Movement Disorders

25^th June 2026

Movement disorders encompass a range of neurological conditions affecting motor control, including hypokinetic disorders (characterised by slowness and poverty of movement, such as Parkinson’s Disease) and hyperkinetic disorders (characterised by involuntary movements including tremor, chorea, dystonia, and tics). These conditions arise from various aetiologies—genetic factors, infections, cerebrovascular disease, medication-induced effects, or neurodegenerative processes. Beyond motor symptoms, movement disorders frequently present with comorbid sleep disturbances, chronic pain, anxiety, and mood dysregulation. A significant proportion of individuals experience inadequate symptom control despite optimised conventional pharmacotherapy, leading many to explore medical cannabinoids as a potential adjunctive treatment option.

How Cannabinoids Can Help

Medical cannabinoids have demonstrated potential for managing multiple symptom domains associated with movement disorders [1,2,3]. Rather than targeting isolated symptoms, cannabinoids interact with the endocannabinoid system—a key neuromodulatory network involved in motor control, nociception, sleep-wake regulation, and emotional processing. For individuals whose symptoms persist despite conventional therapies, cannabinoids may offer additional benefit across interconnected symptom clusters, improving overall functioning and quality of life.

Mechanisms of Action

The endocannabinoid system plays a critical role in regulating movement, pain perception, sleep architecture, and mood homeostasis. Cannabinoids exert their therapeutic effects through multiple receptor systems and signalling pathways operating simultaneously [1,2].

Tetrahydrocannabinol (THC)

THC is the primary psychoactive cannabinoid, mediating therapeutic effects through CB1 receptor agonism in the central and peripheral nervous systems. In some individuals, THC may facilitate relaxation and improve sleep quality. Individual responses vary considerably and are dose-dependent. Accordingly, treatment planning, formulation selection, and dosing should be guided by healthcare professionals with regular reassessment based on individual response patterns.

Cannabidiol (CBD)

CBD is a non-intoxicating cannabinoid exerting therapeutic effects through distinct mechanistic pathways, including 5-HT1A receptor agonism, TRPV1 channel modulation, and CB2-independent actions [5,6,7]. CBD may reduce anxiety and support emotional regulation. The precise mechanisms underlying these effects continue to be elucidated, and treatment requires professional guidance and monitoring.

Common Conditions in Movement Disorders

• Anxiety Disorders: Frequently co-occur with movement disorders and may amplify motor symptoms.
• Depression and Mood Dysregulation: Often secondary to persistent symptoms and functional impairment.
• Sleep Disturbances: Tremor, tics, pain, and medication side effects frequently disrupt sleep architecture.
• Chronic Pain: Common across various movement disorder subtypes and significantly impacts quality of life.
• Executive Dysfunction and Cognitive Changes: May accompany certain neurodegenerative movement disorders.

Conventional Treatments

• Pharmacotherapy: Dopamine agonists and levodopa (Parkinson’s), antiepileptic agents (dystonia), beta-blockers (essential tremor), and neuroleptics for tic disorders.
• Behavioural and Psychological Interventions: Cognitive-behavioural therapy, mindfulness-based stress reduction, and specialist psychiatric support.
• Rehabilitation: Physical therapy, occupational therapy, and speech-language pathology to optimise functional capacity.
• Specialist Neurology: Movement disorder specialist consultation and ongoing management.

Clinical Evidence and Benefits of Cannabinoids

• Sleep Quality and Architecture: Research indicates that cannabinoids, particularly balanced THC:CBD formulations, improve sleep maintenance and reduce sleep latency [4,5]. Clinical data demonstrate that approximately two-thirds of patients (66.7%) showed measurable sleep improvement within the first month. This is clinically significant given that many movement disorder medications adversely affect sleep architecture, and sleep disturbance exacerbates motor and emotional symptoms. Improved sleep quality supports emotional resilience and cognitive flexibility.
• Pain Management: Cannabinoids modulate nociception through multiple pathways—CB1 and CB2 receptor signalling, TRPV1 activation, and modulation of descending pain inhibitory systems [1,2]. This polypharmacological approach may provide superior analgesia with reduced reliance on higher-dose conventional analgesics and their associated adverse effects, thereby improving functional capacity and quality of life.
• Anxiety and Emotional Regulation: Clinical evidence supports significant anxiolytic efficacy [5,6,7]. Approximately 79.2% of patients demonstrated meaningful anxiety reduction within the first month, with sustained improvement throughout treatment. This is particularly relevant in movement disorder populations where anxiety amplifies motor symptoms and impairs response to rehabilitative interventions. By reducing anxiety and supporting emotional wellbeing, cannabinoids may enhance overall symptom management and quality of life.
• Multi-Domain Symptom Management: Evidence suggests cannabinoids simultaneously address multiple interconnected symptom domains—sleep, pain, anxiety, and mood dysregulation—rather than requiring polypharmacy targeting individual symptoms [1,2,3]. This integrated approach may reduce medication burden and improve adherence, representing a distinct advantage over conventional single-target pharmacotherapy.
• Improved Tolerability Profile: Compared to conventional movement disorder medications, cannabinoid-based therapies generally demonstrate fewer and less severe adverse effects. Professional supervision enables precise dose titration and formulation selection optimised to individual response patterns.

