Snider/Parkinsons/CBD/1985

Beneficial and Adverse Effects of Cannabidiol in a Parkinson Patient with
Sinemet-Induced Dystonic Dyskinesia

Stuart R. Snider and Paul Consroe, Tucson, AZ

"Neurology" 35 April 1985 (Suppl 1) p. 201

In idiopathic dystonia, the therapeutic effect of marijuana smoking
is reported to be comparable with diazepam (C.D. Marsden, in Disorders of
Movement, 1981: 81). The non-psychoactive cannabis derivative, cannabidiol
(CBD), also improves dystonia (Consroe and Snider, in Cannabinoids as
Therapeutic Agents, in press). We report the effect of CBD on dystonia
secondary to Sinemet in parkinsonism, a disorder thought to be a relative
contraindication for cannabinoids (D. Moss et al, Pharmacol Biochem
Behav 1981, 1984). The patient, a 42 year-old man with an 8-year history
of parkinsonism, developed peak-dose dyskinesia about 4 years ago and
action dystonia affecting all limbs more recently. Trohexyphenidyl and
bromocriptine each produced only slight improvement. To stable optimal
dosages of the three drugs, CBD was added, starting with 100 mg/d and
increasing by 100 mg weekly. At 100 to 200 mg/d, there was a decrease in
clinical fluctuations and in dyskinesia scores (by 30%) without a
significant worsening of the parkinsonism. At 300 to 400 mg/d, there was
no further improvement in the dyskinesia, and adverse effects (dizziness,
increased Parkinson symptoms) appeared. CBD withdrawal resulted in 3 days
of severe generalized dystonia and several weeks of increased sensitivity
to Sinemet, suggestive of a "drug holiday" effect.

INDEX HOME