Evidence based

CBD and Parkinson’s Disease: Current Research & Understanding

Parkinson’s disease is an incurable neurodegenerative disease. Evidence suggests CBD may provide relief for Parkinson’s disease symptoms and improve the overall quality of life for those affected. Here’s how it works.

Article By
Justin Cooke , posted 1 month ago

Parkinson’s disease is the second most common neurodegenerative disorder, behind Alzheimer’s disease.

The condition affects an estimated 10 million people worldwide — primarily men over the age of 60.

Parkinson’s disease is characterized by muscle tremors, stiffness, and issues with movement.

Although there is no cure for Parkinson’s disease, the progression of the disease can be delayed with carefully orchestrated changes to the diet, lifestyle habits, and the use of medications and supplements.

CBD is a popular supplement among Parkinson’s disease sufferers. It potentially offers benefits towards the underlying cause of the condition and a number of the most common side-effects.

Here, we’ll discuss how CBD can support a Parkinson’s diagnosis, and what you can do to get the most out of your CBD supplementation regimen.

  • MEDICALLY REVIEWED BY

    Abraham Benavides, M.D.,Medical Doctor

    Updated on November 12, 2019

  • Table of Contents

Summary: Using CBD for Parkinson’s Disease

There is no cure for Parkinson’s disease — treatment is aimed at slowing the progression of the disease and managing uncomfortable symptoms as they appear, including possibly dementia, in order to improve a patient’s quality of life.

Parkinson’s patients use CBD supplements to help alleviate symptoms such as depression, anxiety, muscle tremors, and some of the other complications associated with the condition. Current research suggests CBD could play a helpful role in these conditions.

There’s also some indication that CBD can be used to slow the progression for the disease and improves some of the underlying factors involved with the condition like neuroinflammation and dopamine regulation (more on this later).

The Potential Benefits of Using CBD with Parkinson’s Disease May Include:

  • May reduce underlying neuroinflammation — a key component of Parkinson’s disease
  • Could alleviate side-effects — such as muscle tremors, depression, insomnia, and anxiety
  • May improve dopamine production — through the GPR6 receptors in the basal ganglia to boost dopamine production
  • Supports healthy microbiome diversity — theories involving issues between the microbiome and brain health are gaining supportive evidence in recent years

Tips for Getting the Most Out of CBD Supplementation for Parkinson’s Disease

  1. Choose a full-spectrum extract — other cannabinoids in the cannabis plant offer separate benefits to this condition
  2. Always choose a high-quality, certified organic CBD supplement — poor quality products are often contaminated with heavy metals, pesticides, or mold that can be neurotoxic
  3. Be consistent with dosing — it can take several weeks of regular use notice the benefits of the supplement.
  4. Always consult with your doctor before taking CBD — some medications may have a negative interaction with the supplement

What is Parkinson’s Disease (PD)?

Parkinson’s disease (PD) is a neurodegenerative disorder affecting the part of the brain responsible for manufacturing dopamine — an important neurotransmitter associated with things such as mood, hormone balance, motor function, and focus/attention.

Symptoms of this condition usually appear gradually over the course of several years before and after diagnosis. They begin with nonspecific issues like hyposmia (reduced sense of smell), sleep disorders, constipation, and obesity up to 20 years before the more characteristic muscular issues such as rigidity, tremors, and falling. As the disease progresses, non-motor symptoms such as hallucinations, delusions, dementia and depression can appear and worsen over the next 20 years.

Parkinson’s disease by itself isn’t considered fatal — however, some of the complications brought on by the disease are — and can also certainly be life-altering and devastating for patients and families.

A common finding in PD patients is an abundance of Lewy bodies — clusters of proteins inside the neurons that don’t break down as they should through normal enzyme reactions in the brain.

As these Lewy bodies become more abundant and build up, they kill the neurons. This type of neuron injury is also characteristic of other neurodegenerative disorders including Alzheimer’s disease. The main differences are in the composition and location of the proteins.

In the case of Parkinson’s, the majority of these protein clusters are in the basal ganglia of the brainstem — specifically in the substantia nigra pars compacta neurons.

Symptoms of Parkinson’s Disease

  • Muscle tremors
  • Bradykinesia
  • Limb rigidity
  • Mask-like face
  • Gait and balance problems, i.e. shuffling
  • Depression
  • Poor focus or concentration
  • Mood changes
  • Apathy
  • Constipation
  • Excess salivation
  • Urinary retention
  • Sleep behavior disorders
  • Loss of sense of smell
  • Cognitive impairment

Dopamine & Parkinson’s Disease

The majority of symptoms associated with Parkinson’s disease result from a loss of dopamine-producing cells in the brainstem.

