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Background: The long term treatment of Parkinson disease (PD) may be complica ted by the development of levodopainduced dyskinesia. Clinical and animal model data support the view that modulation of cannabinoid function may exert an antid yskinetic effect. The authors conducted a randomized, double blind, placebo co ntrolled crossover trial to examine the hypothesis that cannabis may have a bene ficial effect on dyskinesia in PD. Methods: A 4 week dose escalation study was performed to assess the safety and tolerability of cannabis in six PD patients w ith levodopa induced dyskinesia. Then a randomized placebo controlled crossove r study (RCT) was performed, in which 19 PD patients were randomized to receive oral cannabis extract followed by placebo or vice versa. Each treatment phase la sted for 4 weeks with an intervening 2 week washout phase. The primary outcome measure was a change in Unified Parkinsons Disease Rating Scale (UPDRS) (items 32 to 34) dyskinesia score. Secondary outcome measures included the Rush scale, Bain scale, tablet arm drawing task, and total UPDRS score following a levodopa challenge, as well as patient completed measures of a dyskinesia activities of daily living (ADL) scale, the PDQ 39, on off diaries, and a range of category rating scales. Results: Seventeen patients completed the RCT. Cannabis was well tolerated, and had no pro or antiparkin sonian action. The re was no evidence for a treatment effect on levodopa induced dyskinesia as ass essed by the UPDRS, or any of the secondary outcome measures. Conclusions: Orall y administered cannabis extract resulted in no objective or subjective improveme nt in dyskinesias or parkinsonism.
Background: The long term treatment of Parkinson disease (PD) may be complica ted by the development of levodopainduced dyskinesia. Clinical and animal model data support the view that modulation of cannabinoid function may exert an antid yskinetic effect. The authors conducted a randomized, double blind, placebo co ntrolled crossover trial to examine the hypothesis that cannabis may have a benevolence effect on dyskinesia in PD. Methods: A 4 week dose escalation study was performed to assess the safety and tolerability of cannabis in six PD patients w ith levodopa induced Then a randomized placebo controlled crossover r study (RCT) was performed, in which 19 PD patients were randomized to receive oral cannabis extract followed by placebo or vice versa. Each treatment phase la sted for 4 weeks with an intervening 2 week washout phase . The primary outcome measure was a change in Unified Parkinson’s Disease Rating Scale (UPDRS) (items 32 to 34) dyskinesia score. Secondary ou tcome measures included the Rush scale, Bain scale, tablet arm drawing task, and total UPDRS score following a levodopa challenge, well as patient completed measures of a dyskinesia activities of daily living (ADL) scale, the PDQ 39, on off diaries, Results: Seventeen patients completed the RCT. Cannabis was well tolerated, and had no pro or antiparkin sonian action. The re was no evidence for a treatment effect on levodopa induced dyskinesia as asssed by the UPDRS, or any of the secondary outcome measures. Conclusions: Orall y administered cannabis extract resulted in no objective or subjective improveme nt in dyskinesias or parkinsonism.