Neurologist and movement disorders specialist, Movement Disorders Institute, neurology department, Sheba Tel-Hashomer Medical Center, Israel

Saar Anis, MD

“Cannabis, at this moment, is a symptomatic therapy. In animal models, it shows some effect of maybe keeping the neurons alive, but actually in humans, we don’t know that—[it could even be] the opposite.” 

Therapeutic developments within the movement disorders space are expanding, and according to Saar Anis, MD, neurologist and movement disorders specialist at the Sheba Tel-HaShomer Medical Center in Israel, identifying disease-modifying therapies for conditions such as Parkinson disease, dystonia, and Tourette syndrome may be one of the most promising avenues, referencing the accomplishments that have been made within the field of multiple sclerosis. Exploring genetics is another area of interest, Anis said, as it may be especially important for conditions in which experts know they play a key role. 

Anis recently presented findings from a small, retrospective study on the use of medical cannabis (MC) in treating dystonia at 

The International Parkinson and Movement Disorders (MDS) Society Virtual Congress 2021

, September 17-22, concluding that MC treatment improved dystonia symptoms and related pain. Discussing MC further, Anis mentioned that the treatment is currently symptomatic, with experts unsure of exactly how it may affect neurons in humans. He also spoke on limitations of the study, which had a small sample size of 23 patients and a heterogeneity of various distribution and dystonia etiology. 

Anis S, Faust-Socher D, Sverdlov D, Hezi N, Giladi N, Gurevich T. A real-life study of Medical Cannabis effect on adults with dystonia. Presented at MDS Congress 2021; September 17-22; Virtual. Poster 93.

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When asked about developments, the neurologist and movement disorders specialist at Sheba Tel-HaShomer Medical Center in Israel commented on the need to identify disease-modifying therapies. [WATCH TIME: 3 minutes]

Ongoing Therapeutic Developments for Movement Disorders: Saar Anis, MD

“Medical cannabis, at this moment, is a field with a lot of problems…There are a few studies published this year about the use of cannabis for Parkinson disease patients, from the US, from Germany, and we see that big numbers of patients—even 50%, 60% of patients—are using cannabis at some point. So, as doctors, we’re behind. We still don’t know what we need to say to our patients, how to guide our patients to use [cannabis], and we have problems with the side effects of the treatment.”

Data from a small prospective study on the use of medical cannabis (MC) for patients with dystonia were presented at 

, September 17-22, concluding that MC treatment seemed to improve symptoms and associated pain. Additionally, it was found that patients who smoked MC had significantly higher improvement in dystonia symptoms, reporting up to 80% improvement, whereas those who consumed MC through sublingual oil, reported a 20% improvement. 

Saar Anis, MD, neurologist and movement disorders specialist, Movement Disorders Institute, neurology department, 

, Israel, presented findings at MDS 2021, later speaking with 

 about the use of MC for this patient population, noting the importance of additional research into dosing and titration of treatment. Additionally, specialists in the movement disorders space should understand the pharmacokinetic and pharmacodynamic effects of MC, just as they would with other medications. 

Following his presentation at the MDS Society Virtual Congress 2021, the neurologist and movement disorders specialist at Sheba Tel-HaShomer Medical Center discussed his views on the use of medical cannabis. [WATCH TIME: 3 minutes]

Understanding the Use of Medical Cannabis for Movement Disorders: Saar Anis, MD 

“Something I noticed is that our patients, after a few years of use, start to [develop] a tolerance to cannabis, and they start to use bigger and bigger doses…cannabis is not aspirin—we give it to patients, and they can just raise the dose. We have to monitor these rates of dose [increases] to understand exactly how this affects the brain for the short-term, but also for the long-term.” 

The use of medical cannabis (MC) to treat patients with dystonia was recently evaluated in a small, retrospective study, with data presented at 

, September 17-22. Saar Anis, MD, and lead author of the study, spoke with 

 about the next steps for the use of MC in treating this patient population. 

