←Parkinson Disease
Study register · detail RCT (crossover) · Parkinson Disease · 2001

Cannabinoids reduce levodopa-induced dyskinesia in Parkinson's disease: a pilot study.

Sieradzan et al. ·Neurology Impact 1.0
Clear benefit GRADE Moderate 346 citations
Samplen = 7 Pat.
ControlPlacebo
EndpointLevodopa-induced dyskinesia
Blindingdoppelblind
DesignRCT (crossover)
Cannabinoidthc
Routeoral
Key finding

Nabilone significantly reduces levodopa-induced dyskinesia in Parkinson's patients versus placebo.

Summary

n=7 Parkinson's patients with levodopa-induced dyskinesia, nabilone (cannabinoid receptor agonist) vs. placebo (randomised, double-blind, crossover); nabilone significantly reduced levodopa-induced dyskinesia (p<0.05 implied).

P
PopulationParkinson's patients with levodopa-induced dyskinesia, n=7
I
InterventionNabilone (cannabinoid receptor agonist), oral
C
ControlPlacebo
O
OutcomeNabilone significantly reduces levodopa-induced dyskinesia vs. placebo
Confidence in the evidence
Moderate

The third of four GRADE levels, the effect estimate is probably reliable.

Downgraded for
Imprecision
Quality profile
Sample size ★★★★★
Blinding Double-blind
Effect size Clear benefit
Citations / year ★★★★★
Authors
Sieradzan KA, Fox SH, Hill M, Dick JP, Crossman AR, Brotchie JM.
DOI 10.1212/wnl.57.11.2108↗
Design: RCT (crossover)
Share
Abstract
The lateral segment of the globus pallidus (GPl) is thought to be overactive in levodopa-induced dyskinesia in PD. Stimulation of cannabinoid receptors in the GPl reduces gamma-aminobutyric acid (GABA) reuptake and enhances GABA transmission and may thus alleviate dyskinesia. In a randomized, double-blind, placebo-controlled, crossover trial (n = 7), the authors demonstrate that the cannabinoid receptor agonist nabilone significantly reduces levodopa-induced dyskinesia in PD.
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