Balash Yacov, Bar-Lev Schleider Lihi, Korczyn Amos D, Shabtai Herzel, Knaani Judith, Rosenberg Alina, Baruch Yehuda, Djaldetti Ruth, Giladi Nir, Gurevich Tanya
*Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv; †Sackler School of Medicine, Tel Aviv University, Tel Aviv; ‡Tikun Olam, Research Department, Tel Aviv; §School of Public Health, Epidemiology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv; ∥OneWorld Cannabis Ltd, Petah-Tikva; ¶Movement Disorders Center, Rabin Medical Center, Petah-Tikva; and #Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
Clin Neuropharmacol. 2017 Nov/Dec;40(6):268-272. doi: 10.1097/WNF.0000000000000246.
The use of medical cannabis (MC) is controversial. Support for its benefits is based on small clinical series.
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.
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.
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.
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.
医用大麻(MC)的使用存在争议。对其益处的支持基于小型临床系列研究。
本研究旨在报告一项标准化访谈研究的结果,该研究回顾性评估了医用大麻对帕金森病(PD)症状的影响及其对接受至少3个月治疗患者的不良反应。
该调查采用电话访谈,使用基于对各种帕金森症状变化的主观整体印象的结构化问卷以及关于不良反应的是/否问题。
47名非痴呆型帕金森病患者(40名男性)参与。他们的平均年龄为64.2±10.8岁,平均病程为10.8±8.3年,Hoehn和Yahr(H&Y)中位数为III期。医用大麻的使用时长为19.1±17.0个月,平均每日剂量为0.9±0.5克。医用大麻的给药方式主要是吸烟(38例,80.9%)。跌倒症状改善的效应量(r)为0.89,疼痛缓解为0.73,抑郁为0.64,震颤为0.64,肌肉僵硬为0.62,睡眠为0.60。医用大麻最常报告的不良反应是吸烟使用者中的咳嗽(34.9%)以及意识模糊和幻觉(各占17%),导致5名患者(10.6%)停止治疗。
在这项2中心回顾性试点调查中,发现医用大麻在治疗初期可改善帕金森病症状,且未造成重大不良反应。使用范围和报告的效果支持进一步研发源自大麻的更安全、更有效的药物。