Anis, who is a neurologist and movement disorders specialist at the Movement Disorders Institute, neurology department, at

 in Israel, emphasized the need to understand how different cannabinoids affect patients’ brains, specifically for hyperkinetic movement disorders. Additionally, dosing and titration will be of importance, as Anis noted that patients often develop an MC tolerance, therefore feeling the need to increase their own dose. A larger number of patients will need to be studied as well, prior to the general legalization of medical cannabis, he said.

Next steps for medical cannabis will need to include how cannabinoids affect the brain, according to the neurologist and movement disorders specialist at Sheba Tel-HaShomer Medical Center in Israel.  

Future Research into Medical Cannabis for Dystonia: Saar Anis, MD

“We know, especially using high-THC products, [and] especially at the beginning [of use], we should anticipate and look for cognitive and psychiatric side effects, and even psychosis…This is something that we as physicians have to know, have to study, and that's why I think this is the second direction of future research.”

Data from a small, retrospective study on the use of medical cannabis (MC) in treating patients with dystonia were presented at 

 sat down with lead author Saar Anis, MD, as he discussed the future direction of patient care for this population and how he anticipates future research will integrate the use of MC. 

Anis, who is a neurologist and movement disorders specialist at the Movement Disorders Institute, neurology department, 

 in Israel, called attention to the need to identify whether tetrahydrocannabinol or cannabidiol compounds are more optimal for improving symptoms of dystonia and hyperkinetic disorder in general. Another key area for investigation, Anis said, would be in evaluating dystonia etiology and whether MC is more effective, depending on the cause of the condition, whether genetics or Parkinson disease. 

Further discussed were psychiatric effects associated with MC use, which Anis noted as a concern physicians should be aware of, particularly at the initiation of usage, adjusting dosing as needed to resolve adverse effects.

Anis S, Faust-Socher D, Sverdlov D, Hezi N, Giladi N, Gurevich T. A real-life study of Medical Cannabis effect on adults with dystonia. Presented at MDS Congress 2021; September 17-22; Virtual. Poster 93. 

The neurologist and movement disorders specialist at Sheba Tel-HaShomer Medical Center in Israel discussed future use of medical cannabis and concerns for psychiatric adverse effects.  

Improving Care in Dystonia via Medical Cannabis: Saar Anis, MD

“I can say that the results were pretty good because more than 50% of patients reported, subjectively of course, that they gained satisfactory [improvement with] using cannabis on the dystonia itself. More than 85% of those patients reported improvement in the pain related to dystonia—which is pretty amazing—and also, around 60% of those 23 patients reported improvement in their quality of life during the use of cannabis.”

The International Parkinson and Movement Disorder Society (MDS) Virtual Congress 2021

, September 17-22, featured a presentation on data from a retrospective study evaluating the effect of medical cannabis (MC) on patients with dystonia. 

Saar Anis, MD, lead author of the study, sat down with NeurologyLive to discuss its key findings, which concluded that smoking MC was significantly more efficacious than consuming MC via cannabis oil extract. Anis, who is a neurologist and movement disorders specialist at the Movement Disorders Institute in the neurology department at 

 in Israel, noted the study included a total of 23 patients with dystonia of varying etiologies. 

Patients had a mean age of 52.7 years and had been using MC for an average of 2.5 years, which according to Anis, is a longer period of time for patients to be taking a medication for dystonia. The study also found that tetrahydrocannabinol-rich products were better in treating dystonia and associated pain, when compared to cannabidiol-rich products—something Anis noted was surprising. 

Anis S, Faust-Socher D, Sverdlov D, Hezi N, Giladi N, Gurevich T. A real-life study of Medical Cannabis effect on adults with dystonia. Presented at MDS Congress 2021; September 17-22; Virtual. Poster 93.

The neurologist and movement disorders specialist at Sheba Tel-HaShomer Medical Center in Israel outlined the small, retrospective study, shedding light on its findings. 

Saar Anis, MD

Articles

Ongoing Therapeutic Developments for Movement Disorders: Saar Anis, MD

Understanding the Use of Medical Cannabis for Movement Disorders: Saar Anis, MD

Future Research into Medical Cannabis for Dystonia: Saar Anis, MD

Improving Care in Dystonia via Medical Cannabis: Saar Anis, MD

Efficacy of Medical Cannabis for the Treatment of Dystonia: Saar Anis, MD

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