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Movement Disorders and Medical Cannabis

by Sarah Walker

February 15, 2024 03:20 pm ET Estimated Read Time: 17 Minutes

Medically reviewed by Dr. Abraham Benavides Fact checked by Kymberly Drapcho

What You Need To Know: Medical Cannabis and Movement Disorders

Movement disorders, comprising over 30 neurological conditions, affect around 40 million people globally, with projections indicating a significant rise by 2050. Cannabis is gaining attention as a potential therapeutic tool for movement disorders due to its impact on the endocannabinoid system (ECS), which plays a crucial role in motor function and dysfunction. While the American Academy of Neurology doesn’t currently support medical marijuana legalization for neurological conditions, there’s acknowledgment of cannabis’s potential usefulness in treating neurologic disorders.

Limited human trials suggest positive effects of cannabinoids like CBD and THC in alleviating symptoms of movement disorders such as Parkinson’s disease and Tourette syndrome. Observational studies indicate improvements in motor symptoms and overall well-being in patients using marijuana, particularly in Parkinson’s cases.

The Tourette Association of America supports further research into medical marijuana for tic disorders, emphasizing the need for more comprehensive government-backed studies. Complementary treatments, including cannabis, are seen as potential enhancers of conventional therapies, but caution is urged due to possible side effects. Ongoing research into the ECS and cannabis holds promise for advancing treatments for movement disorders.

The Science Behind Cannabis for Movement Disorders

1. Are Cannabinoids a Good Treatment Option for Movement Disorders?
2. How Does the Endocannabinoid System Play a Role in Treating Movement Disorders?
3. What Cannabis Preparations Are Suitable for Movement Disorders?
4. Can Cannabis Give You Tics?
   1. TAA Supports the Idea of Cannabis for Tics
5. Complementary Treatments Worth Discussing With Your Doctor
6. What are the Signs, Symptoms, and Types of Movement Disorders?
7. Movement Disorders: Causes and Complications
8. Talking to Your Doctor About Treatments for Movement Disorders

Movement disorders is an umbrella term used to describe a category of over 30 nervous system (neurological) conditions that cause increased, reduced, or slow movements. According to the Parkinson and Movement Disorder Alliance, these conditions collectively affect approximately 40 million people, and cases are expected to increase on a grand scale by the year 2050 (10, 2). 

With an aging global population and the prevalence increasing for many common movement disorders, the importance of pushing beyond existing therapeutics to relieve patients of the burden has never been greater (2). Cannabis is gaining a new reputation as a therapeutic and pharmacological tool for various medical conditions, diseases, and ailments, such as movement disorders, neurological disorders, and chronic pain.

A growing field of research points to the potential of using cannabis for movement disorders and neurodegenerative diseases, particularly since the endocannabinoid system (ECS) is strongly tied to motor function and dysfunction (6).

Are Cannabinoids a Good Treatment Option for Movement Disorders?

The American Academy of Neurology (AAN) does not support or advocate for the legalization of medical marijuana for neurological conditions until further research into the safety, efficacy, tolerability, and therapeutic potential of medical cannabis is carried out (7). However, they do acknowledge that “cannabis may be useful in treating neurologic disorders.” They also continue to support long-term cannabis research proposals. 

Currently, a limited number of human clinical trials have spotlighted the positive effects of using cannabis-derived cannabinoids, such as cannabidiol (CBD) and tetrahydrocannabinol (THC) to ease the symptoms of movement disorders. 

While the evidence from controlled studies is lacking, there is proof pointing to the therapeutic value of cannabinoids in cases of movement disorders including Parkinson’s disease, Tourette syndrome, levodopa-induced dyskinesia, and certain types of dystonia and tremor. An abundance of central cannabinoid receptors are found in the output nuclei of the basal ganglia area of the brain, thus suggesting that they play an important role in motor activity regulation (32).

A clinical observational study of 22 marijuana-smoking patients with Parkinson’s disease demonstrated an improvement in motor symptoms including bradykinesia, resting tremor, rigidity, and posture (17). Non-motor symptoms including sleep and pain were also improved. 

