Factors to Consider When Treating Neurodegenerative Diseases
Types of Neurodegenerative Diseases and Overlaps
Neurodegenerative diseases encompass a variety of conditions, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS). These diseases may present overlapping symptoms such as cognitive decline, motor impairment, and difficulties in speech. Treatment modalities often have points of intersection, especially when targeting symptom relief.
- Alzheimer’s Disease: Primarily manifests as memory loss and cognitive decline. Common treatments include Donepezil and Rivastigmine (Birks, 2006).
- Parkinson’s Disease: Characterized by tremors, stiffness, and slow movement. Common treatments include Levodopa and Pramipexole (Connolly & Lang, 2014).
- Multiple Sclerosis: Affects the central nervous system causing various motor and sensory problems. Corticosteroids are often prescribed (Rae-Grant et al., 2018).
- ALS: A rapidly progressive disease affecting motor neurons. Riluzole is a commonly prescribed medication (Miller et al., 2012).
Existing Treatments: OTC and Prescription
Treatment approaches can vary from over-the-counter (OTC) supplements like vitamins to prescription medications, which include oral pills, nasal sprays, and injectables. Non-pharmacological interventions such as physical therapy, lifestyle modification, and diet are also important considerations.
Cannabinoid Options
Cannabinoids like THC (tetrahydrocannabinol) and CBD (cannabidiol) offer alternative therapeutic pathways. THC products may have psychoactive or euphoric effects, whereas CBD is non-euphoric. Timing for onset of action and duration varies, with inhaled forms acting quickly but for shorter periods, and oral forms taking longer to act but having extended effects (MacCallum & Russo, 2018).
Comparison Table
| Formulation | Onset Time | Duration | Application | Euphoria | Applicable Diseases |
|---|---|---|---|---|---|
| THC Oral | 30-90 min | 4-12 hrs | Pill | Yes | All |
| CBD Oral | 30-90 min | 4-12 hrs | Pill | No | All |
| THC Inhaled | 1-3 min | 2-4 hrs | Vapor | Yes | All |
| CBD Topical | 20-40 min | 2-6 hrs | Cream | No | MS, ALS |
| Ibuprofen | 15-30 min | 4-6 hrs | Pill | No | N/A |
| Nasal Corticosteroids | Immediate | Long-term | Nasal Spray | No | MS |
Interactions and Overlaps
Patients should exercise caution when combining cannabinoid therapies with other medications, as they can affect liver enzyme activity and alter the effectiveness or side effects of other drugs (Zendulka et al., 2016).
Special Note for Certain Medical Conditions
Patients with certain medical conditions, such as liver disease, cardiovascular issues, or a history of substance use disorders, should consult Dr. Caplan at CED Clinic for specialized, thoughtful care in cannabinoid therapy.
References
- Birks, J. (2006). Cholinesterase inhibitors for Alzheimer’s disease. Cochrane Database of Systematic Reviews, 1.
- Connolly, B., & Lang, A. E. (2014). Pharmacological treatment of Parkinson disease: A review. JAMA, 311(16), 1670–1683.
- Rae-Grant, A., Day, G. S., Marrie, R. A., Rabinstein, A., Cree, B. A. C., Gronseth, G. S., … & Armstrong, M. J. (2018). Practice guideline recommendations summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology, 90(17), 777-788.
- Miller, R. G., Jackson, C. E., Kasarskis, E. J., England, J. D., Forshew, D., Johnston, W., … & Woolley, S. C. (2012). Practice parameter update: The care of the patient with amyotrophic lateral sclerosis: Multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 73(15), 1227-1233.
- MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12-19.
- Zendulka, O., Dovrtělová, G., Nosková, K., Turjap, M., Šulcová, A., Hanuš, L., & Juřica, J. (2016). Cannabinoids and Cytochrome P450 Interactions. Current Drug Metabolism, 17(3), 206-226.
Please note, this article is for informational purposes and should not replace professional medical advice. Always consult a qualified healthcare provider for personalized treatment options.
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