As the dopamine-producing neurons in the brainstem are lost, it becomes more difficult to manufacture the dopamine the brain needs to function properly. In fact, by the time characteristic muscle symptoms are clinically apparent, over 80% of the dopamine-producing neurons are gone. Without enough dopamine, symptoms like muscle tremors, lockjaw, weakness in the arms and legs, and poor balance are more frequent.

A loss of dopamine is linked with symptoms including:

  • Mood changes
  • Loss of normal muscle control
  • Hormonal changes
  • Poor libido
  • Difficulty concentrating
  • Depression

Norepinephrine & Parkinson’s Disease

Norepinephrine and epinephrine is structurally similar to dopamine and is built through the same pathway as dopamine. Therefore, epinephrine levels also suffer a decrease in production from Parkinson’s disease [1].

These neurotransmitters are major players in the sympathetic nervous system. As they start to become less abundant in the brain and blood vessels, we lose the ability to regulate autonomic functions including heart rate and blood pressure.

A loss of norepinephrine and/or epinephrine are linked with symptoms including:

  • Fatigue
  • Changes in blood pressure
  • Problems with digestion
  • Poor concentration
  • Depression

What Causes Parkinson’s Disease?

The cause for Parkinson’s disease is still unknown — however, there are a few factors that we now know contribute to the condition over time.

Older studies used to report Parkinson’s disease as being non-hereditary — meaning a disease that isn’t passed on through genes [4]. Newer studies, however, found at least two gene variants related to Parkinson’s disease [5] — LRRK2 and GBA genes, albeit rarely. Most cases by far are idiopathic.

Some factors believed to be linked with Parkinson’s disease include:

  1. Heavy metal exposure
  2. Traumatic head injuries
  3. Genetic factors
  4. Paraquat exposure (pesticide)
  5. Leaky gut syndrome
  6. Poor microbiome diversity
  7. Mitochondrial disease

The Stages of Parkinson’s Disease

Stage 1

Symptoms appear but are mild in nature. They usually don’t interfere with daily activities. The most common symptoms to appear are postural changes, muscle tremors, and changes in facial expression.

Stage 2

Stage two involves an increase in the severity of symptoms discovered in stage one and the development of symptoms affecting movement. It may be more difficult to walk normally, maintain correct posture, and normal tasks begin to become difficult. Usually, people in stage two don’t require outside assistance.

Stage 3

This stage is characterized by problems with maintaining balance and difficulties with day-to-day activities such as eating, using the toilet, or getting dressed. People in stage three may need assistance, while others remain independent.

Stage 4

By stage four, symptoms have become pronounced. Standing is possible, but walking requires the support of a walker or another person. Daily activities such as eating, bathing, and moving around require assistance. People at this stage are not able to live independently.

Stage 5

This is the last stage of Parkinson’s disease progression. Patients are unable to stand or walk on their own and are usually confined to a bed or wheelchair. Hallucinations and delusions may appear during this stage. Full-time assistance is required for people in this stage of disease.

How is Parkinson’s Disease Treated?

Most of the treatments for Parkinson’s disease are aimed at managing symptoms in order to optimize a patient’s quality of life. There are several medications and supplements that improve dopamine production in the brain, but these won’t cure the condition — only reduce the severity of symptoms associated with low dopamine. The medications will also need to be readjusted over time, along with regular follow ups with a neurologist.

Treatment Options for Parkinson’s Disease and Symptoms Includes:

  • Amantadine
  • Anticholinergic drugs
  • Antidepressants (SNRIs, SSRIs, TCAs)
  • Antioxidant supplementation
  • Cardio-aerobic exercise
  • Coffee consumption
  • COMT inhibitors
  • Deep brain stimulation
  • Dopaminergic medications (MAO-B Inhibitors, amphetamines)
  • Ensure adequate, restful sleep each night
  • High fiber diets
  • L-dopa supplementation
  • Meditation/yoga/Tai-chi
  • Occupational therapy
  • Probiotic supplementation
  • Speech therapy

How CBD May Help Parkinson’s Disease

There are a few ways CBD may support the symptoms of Parkinson’s disease. Before we get into this in more detail, it’s important to remember that CBD (or anything else for that matter), can’t cure Parkinson’s disease. CBD can, however, make side-effects of the condition more manageable, and perhaps may slow the progression of the disease for some people. Future research should be better able to characterize and describe the efficacy and usefulness of CBD for Parkinson’s disease and its multiple symptoms, which remains limited at this time.