Moreover, research has shown that cannabinoid antagonists may be useful in the treatment of chorea in Huntington’s disease and hypokinetic Parkinsonian syndromes (16). 

The Tourette Association of America (TAA), after a thorough literature review, acknowledges that a reduction in tics has been reported following the use of cannabis-based medicines in certain studies (8). For patients with multiple sclerosis, cannabinoids like THC and CBD may be beneficial for relieving the symptoms of pain, muscle spasms, and spasticity.

Some MDs are also recommending cannabis as a tool for psychiatry, with placebo-controlled crossover studies in animal models and randomized controlled trial results indicating that cannabis harbors neuroprotective, antidepressant, antianxiety, and sleep-promoting qualities. Non-motor symptoms like sleeping disorders, anxiety, and depression may arise in patients with movement disorders like Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease.

How Does the Endocannabinoid System Play a Role in Treating Movement Disorders?

The endocannabinoid system (ECS) is involved in a vast array of physiological functions, such as cognition, feeding behaviors, and pain (34). Neurotransmission involved in motor function is modulated by the ECS, especially within the basal ganglia–a group of motor neurons in the brain found deep beneath the cerebral cortex. These nuclei are crucial for movement, perception, and judgment.

Data from animal studies and clinical studies have indicated that the ECS is involved in motor control and movement, suggesting that exogenous cannabinoids could have the potential for the treatment of motor symptoms in movement disorders (33). 

Evidence suggests that the ECS is essential in oxidative stress, neurodegeneration, and neuro-immune modulation. The ECS also affects our mood through exerting influence on our endocannabinoid levels; dopamine, GABA, and serotonin receptors (for antidepressant and anti-anxiety functions); and other receptors such as pain and inflammatory receptors that also affect how we feel (4). 

Cannabinoids can help promote sleep and potentially regulate certain sleeping disorders such as restless leg syndrome, a movement disorder that happens at bedtime (36). Additionally, certain terpenes, such as alpha-pinene and linalool, can help curb short-term memory deficits and improve sleep, anxiety, depression, and agitation in people with concurrent dementia (35). 

Since the symptoms of the most commonly diagnosed movement disorders tend to surface as a direct effect of an ongoing neurodegenerative illness, cannabinoids could help to maintain balance by boosting the ECS (9).

All of the aforementioned processes are affected by movement disorders. This, combined with the fact that functional cannabinoid receptors (such as CB1 receptors) and ligands are present in those regions, lends motivation for further research into therapeutic cannabinoid solutions that may ease, prevent, and treat the symptoms of movement disorders (11). 

What Cannabis Preparations Are Suitable for Movement Disorders?

Since people with movement disorders usually require fast relief from their symptoms, it’s best to find a cannabis preparation that works quickly. Smoking, dry herb or concentrate vaping, mouth sprays (e.g. Sativex), and tinctures ensure the fastest ingestion methods, with the effects likely to surface within a few minutes.

Alternatively, patients with movement disorders may choose oral solutions like capsules, pills, and supplements for longer-lasting relief from their symptoms. However, much like with cannabis-infused edibles, the body must first break down the cannabinoids before they release their effects.

Can Cannabis Give You Tics?

One of the most common questions asked by TS patients who are considering medical cannabis as a treatment option is: “Can marijuana give you tics?” The answer is no, but it’s important to differentiate between tics and a different cannabis-related phenomenon referred to as “the shakes.”

Although heavy cannabis use may sometimes be associated with involuntary muscle twitches and tremors (“the shakes”), there is no evidence to suggest that the plant causes any of the symptoms of Tourette’s syndrome or tic-related disorders. Sometimes, cannabis consumers with a low tolerance may feel shaky and jittery or experience muscle spasms after consuming THC-rich cannabis.

When consumed in high doses, tetrahydrocannabinol (THC) is also renowned for sparking feelings of anxiety or paranoia, which is why it’s important to start with a low dose and progress slowly as a first-time consumer. Conversely, scientists have postulated that THC could actually help to relieve tics in certain doses. 

