CBD Oil For Dystonia Abstracts from the International Congress of Parkinson’s and Movement Disorders. A real-life study of Medical Cannabis effect on adults with dystonia S. Anis, A. Patients with dystonia who smoked medical cannabis vs those who consumed cannabis oil extract were more likely to report dystonia symptom improvement.
CBD Oil For Dystonia
Abstracts from the International Congress of Parkinson’s and Movement Disorders.
A real-life study of Medical Cannabis effect on adults with dystonia
S. Anis, A. Faust-Socher, D. Sverdlov, N. Hezi, N. Giladi, T. Gurevich (Tel Aviv, Israel)
Objective: To assess the effect of Medical Cannabis (MC) on patients with dystonia.
Background: MC has been suggested to treat involuntary contractions of muscles in patients with dystonia and alleviate related pain, in a few case reports and case series. The suggested mechanism is activation of cannabinoid receptors in the basal ganglia, enhancing the release of γ-aminobutyric acid (GABA). MC is approved by the Israeli Ministry of Health (MOH) since 2013 for symptomatic treatment in patients with movement disorders accompanied by pain.
Method: Patients with dystonia of all types (primary and secondary, focal, segmental, generalized) with an MOH approved MC license were interviewed via phone regarding treatment efficacy and side effect profile from chronic MC consumption. Global efficacy was rated on a Likert scale of 1-5.
Results: Twelve patients with dystonia (6 females, mean age 54.6) were interviewed for this study. Three patients suffered from focal dystonia, seven patients from generalized dystonia and two patients from hemi-dystonia. The etiology of the dystonia was known in 5 patients (DYT1, DYT6 and three patients with Parkinson’s disease). Duration of MC use (years) was 2.80±0.79, average dose of MC (grams/month) was 34.29±5.68, %THC 11.63±2.12, %CBD 9.44±1.47, mode of administration: cigarettes/vapor (42%), oil (42%), both (16%), frequency of use 4.73±1.54 (per day), number of puffs/drops for each use 6.60±1.88. The total global impression efficacy score for dystonia was 3.16 out of a total 5 possible points. Efficacy for pain was 3.67 out of 5. Nine out of twelve patients reported improvement in sleep. Most common side effects were dry mouth (75%) and fatigue (50%). Five patients (42%) suffered from psychiatric side effects: three suffered from anxiety (one with hallucinations) while two suffered from mood worsening (one with suicidal thinking) soon after treatment initiation. Side effects resolved in 4 patients after treatment modification and only one patient had to stop treatment. One patient stopped treatment due to inefficacy.
Conclusion: MC seems to mitigate dystonic muscle activity and related pain. Psychiatric side effects of MC treatment have to be monitored especially following treatment initiation. Larger cohort should be further investigated to determine MC efficacy, mechanism of action, optimal doses and the best THC/CBD ratio for the treatment of dystonia.
Medical Cannabis Improves Dystonia Symptoms and Alleviates Pain
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Consumption of medical cannabis in adults with dystonia improves symptoms and alleviates related pain, according to study findings presented at the International Congress of Parkinson’s Disease and Movement Disorders Society (MDS) Virtual Congress 2021, held from September 17 to 22, 2021.
Previous research has found medical cannabis may help treat involuntary muscle contractions and reduce related pain in patients with dystonia by the activation of cannabinoid receptors in the basal ganglia that release γ-aminobutyric acid (GABA). This could potentially reduce severity and improve quality of life for patients with dystonia. From 2013, the Israeli Ministry of Health (MOH) has accepted the use of medical cannabis for symptomatic treatment in patients with movement disorders and related pain.
The current study aimed to assess the effect of medical cannabis on dystonia muscle activity and related pain in patients with an MOH-approved medical cannabis license.
Patients with dystonia (n=23) with an approved medical cannabis license from the MOH were contacted via telephone by researchers from the Tel Aviv University, Israel. Using a 5-point Likert scale, participants’ demographics, medical cannabis use, and treatment effects were assessed.
A total of 11 women and 12 men, with a mean age of 52.7 years, were included in the analysis. Dystonia etiologies were generalized (n=9), focal (n=6), segmental (n=5), hemidystonia (n=2), or multifocal (n=1) caused by Parkinson disease (n=6), monogenic variants (n=4), or unknown (n=13).
Participants indicated that they had been using medical cannabis for an average of 2.5±1.0 years. Medical cannabis was consumed at a mean dose of 22.6±20.1 grams per month and at a frequency of 3.3±4.3 times per day. The medical cannabis was composed of 10.6%±6.6% tetrahydrocannabinol (THC) and 8.0%±5.7% cannabidiol. Participants also indicated that they used cannabis oil extract (47.8%), smoked dried buds (43.5%), or both (8.7%).
The subjective, self-reported efficacy of medical cannabis for dystonia was 3.3/5, pain was 3.7/5, and quality of life was 3.6/5. The majority of participants (70%) also reported an improvement in sleep.
Participants who experienced more improvements to their dystonia reported using a higher THC dose than those who showed little improvement, with a positive correlation between THC dose and dystonia symptom improvement (R 2 =0.012).
Participants who smoked medical cannabis vs those who consumed the oil were more likely to report dystonia symptom improvement.
Adverse effects included dry mouth (65%), worsening mood (n=3), anxiety (n=2), anxiety with hallucinations (n=1), and suicidal ideation (n=1). Three participants stopped receiving treatment with medical cannabis due to inefficacy or adverse effects.
Study limitations included its small size and the inclusion of patients with differing dystonia symptoms, using uncontrolled dosing and administration methods. Therefore, these findings should be validated in a larger, controlled study.
“[Medical cannabis] seems to improve symptoms of dystonia and related pain. Higher daily dose of THC and smoking rather than sublingual oil are significantly more efficacious,” the researchers concluded.
Anis S, Faust-Socher A, Sverdlov D, et al. A real-life study of medical cannabis effect on adults with dystonia. Presented at: MDS Virtual Congress 2021; September 17-22, 2021. Poster 93.