CBD offers the following potential benefits towards Parkinson’s disease:

1. Anti-Inflammatory

Inflammation in the brain is closely associated with Parkinson’s disease [6]. As damage occurs in the dopamine-producing neurons in the brain, inflammation gradually worsen. As inflammation intensifies, it speeds up the neurodegenerative processes in the brain — aggravating the condition.

Inflammation may or may not be an underlying cause for Parkinson’s, we still don’t know for sure. What we do know, however, is that this form of inflammation isn’t making the condition any better. Therefore one of the primary treatments for this condition is to try and lower inflammation in the brain. This helps the neurons recover, and may slow the progression of the disorder.

CBD is especially proficient at addressing inflammation in the brain as it mediates several key pathways involved with the inflammatory process [7].

Inflammation in the brain is thought to be one of the main perpetuating factors of Parkinson’s disease [6].

2. May Reduce Muscle Tremors

Muscle tremors are one of the primary symptoms of Parkinson’s disease. It has a major impact on the quality of life of those affected.

CBD has shown promise in early research to variably improve muscle tremors in mice with Parkinson’s disease [8], and similar potential neurodegenerative disorders like multiple sclerosis [9], and Huntington’s disease [10] — all worth further clinical investigation.

3. Possibly Helps Alleviate Depression

Studies suggest that 45% of people with Parkinson’s disease also suffer from depression [2, 3].

One of the most important benefits of CBD is in the potential relief of depression. The main mechanism CBD is thought to relieve symptoms of depression is through its ability to reduce neuroinflammation — a condition that’s also present with many Parkinson’s disease patients and is likely a contributor to so many Parkinson’s patients also suffer from depression.

4. Improves Sleep Quality and Onset

Sleep disorders are a common side-effect of Parkinson’s disease [13].

There are several reasons for this, including:

  1. Involuntary muscle movements sleeping
  2. Muscle contractions in the early hours of the morning
  3. Painful cramps at night
  4. Tremor and difficulty turning in bed
  5. Medication side-effects (such as levodopa, other dopamine agonists and antidepressants)
  6. Hallucinations
  7. Vivid dreams

Insomnia can also result from other associated medical conditions:

  1. Depression
  2. Dementia
  3. Panic attacks & anxiety
  4. Rapid eye movement behavioral disorder (REM-BD)
  5. Restless legs syndrome (RLS)
  6. Periodic leg movements (PLMS)

CBD is well-known for its mild sedative benefits [11]. CBD improves both sleep quality and quantity in a series of clinical trials [12].

Other cannabinoids, including CBG (cannabigerol), are thought to offer muscle relaxant properties — adding layers of support for some of the primary causes of insomnia among Parkinson’s disease [14].

5. Supports Dopamine Production

The primary cause of symptoms with Parkinson’s disease is low dopamine production in the brain. Therefore, one of the most important targets of effective treatment is on the dopamine-producing neurons in the brain.

CBD has been shown — in at least one preclinical study — to improve dopamine production [15]. It works through a newly discovered receptor known as the GPR6 receptors located in the same region where dopamine is manufactured [16].

This is a new and very important discovery. New research is currently underway to understand these effects in more detail and better discern the role CBD could possibly play in the role of Parkinson’s management.

If these findings are shown to be therapeutically relevant through future research, we can expect to see CBD become a primary treatment option for Parkinson’s disease. At this point, the research is inconclusive.

There aren’t enough clinical studies to highlight a specific dosage range for Parkinson’s disease, however, there is a lot of research on CBD use for a similar condition, multiple sclerosis.

Studies on multiple sclerosis and other forms of neurodegenerative disorders often use large doses of CBD to produce benefits. In general, to get the same level of benefits found in the research, a higher dose is needed.

We recommend starting at the low-strength dose as highlighted in the chart below and build up over time to the highest dose. If no side-effects are experienced, stay at this dose.

For maximum benefit, incorporate CBD for long-term treatment. This is why it’s important to find a dose that allows for the highest amount of CBD possible without producing any side-effects or medication interactions.

Recommended Strength For Parkinson’s Disease: High Strength

Daily Doses of CBD by Weight and Strength (in mg)

Weight (lbs)Low StrengthMedium StrengthHigh Strength

100 lbs

10 mg

30 mg

60 mg

125 lbs

13 mg

38 mg

75 mg

150 lbs

15 mg

45 mg

90 mg

175 lbs

17 mg

52 mg

105 mg

200 lbs

20 mg

60 mg

120 mg

225 lbs

22 mg

67 mg

135 mg

250 lbs

25 mg

75 mg

150 mg

Final Verdict: Using CBD for Parkinson’s Disease

There’s no cure for Parkinson’s disease — most of the treatment options available, including CBD are used to slow the progression of the disease and manage symptoms to improve a patient’s quality of life.