Numerous factors may influence the onset of cannabis-related muscle spasms and overall shakiness, two of which include:

• Climate: Cannabis may reduce body temperature by inducing “THC-induced hypothermia” and therefore when consumed in a cold environment, the muscles can become stiff and shaky.
• Overstimulation: If you consume stimulants like caffeine or nicotine, the nervous system will kick into overdrive. Consequently, increased levels of dopamine will enter the bloodstream and make you feel alert. Combined with the use of high-THC weed, this could result in a case of “the shakes.”

According to some research, cannabis might reduce tics and premonitory urges, as well as increase focus and concentration. It may even improve the quality of sleep and relaxation. Some studies have also praised the plant’s suitability for easing depressive episodes, ADHD, OCD, and rage attacks in patients with tic disorders. 

Anecdotal reports in cases of TS demonstrate the power of using THC to minimize tics and related behavioral problems. One particular pilot study gleaned promising results. The randomized double-blind placebo-controlled crossover single-dose trial of Delta(9)-THC involved administering the cannabinoid to 12 TS-diagnosed patients in doses of 5.0, 7.5, or 10.0 milligrams. 

Post-consumption, patients were assessed on tic severity. Researchers conjectured that THC was both “effective and safe in treating tics and OCB in TS.” To reach their conclusion, the team utilized a self-rating scale, as well as a Tourette’s syndrome Symptom List (TSSL), Tourette’s syndrome Global Scale, Shapiro Tourette’s syndrome Severity Scale, and Yale Global Tic Severity Scale (YGTS). 

A separate 6-week randomized trial published in 2003 came to a similar conclusion. After utilizing DSM-III-R criteria for diagnostic accuracy, researchers and doctors treated 24 TS patients with up to 10 milligrams of THC over the course of six weeks. Even with seven patients withdrawing from the study (only one of whom reportedly experienced negative side effects), the psychoactive cannabinoid THC was shown to be “effective and safe in the treatment of tics.” To that end, the research team suggested that “the central cannabinoid receptor system might play a role in TS pathology.”

Anecdotal case reports, patient reports, and small-scale studies have unveiled encouraging findings on the subject of reducing tics with medical marijuana. With such positive research surfacing, there has been a noticeable rise in inquiries about the use of cannabis to mediate the symptoms of Tourette Syndrome and tic-related disorders.

In Germany, the results of standardized interviews uncovered some fascinating findings about the benefits of using weed to combat tics. Published in 1998, the interviews involved 64 TS-diagnosed consecutives who were searching for treatment methods, 17 of whom were marijuana users. Of those marijuana consumers, 82% reported a significant drop in their symptoms after using the plant. Some patients even claimed that medical cannabis helped to banish their tic symptoms permanently.

In Canada, investigative outcomes were equally as promising. According to the key takeaways from a retrospective review of 19 Canadian patients, all of whom were long-term cannabis users, the plant contributed to a “60% decrease in tic severity and improvement in co-occurring symptoms.” Although the results were mostly positive, almost 60% reported adverse effects after cannabis use, such as drowsiness, sleepiness, dry mouth, and impaired short-term memory or concentration.

There was no specific method of consumption noted in the review, with patients reportedly using the plant in various forms, such as edibles, vaporized cannabinoids, and smokable cannabis. With the Cannabis Act coming into effect across the Great White North in 2018 and the review being published in 2017, it’s likely that the patients obtained their cannabis from illicit sources. Therefore, more up-to-date studies should be carried out into the use of legal cannabis for tics.

TAA Supports the Idea of Cannabis for Tics

The Tourette Association of America (TAA), a leading national non-profit organization in the United States devoted to amplifying the quality of life for people who are impacted by Tourette Syndrome and Tic Disorders, recently formed a Cannabis Consortium made up of expert clinicians and researchers to gain a clearer understanding of the way(s) in which medicinal-grade cannabis may benefit patients with TS and tic disorders.

