The Use of Cannabis-Based Medicine in Selected Neurological Disorders

Cannabis-based medicine (CBM) is used in a wide variety of different neurological disorders. While the use of CBM in the treatment of pain, AIDS wasting, loss of appetite, and spasticity is well established, CBM application in movement disorders and neurodegenerative disorders is still an emerging topic. The purpose of this chapter is to summarize current evidence behind the use of CBM in selected neurological diseases, mainly movement and neurodegenerative disorders. The best evidence for efficacy of CBM is for Tourette syndrome resulting in an improvement of tics and psychiatric comorbidities. In this indication, delta-9-tetrahydrocannabinol (THC)-containing CBMs are recommended. There is limited evidence that CBMs are also effective in Parkinson's disease in which they may improve tremor, but also non-motor symptoms such as pain and sleeping problems. With respect to other neurodegenerative diseases, there is limited evidence that CBMs may improve behavioral symptoms in Huntington's disease. In addition, it has been speculated that CBMs may have neuroprotective effects, but this has not yet been confirmed in the clinical setting.