Expert Voices: Can Cannabis Use Help Relieve Parkinson’s Symptoms? | Cannabis key dosage for patients with walking, balance or dizziness problems

In this episode of our “Expert Voices” series, Parkinson’s News Today asked Dr. Michelle Sexton to answer some of your questions about cannabis.

Sexton is a naturopathic doctor who completed pre- and postdoctoral fellowships at the University of Washington, where she studied the endocannabinoid system and its roles in neuroinflammation and neurodegeneration. His predoctoral and postdoctoral research on the topic of cannabinoids and their roles in neuroinflammation and neurodegeneration, funded by the National Institutes of Health, investigated cannabis use and its impact on inflammatory markers. She continued her research on the health effects of cannabis at the University of California, San Diego (UCSD) as an adjunct assistant professor in the Department of Anesthesiology. She is a medical staff professional at UCSD’s Center for Integrative Medicine, the first cannabis clinic at a major medical center.

Sexton’s clinical practice, research, and teaching focus on the endocannabinoid system and its roles in integrative medicine to treat a range of conditions across the lifespan. Sexton has presented his research internationally and published numerous articles in peer-reviewed journals. She began her healthcare career as a herbalist and midwife. She opened the first cannabis testing laboratory in Washington State and was editor of the botanical monographs for the American Herbal Pharmacopoeia. She is a member of the International Cannabinoid Research Society, the International Association of Cannabinoid Medicines, the California Naturopathic Doctors Association and the American Association of Naturopathic Doctors. She maintains a private medical practice in San Diego.

Dr. Sexton works at UCSD’s Center for Integrative Medicine, the first cannabis clinic at a major medical center. (Photo courtesy of Dr. Michelle Sexton)

What misconceptions surrounding cannabis use for Parkinson’s disease would you like to dispel?

Cannabis is not known to be a cure for any disease, including neurological disease. It is not a solution to all the ills of people with Parkinson’s disease (PPD). As with any potential therapy, some people will respond well and see symptom relief and some will not. If you decide to try cannabis, you will need to weigh the positive benefits against the negative side effects and determine for your own situation whether cannabis use may be helpful for you and your unique symptom profile and/or contribute to your quality. of life. Side effects may include effects on cognitive function, perception of space and time, dizziness, nausea, and others.

Any advice for people with Parkinson’s who are considering using medical cannabis?

In a perfect world, you would be able to discuss the use of medical cannabis with your doctor. However, due to the unusual situation of cannabis being understudied when it is widely used as medicine, medical professionals may not feel ready to provide guidance on such use.

However, it is important to be open with your doctor if you decide to use cannabis, so that it can be useful to help monitor negative side effects or the potential for drug interactions. There are a plethora of “experts” who give advice on cannabis use. Some are health professionals and some are not. Beware who you get advice from. The best advice on how to use and dose cannabis will come from someone who has a lot of experience working with PPD, as well as a solid background in cannabis science.

Be wary of what you read on the internet, as it can be difficult to separate facts from marketing claims about what to expect from cannabis use. Research on cannabis in PPD is very limited.

Words of warning?

Cannabis, especially inhaled cannabis, can affect the cerebellum, the part of the brain that helps us maintain balance, helps us make precise movements. The cerebellum is rich in the CB1 receptor, the protein that cannabis THC binds to. So for people with PD who have balance problems, dizziness, or trouble walking, caution is advised.

Additionally, CB1 receptors are also found on smooth muscle tissue and endothelial cells, and when THC acts on the receptor there, it causes blood vessels to dilate. When this happens, it causes a hypotensive effect or a drop in blood pressure. Because PPD may already have orthostatic or orthostatic hypotension, this also warrants caution. Particularly if you are at risk of falling, starting to use cannabis may indicate that you should always use a walking aid. Staying well hydrated, using electrolytes, and getting up slowly are ways to lessen these effects. Rather than inhaling cannabis, oral administration may have less pronounced effects on dizziness, balance, and low blood pressure, but dose matters!

How could medical cannabis be particularly suitable for people with Parkinson’s disease?

The most striking observation from clinical practice concerns the beneficial effects on sleep. Other ways include reducing anxiety, reducing tremors and improving quality of life (forgetting about the disease).

Do you find that patients’ symptoms respond most positively to a high-THC strain or a high-CBD strain?

It is not really possible to answer this question because the effects are very individual. In general, for therapeutic purposes (medical use), low doses of THC are more likely to be beneficial. A type of plant (chemotype or cultivar; strain is a word used in microbiology) that is high in CBD will have a much lower THC content and therefore might be better suited for medicinal use. Chemotypes are more important when using inhaled cannabis than when using oral cannabis. This is due to the essential oil part of the plant, which can guide the effects when inhaled. Since the essential oil component will be metabolized by the liver when taking cannabis orally, the biological effects of these compounds will be barely noticeable, if at all.

What kind of positive effects in the consumption of medical cannabis have you observed?

As already mentioned, the most striking effect concerns sleep and, in general, cannabis could be considered a quality of life drug. The mild mood-enhancing, anti-anxiety, sleep-promoting, calming, relaxing, and euphoric effects can be achieved with a low dose of THC, reducing the chances of impairment, either cognitively or physically.

Do you recommend a particular delivery route for cannabis?

Inhalation is for those who need quick effects, while taking a cannabis product orally will have much longer lasting effects. Administration and dose are highly variable and depend on many factors, including consideration of drug interactions and existing balance problems, hypotension, dizziness, and cognitive function. The best advice will come from a medical professional skilled in the use of medical cannabis. Beware of information from dispensary staff as they may be biased or misinformed about medical cannabis.

Is there any current or recent cannabis research that excites you?

It’s exciting to see everything of cannabis research that is currently being conducted, as in the past, funding was only available to study the harms of cannabis. It seems like the time has come for better understanding and evidence of the applicability of cannabis, as well as other botanical medicines, to treat typically difficult-to-treat chronic diseases and to provide potential improvements in quality of life!

Expert Voices is a monthly series featuring a Q&A with an expert from the Parkinson’s space on a specific topic. These topics and questions are selected from a survey in which we ask readers what they would like to learn more from experts. If you would like to submit topics or questions for consideration in an upcoming episode of the series, click here to take the survey.

News about Parkinson’s disease today is strictly a disease news and information site. It does not provide medical advice, diagnosis or treatment. This content is not intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of anything you read on this website.

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