As part of the TAA’s efforts, researchers are being financially aided in their quest to unravel the truth about the behavioral, pharmacological, and alternative or complementary treatments and therapies associated with TS. Research has been encouraged following a surge in the number of inquiries regarding the use of medical marijuana.

A fairly recent impact survey carried out by the TAA showed that 47% of adults and 44% of parents of children who’ve been diagnosed with Tourette Syndrome are unsatisfied with the level of symptomatic relief attained through the use of prescribed and controlled medications. 

Based on the currently available evidence, the TAA confirms that the use of medical marijuana and cannabis-derived treatments for TS may be worthwhile for some patients. However, the research is lacking. In order to fully understand the prospective benefits, risks, efficacy, and side effects of treatments like medical marijuana for adolescents and children with tics, more government-backed experiments ought to take place.

Amid the rise of legalization across the U.S. landscape, further research into the neurobiological pathways targeted by cannabis is being focused on. However, until more condition-specific studies are carried out, the cannabis plant and its derived extracts cannot be considered a cure for TS and other types of tic disorders, nor can cannabis be considered a cause of tics.

Despite the lack of conclusive medical research into cannabis for TS and tics, the TAA supports the idea of eliminating regulatory roadblocks to permit broader investigations on cannabis’ medicinal properties; particularly in the U.S. 

Additionally, TAA officials are optimistic that cannabis may be reevaluated and rescheduled in the near future – a scenario that would accelerate the rate at which clinical trials are performed into the suitability of cannabis as a potential new medication for uncontrollable convulsions, tremors, spasms, twitches, and TS-related tics.

Complementary Treatments Worth Discussing with Your Doctor 

When combined with prescribed medicine and treatment regimens, “complementary medicine,” “complementary and alternative medicine,” and “complementary therapies” can help boost the body’s natural healing capabilities and enhance the central nervous system.

A systematic review published in 2015 explored the effects of complementary physical therapies on quality of life, falls, and motor performance in people living with PD (1). Based on the findings, complementary physical therapies like dancing, hydrotherapy, and robotic gait training lend therapeutic promise to movement disorders.

Examples of some other types of complementary medicine that are generally welcomed by neurologists in cases of movement disorders include acupuncture, cannabis, meditation, tai qi, and yoga (27). However, these complementary treatments are just a guideline and should not replace doctor-recommended treatments.

Keep in mind that while medical marijuana and other complementary medicines can prove beneficial for you or a loved one with movement disorders, it’s important that you continue using any medication(s) that are prescribed by your doctor. Cannabis impairment may cause adverse effects like dizziness, motor discoordination, confusion, and paranoia, so it is important to proceed with caution if you consider using cannabis for epilepsy or other movement disorders.

What are the Signs, Symptoms, and Types of Movement Disorders?

The signs and symptoms of movement disorders depend on the root cause and may vary from person to person. However, the World Health Organization (WHO) notes that movement disorders tend to share similar challenges. 

Globally, patients with movement disorders will experience a variety of symptoms that may include: 

• physical coordination issues
• difficulty walking
• slurred speech
• muscle weakness
• muscle spasms
• abnormal posture 
• twitching 

In addition to this, movement disorders may cause tremors and essential tremors, which result in shaking or involuntary trembling in one or more parts of your body (29).

Doctors have to perform a careful neurological exam, take a thorough history, and order imaging studies to differentiate between movement disorders that have some overlapping features.

Parkinson’s disease, atypical parkinsonian disorders, ataxia, tic disorders, functional movement disorders, Huntington’s disease, essential tremor, and dystonia are the most prevalent movement disorders (12). Restless leg syndrome is another common movement disorder that often co-occurs with some of these conditions.

Movement Disorders: Causes and Complications

Certain predisposing conditions can increase one’s risk of developing a movement disorder. For example, the risk of developing a movement disorder may rise in patients who suffer from diabetes. Someone with a history of stroke also faces a higher risk. There are a myriad of other factors that can cause chorea (involuntary, irregular movement). Chorea is a general movement symptom of other neurologic conditions.