CBD is a potentially excellent option for both — it may alleviate many of the most common side-effects of the conditions (insomnia, depression, anxiety, muscle tremors) and perhaps may slow the progression of Parkinson’s, although more clinical research is needed to demonstrate this.

It’s important to consult with your doctor before using CBD to ensure it won’t have any negative interactions with the medications you’re taking. Patients with Parkinson’s disease will need multifaceted treatment and regular follow ups with their neurologist to readjust medication as needed.

Anecdotally, Most Parkinson’s patients use a high dose of CBD for long periods of time.

For maximum benefits, opt for a high-potency full-spectrum CBD oil to take advantage of other cannabinoids such as CBG that have their own set of benefits to offer Parkinson’s symptoms.

We also recommend using only high-quality CBD and hemp oils. Low-quality products may be contaminated with heavy metals or pesticides that can actually make symptoms even worse.

Always do your research before buying CBD to make sure the companies you’re buying from use high-quality hemp, free from contaminants.

References

  1. Delaville, C., De Deurwaerdère, P., & Benazzouz, A. (2011). Noradrenaline and Parkinson’s disease. Frontiers in systems neuroscience, 5, 31.
  2. Lemke, M. R. (2002). Effect of reboxetine on depression in Parkinson’s disease patients. The Journal of clinical psychiatry, 63(4), 300-304.
  3. Lemke, M. R., Fuchs, G., Gemende, I., Herting, B., Oehlwein, C., Reichmann, H., … & Volkmann, J. (2004). Depression and Parkinson’s disease. Journal of Neurology, 251(6), vi24-vi27.
  4. Jankovic, J., & Tolosa, E. (Eds.). (2007). Parkinson’s disease and movement disorders. Lippincott Williams & Wilkins.
  5. Ozelius, L. J., Senthil, G., Saunders-Pullman, R., Ohmann, E., Deligtisch, A., Tagliati, M., … & Lipton, R. B. (2006). LRRK2 G2019S as a cause of Parkinson’s disease in Ashkenazi Jews. New England Journal of Medicine, 354(4), 424-425.
  6. Hirsch, E. C., & Hunot, S. (2009). Neuroinflammation in Parkinson’s disease: a target for neuroprotection?. The Lancet Neurology, 8(4), 382-397.
  7. Baker, D., Jackson, S. J., & Pryce, G. (2007). Cannabinoid control of neuroinflammation related to multiple sclerosis. British journal of pharmacology, 152(5), 649-654.
  8. Kluger, B., Triolo, P., Jones, W., & Jankovic, J. (2015). The therapeutic potential of cannabinoids for movement disorders. Movement disorders, 30(3), 313-327.
  9. Malfitano, A. M., Proto, M. C., & Bifulco, M. (2008). Cannabinoids in the management of spasticity associated with multiple sclerosis. Neuropsychiatric disease and treatment, 4(5), 847.
  10. Dowie, M. J., Howard, M. L., Nicholson, L. F. B., Faull, R. L. M., Hannan, A. J., & Glass, M. (2010). Behavioural and molecular consequences of chronic cannabinoid treatment in Huntington’s disease transgenic mice. Neuroscience, 170(1), 324-336.
  11. Crippa, J. A., Guimarães, F. S., Campos, A. C., & Zuardi, A. W. (2018). Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Frontiers in Immunology, 9. https://doi.org/10.3389/FIMMU.2018.02009
  12. Russo, E. B., Guy, G. W., & Robson, P. J. (2007, August 1). Cannabis, pain, and sleep: Lessons from therapeutic clinical trials of sativexρ, a cannabis-based medicine. Chemistry and Biodiversity. Wiley-Blackwell. https://doi.org/10.1002/cbdv.200790150
  13. Sleep disorders in Parkinson’s disease: Diagnosis and management. Ann Indian Acad Neurol. 2011;14(Suppl 1):S18-20.
  14. Evans, F. J. (1991). Cannabinoids: the separation of central from peripheral effects on a structural basis. Planta medica, 57(S 1), S60-S67.
  15. Morales, P., Isawi, I., & Reggio, P. H. (2018). Towards a better understanding of the cannabinoid-related orphan receptors GPR3, GPR6, and GPR12. Drug metabolism reviews, 50(1), 74-93.
  16. Laun, A. S., & Song, Z. H. (2017). GPR3 and GPR6, novel molecular targets for cannabidiol. Biochemical and biophysical research communications, 490(1), 17-21.

Conditions that May Respond to Cannabidiol