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DOI: 10.1055/s-0043-120668
Cannabis bei Parkinson – Hype oder Heilmittel?
Cannabis in Parkinson’s Disease: Hype or help?Publication History
06/14/2017
02/10/2017
Publication Date:
11 January 2018 (online)
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Zusammenfassung
In Deutschland können seit März 2017 Patienten mit einer schwerwiegenden Erkrankung Cannabisblüten und -extrakte sowie synthetische Cannabinoide zu Lasten der Krankenkassen verordnet werden. Die Zulassung von medizinischem Cannabis beinhaltet keine Festlegung auf eine Indikation und ist somit auch für Parkinson-Patienten relevant. Laut Gesetz haben schwerbetroffene Patienten sogar einen Anspruch auf Versorgung mit medizinischem Cannabis, wenn übliche Maßnahmen nicht erfolgreich waren oder nicht vertragen wurden oder „eine nicht ganz entfernte Aussicht auf eine spürbare positive Einwirkung auf schwerwiegenden Symptome besteht“.
Vor diesem Hintergrund und verstärkt durch Medienberichte fragen zunehmend Parkinson Patienten nach Verordnung von Cannabis. Dies stellt die behandelnden Neurologen vor eine neue Herausforderung.
Dieser Artikel gibt einen Überblick über die verschreibungsfähigen Cannabisprodukte und Applikationsformen sowie die Datenlage für Cannabis bei motorischen- und nicht-motorischen Parkinson Symptomen. Ferner werden aus Sicht der Autoren Indikationen definiert, für welche im Einzelfall Cannabis bei Parkinson-Patienten hilfreich sein könnte und ggf. dem Wunsch des Patienten nach Verordnung stattgegeben werden sollte. Es werden praxisrelevante Empfehlungen für die Verordnung von Cannabinoiden sowie die Beratung des Patienten, einschließlich hinsichtlich der Fahrfähigkeit ausgesprochen.
Abstract
Cannabis buds and extracts as well as synthetic cannabinoids have been available on prescription to patients with severe diseases since March 2017, with the costs covered by health insurance companies.
The prescription of medical marihuana is not restricted to specific symptoms and is therefore also valid for patients with Parkinson‘s disease. From a legal perspective, patients who are seriously ill even have the right to be treated with cannabis if standard treatment methods are unsuccessful or result in unbearable side effects. This also applies even if only a slight chance of noticeable improvement is predicted as a result of the cannabis treatment.
Bearing this in mind and due to an intense media coverage of this topic, more and more patients with Parkinson‘s disease are requesting cannabis prescription, which is a challenging situation to their neurologists.
This article provides an overview of the various cannabis products that can be prescribed, the different modes of administration and the available literature regarding motor- and non-motor symptoms in Parkinson‘s disease. Furthermore, the authors state their opinion on which indications cannabinoids could be useful in treating patients with Parkinson‘s disease or in which situation the patient could or even should be prescribed cannabinoids. Additionally, this article presents practical recommendations for the prescription of cannabinoids and patient counseling, e. g., on the effects of medical marijuana on driving capacity.
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