Study register · detailKohortenstudie · Parkinson Disease · 2017
Medical Cannabis in Parkinson Disease: Real-Life Patients' Experience.
Balash et al.·Clinical neuropharmacologyImpact 1.2
Clear benefitGRADEVery low82 citations
Samplen = 47 Pat.
Durationat least 3 months of treatment…
EndpointSubjective global impression
Blindingn.a.
DesignKohortenstudie
Cannabinoidvollspektrum
Max. dose900.0 mg
Routeinhalativ
”Key finding
Medical cannabis showed improvements in various Parkinson's symptoms, in particular falls (r=0,89), pain relief (r=0,73), depression (r=0,64), tremor (r=0,64), muscle stiffness (r=0,62) and sleep (r=0,60), but caused significant side effects (confusion and hallucinations) leading to discontinuation in 10,6% of patients.
Summary
n=47 non-demented Parkinson's patients (mean disease duration 10,8±8,3 years, median H&Y stage III), retrospective telephone survey after ≥3 months of cannabis treatment (mean duration 19,1±17,0 months). Effect size (r) for improvements: falls r=0,89, pain reduction r=0,73, depression r=0,64, tremor r=0,64, muscle stiffness r=0,62, sleep r=0,60. Most common side effects: cough (34,9% among smokers), confusion and hallucinations (17% each), 10,6% treatment discontinuation due to side effects.
P
PopulationNon-demented Parkinson's patients on medical cannabis (≥3 months), n=47, mean age 64,2 years, median H&Y stage III
I
InterventionMedical cannabis, mean daily dose 0,9 g, predominantly smoked as a cigarette (80,9%), mean duration of use 19,1 months
O
OutcomeLarge effect sizes (r) for fall reduction (0,89), pain relief (0,73), depression (0,64), tremor (0,64), muscle stiffness (0,62) and sleep (0,60); most common adverse effects: cough (34,9%), confusion/hallucinations (17% each), treatment discontinuation in 10,6%
Confidence in the evidence
Very lowLowModerateHigh
Very low
The lowest GRADE level, the effect estimate remains uncertain.
Downgraded for
Imprecision
Quality profile
Sample size★★★★★
Blinding—
Effect sizeClear benefit
Citations / year★★★★★
Authors
Balash Y, Bar-Lev Schleider L, Korczyn AD, Shabtai H, Knaani J, Rosenberg A, Baruch Y, Djaldetti R, Giladi N, Gurevich T
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 (r) 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.