Side Effects of CBD

CBD is generally well-tolerated, with mild-to-moderate side effects including gastrointestinal symptoms (diarrhoea, nausea), appetite dysregulation, somnolence, and fatigue [5]. Hepatic enzyme elevation may occur, particularly with concomitant valproate therapy. Serious adverse events are rare. Baseline and periodic liver function monitoring is recommended, particularly for individuals with hepatic impairment or on hepatotoxic medications.

Drug Interactions

Cannabinoids, particularly CBD, inhibit hepatic cytochrome P450 enzymes (CYP3A4, CYP2C9), potentially increasing plasma concentrations of substrates including certain antiepileptics, antipsychotics, and cardiovascular medications. The magnitude of interaction varies based on cannabinoid formulation, individual metabolic capacity, and specific medications. Comprehensive medication review and potential dose adjustment should be undertaken prior to initiating cannabinoid therapy.

Conclusion

For individuals with movement disorders experiencing inadequate symptom control despite optimised conventional pharmacotherapy and behavioural interventions, medical cannabinoids represent a potentially valuable adjunctive option. CBD-predominant formulations show particular promise for anxiety and sleep management [5,6,7]. Cannabinoid therapy is most effective when integrated with, rather than replacing, evidence-based conventional approaches. Collaborative care involving movement disorder specialists, prescribing clinicians, and the patient optimises therapeutic outcomes while maintaining focus on established disease-modifying and symptomatic treatments.

How to Access AKOS BIO Cannabinoid Therapy

If you are interested in exploring cannabinoid-based treatment as part of your therapeutic plan, discuss this option with your treating healthcare provider. They can help determine whether cannabinoid therapy may be be appropriate for your individual circumstances.

Alternatively, if you would like to explore AKOS BIO’s pharmaceutical-grade cannabinoid products, you can book a consultation with an independent prescribing healthcare practitioner via the AKOS BIO website.

AKOS BIO provides pharmaceutical-grade cannabinoid products and educational resources to support patients and healthcare professionals. Prescribing decisions are made independently by qualified healthcare practitioners.

In South Africa, AKOS BIO doctors will apply for your Section 21 licence (SAHPRA) on your behalf if medical cannabis is appropriate for your condition. The permit is valid for six months and can be renewed if treatment is effective.

For more information or to book a consultation:

Website: [www.akos-bio.com](https://www.akos-bio.com)

WhatsApp: 066 269 1108

References

[1]. Stampanoni Bassi M, Sancesario A, Morace R, Centonze D, Iezzi E. Cannabinoids in Parkinson’s disease. Cannabis Cannabinoid Res. 2017;2(1):21-29. https://doi.org/10.1089/can.2017.0002

[2]. McCartney D, Suraev AS, Doohan PT, Irwin C, Kevin RC, Grunstein RR, Hoyos CM, McGregor IS. Effects of cannabidiol on simulated driving and cognitive performance: a dose-ranging randomised controlled trial. J Psychopharmacol. 2022;36(6):651-662. https://doi.org/10.1177/02698811221095356

[3]. Oikonomou P, Jost WH. Randomized controlled trials on the use of cannabis-based medicines in movement disorders: a systematic review. J Neural Transm. 2022;129(10):1247-1256. https://doi.org/10.1007/s00702-022-02529-x

[4]. Kuhathasan N, Dufort A, MacKillop J, Gottschalk R, Minuzzi L, Frey BN. The use of cannabinoids for sleep: A critical review on clinical trials. Experimental and Clinical Psychopharmacology. 2019;27(4):383-401. https://doi.org/10.1037/pha0000285

[5]. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in anxiety and sleep: A large case series. The Permanente Journal. 2019;23:18-041. https://doi.org/10.7812/TPP/18-041

[6]. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015;12(4):825-836. https://doi.org/10.1007/s13311-015-0387-1

[7]. Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219–1226. https://doi.org/10.1038/npp.2011.6