Resumo
Objetivo: Compreender a efetividade do uso da Cannabis medicinal no tratamento dos sintomas motores e não-motores característicos da Doença de Parkinson (DP). Revisão bibliográfica: O tratamento com Cannabis, especificamente o Canabidiol (CBD), tem sido estudado para várias doenças neurodegenerativas, incluindo a DP. Enquanto o CBD mostra potencial em aliviar sintomas como distonia e discinesias, sua eficácia nos sintomas motores da DP ainda carece de evidências robustas. Os receptores canabinoides CB1 e CB2 estão presentes em áreas cruciais para a coordenação motora, e o CBD pode influenciar a neurotransmissão dopaminérgica, mas os resultados sobre seu efeito nos sintomas motores da DP são inconsistentes. Além disso, embora o CBD possa melhorar sintomas não motores como ansiedade e distúrbios do sono, os efeitos adversos, incluindo sedação e alucinações, são preocupantes Parte superior do formulário. Considerações finais: O uso de derivados do cannabis não demonstrou grandes vantagens na Doença de Parkinson. O Canabidiol se demonstrou insuficiente no tratamento dos sintomas motores e seus efeitos adversos incertos tornam seu uso arriscado.
Referências
ALBIN RL, et al. The functional anatomy of basal ganglia disorders. Trends In Neurosciences, 1989; 12: 366-375.
ARAÚJO M, et al. Mecanismo de ação dos canabinoides: visão geral. Brazilian Journal Of Pain, 2023; 6: 109-13.
ARMSTRONG MJ e OKUN MS. Diagnosis and Treatment of Parkinson Disease. Jama, 2020; 323(6): 548.
BATISTA J, et al. Efeitos adversos do uso dos canabinoides: qual o paradigma de segurança? Brazilian Journal Of Pain, 2023; 6: 38-43.
CABREIRA V e MASSANO, J. Doença de Parkinson: Revisão Clínica e Atualização. Acta Médica Portuguesa, 2019; 32: 661.
CAMARGO MF, et al. Canabinoides como uma nova opção terapêutica nas doenças de Parkinson e de Alzheimer: uma revisão de literatura. Revista brasileira neurologia, 2019; 55(2): 17-32.
CASSANO T, et al. From Cannabis sativa to cannabidiol: Promising therapeutic candidate for the treatment of neurodegenerative diseases. Frontiers in pharmacology, 2020; 11: 124.
CHEN Z, et al. Autonomic dysfunction in Parkinson’s disease: implications for pathophysiology, diagnosis, and treatment. Neurobiology Of Disease, 2020; 134: 104700.
CHURCH FC. Treatment options for motor and non-motor symptoms of Parkinson’s disease. Biomolecules, 2021; 11(4): 612.
COORAY R, et al. Current Aspects of the Endocannabinoid System and Targeted THC and CBD Phytocannabinoids as Potential Therapeutics for Parkinson’s and Alzheimer’s Diseases: a Review. Molecular Neurobiology, 2020; 57: 4878–4890.
CRAVANAS B, et al. The effects of Cannabis on hallucinations in Parkinson's disease patients, Journal of the Neurological Sciences, 2020; 15 (419): 117206.
CRIPPA JAS et al; Is cannabidiol the ideal drug to treat non-motor Parkinson's disease symptoms? European Archives of Psychiatry and Clinical Neuroscience, 2019; 269(1): 121-133.
DEUEL LM e SEEBERGER LC. Complementary Therapies in Parkinson Disease: a Review of Acupuncture, Tai Chi, Qi Gong, Yoga, and Cannabis. Neurotherapeutics, 2020; 17(4): 1434-1455.
FARIA SM, et al. Effects of acute cannabidiol administration on anxiety and tremors induced by a Simulated Public Speaking Test in patients with Parkinson’s disease. Journal Of Psychopharmacology, 2020; 34(2): 189-196.
FIGURA M, et al. Cannabis in Parkinson’s Disease - the patient’s perspective versus clinical trials: a systematic literature review. Neurologia i Neurochirurgia Polska, 2022; 56: 21–27.
HAYES MT. Parkinson's Disease and Parkinsonism. The American Journal Of Medicine, 2019; 132: 802-807.
JUNIOR NCF, et al. Cannabidiol and Cannabinoid Compounds as Potential Strategies for Treating Parkinson’s Disease and l-DOPA-Induced Dyskinesia. Neurotoxicity Research, 2019; 37: 12–29.
KANJANARANGSICHAI A, et al. Cannabidiol-enriched cannabis extraction product in Parkinson's disease: A randomized, double-blind, and placebo-controlled trial in Buriram Hospital. J Neurosci Rural Pract, 2022; 13(4): 663-668.
KLUGER BM, et al. Cannabinoids in movement disorders. Parkinsonism & Related Disorders, 2022; 102: 124-130.
LACROIX C, et al. What Do We Know About Medical Cannabis in Neurological Disorders and What Are the Next Steps? Frontiers in pharmacology, 2022; 13: 883987.
LANCIEGO JL, et al. Functional Neuroanatomy of the Basal Ganglia. Cold Spring Harbor Perspectives In Medicine, 2012; 2: 9621.
PAES-COLLI Y, et al. Phytocannabinoids and Cannabis-Based Products as Alternative Pharmacotherapy in Neurodegenerative Diseases: From Hypothesis to Clinical Practice. Frontiers in Cellular Neuroscience, 2022; 16: 917164.
PATRICIO F, et al. Cannabidiol as a therapeutic target: evidence of its neuroprotective and neuromodulatory function in Parkinson’s disease. Frontiers in Pharmacology, 2020; 11: 595635.
RYMAN SG e POSTON KL. Biomarcadores de ressonância magnética de sintomas motores e não motores na doença de Parkinson. Parkinsonismo e distúrbios relacionados, 2020; 73: 85-93.
SANTOS GF, et al. Doença de Parkinson: Padrão epidemiológico de internações no Brasil. Research, Society and Development, 2022; 11: 13511124535.
SIMON DK, et al. Parkinson Disease Epidemiology, Pathology, Genetics, and Pathophysiology. Clinics In Geriatric Medicine, 2020; 36: 1-12.
TAMBE SM, et al. Neuroprotective potential of cannabidiol: Molecular mechanisms and clinical implications. Journal of Integrative Medicine, 2023; 21(3): 236-244.
THALER A e ALCALAY RN. Diagnosis and Medical Management of Parkinson Disease. Continuum: Lifelong Learning in Neurology, 2022; 28(5): 1281-1300.