Based on a research review published in Revue Neurologique, stroke may be associated with various types of movement disorders, including hyperkinetic syndromes (hemichorea-hemiballism, unilateral asterixis, limb-shaking, dystonia, tremor, myoclonus) and hypokinetic syndromes (especially vascular parkinsonism) (26).

Some other common causes of movement disorders include:

• Brain, spinal cord, or peripheral nerve damage
• Genetic and autoimmune conditions
• Traumatic injury
• Infections
• Medication side effects
• Metabolic disorders
• Endocrine disorders
• Pregnancy (3) 
• Nervous system disease
• Stroke and vascular diseases
• Toxins (28, 30, 31) 

Certain complications of movement disorders can arise in patients; seeking medical treatment is essential for helping to manage or mitigate some of these possibly serious complications (14). Examples include:

• Stiffness or rigidity
• Freezing or slowed movements
• Uncontrollable movements of the trunk, limbs, or face
• Depression and anxiety
• Dementia
• Instability, loss of balance, frequent falls
• Loss of coordination
• Blood pressure loss 
• Dizziness/lightheadedness
• Fainting or blurred vision (orthostatic hypotension)
• Male impotence
• Urinary difficulties
• Constipation
• Speech and swallowing difficulties

To reduce the chances of complications, a doctor may prescribe beta blockers and anti-seizure medications that minimize shaking, tremors, and other physical symptoms (21). Approximately 50-75% of patients taking beta blockers for essential tremors experience a reduction in their tremors (13).

In cases of dystonia, anticholinergic agents may prove useful for decreasing the effects of a brain chemical called acetylcholine. Excess acetylcholine can cause symptoms like cramps, muscle weakness, and blurry vision – common symptoms of movement disorders (18).

Healthcare professionals may also advise that patients receive Deep Brain Stimulation (DBS) to reduce involuntary movements. MR-guided focused ultrasound (MRgFUS) is currently FDA-approved for the treatment of essential tremor and Tremor dominant Parkinson’s disease. It is now also being studied as a treatment for certain movement disorders and neurologic conditions, including the tremors associated with multiple sclerosis and epilepsy (15).

Talking to Your Doctor About Treatments for Movement Disorders

Getting to the root cause of movement disorders requires an in-depth medical examination. A neurologist will also need to spend some time asking about your medical and family history to understand whether or not the condition has been inherited from family members.

 Your doctor will check your motor skills and reflexes with a physical exam and a neurological assessment. Additional tests may also be necessary, such as:

• blood tests
• electromyography to measure the electrical impulses along muscle tissue, nerves, and nerve roots
• electroencephalogram (EEG) to analyze the brain’s electrical activity
• electrocardiogram (ECG or EKG) to monitor the heart’s electrical activity
• lumbar puncture to assess the cerebrospinal fluid
• muscle biopsy to differentiate between muscle and nerve disorders (21) 

Imaging tests are useful for diagnosing movement disorders. Imaging is sometimes sufficient to deliver an accurate diagnosis, and it is beneficial for interpreting clinical findings. Examples of commonly conducted imaging tests in cases of movement disorders include:

• Magnetic Resonance Imaging (MRI): Movement disorder-related brain problems, such as atrophy, can usually be detected with MRI scanning (22). 
• Positron Emission Tomography (PET): Doctors can glean information about brain metabolism and chemistry with functional and neurochemical brain imaging that utilizes PET technology (24). 

Movement disorder symptoms may be similar to those of stroke and cardiovascular disease. To understand what you are dealing with, your doctor may examine the vessels supplying blood to the brain with the following tests: Computed tomography (CT), CT Angiography (CTA), MR Angiography (MRA), Carotid Ultrasound, and Cerebral Angiography (24, 20, 23, 25, 19).

Note: Veriheal does not intend to give this as professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided on this page. Always consult a physician before making any decision on the treatment of a medical condition.