's Disease: A Randomized Trial.
No benefit demonstrated RCT

RCT n=61 (CBD/THC n=31, Placebo n=30), 2 Wochen Titration auf finale Dosis 191,8±48,9 mg CBD + 6,4±1,6 mg THC täglich. Primärer Endpunkt motor MDS-UPDRS: Reduktion -4,57 (95% CI -8,11 bis -1,03; p=0,013) in CBD/THC-Gruppe vs. -2,77 (-4,92 bis -0,61; p=0,014) in Placebo; Gruppen-Differenz nicht signifikant: -1,80 (-5,88 bis 2,27; p=0,379). Kein Benefit, möglicherweise verschlechterte Kognition und Schlaf; starker Placebo-Effekt. Nebenwirkungen mild, häufiger in CBD/THC-Gruppe.

10.1002/mds.29768 View study →
A Peball et al. · 2020 · Annals of neurology
118 citations
Non-Motor Symptoms in Parkinson's Disease are Reduced by Nabilone.
Mixed RCT

Phase-II-RCT, n=47 Parkinson-Patienten mit stabiler Motorik aber störenden Non-Motor-Symptoms (NMS, MDS-UPDRS-I ≥4). Open-label Nabilone-Titration (0,25–1 mg 2×/d), dann Randomisierung Responder zu Nabilone vs. Placebo (n=19). Primärer Endpunkt MDS-UPDRS-I nach 4 Wochen: Placebo-Gruppe verschlechterte sich um 2,63 Punkte (95% CI 1,53–3,74, p=0,002), Nabilone-Gruppe nur um 1,00 Punkte (95% CI −0,16–2,16, p=0,280); Differenz 1,63 Punkte (95% CI 0,09–3,18, p=0,030, Effektgröße 0,66). Positive Effekte v.a. auf Angst und nächtliche Schlafprobleme. 77% AEs in Titrationsphase (meist transient), keine schwerwiegenden AEs.

10.1002/ana.25864 View study →

The impediment to action advances action. — Marcus Aurelius