Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain.

Image result for journal of pain and symptom management impact factor

“This study compared the efficacy of a tetrahydrocannabinol:cannabidiol (THC:CBD) extract, a nonopioid analgesic endocannabinoid system modulator, and a THC extract, with placebo, in relieving pain in patients with advanced cancer. This study shows that THC:CBD extract is efficacious for relief of pain in patients with advanced cancer pain not fully relieved by strong opioids.”  http://www.ncbi.nlm.nih.gov/pubmed/19896326

“In conclusion, THC:CBD extract, a nonopioid analgesic, endocannabinoid system modulator, has been shown to be a useful adjunctive treatment for relief of pain in patients with advanced cancer who experience inadequate analgesia despite chronic opioid therapy. The reductions in pain scores were neither because of a change in opioid background medications nor because of an increase in use of breakthrough medication. Therefore, we can conclude that the observed reduction in pain scores is attributable to the positive analgesic effects of THC:CBD extract.” http://www.jpsmjournal.com/article/S0885-3924(09)00787-8/fulltext

An Open-Label Extension Study to Investigate the Long-Term Safety and Tolerability of THC/CBD Oromucosal Spray and Oromucosal THC Spray in Patients With Terminal Cancer-Related Pain Refractory to Strong Opioid Analgesics.

  “Chronic pain in patients with advanced cancer poses a serious clinical challenge. The Δ9-tetrahydrocannabinol (THC)/cannabidiol (CBD) oromucosal spray (U.S. Adopted Name, nabiximols; Sativex(®)) is a novel cannabinoid formulation currently undergoing investigation as an adjuvant therapy for this treatment group.

OBJECTIVES:

This follow-up study investigated the long-term safety and tolerability of THC/CBD spray and THC spray in relieving pain in patients with advanced cancer.

CONCLUSION:

This study showed that the long-term use of THC/CBD spray was generally well tolerated, with no evidence of a loss of effect for the relief of cancer-related pain with long-term use. Furthermore, patients who kept using the study medication did not seek to increase their dose of this or other pain-relieving medication over time, suggesting that the adjuvant use of cannabinoids in cancer-related pain could provide useful benefit.”

http://www.ncbi.nlm.nih.gov/pubmed/23141881

Treatment of Tourette syndrome with cannabinoids.

Abstract

“Cannabinoids have been used for hundred of years for medical purposes. To day, the cannabinoid delta-9-tetrahydrocannabinol (THC) and the cannabis extract nabiximols are approved for the treatment of nausea, anorexia and spasticity, respectively. In Tourette syndrome (TS) several anecdotal reports provided evidence that marijuana might be effective not only in the suppression of tics, but also in the treatment of associated behavioural problems. At the present time there are only two controlled trials available investigating the effect of THC in the treatment of TS. Using both self and examiner rating scales, in both studies a significant tic reduction could be observed after treatment with THC compared to placebo, without causing significant adverse effects. Available data about the effect of THC on obsessive-compulsive symptoms are inconsistent. According to a recent Cochrane review on the efficacy of cannabinoids in TS, definite conclusions cannot be drawn, because longer trials including a large number of patients are missing. Notwithstanding this appraisal, by many experts THC is recommended for the treatment of TS in adult patients, when first line treatments failed to improve the tics. In treatment resistant adult patients, therefore, treatment with THC should be taken into consideration.”

http://www.ncbi.nlm.nih.gov/pubmed/23187140

Marijuana-like brain chemicals could be key to treating fragile X syndrome.

“In an international collaboration of research centers from America and Europe, scientists have revealed that increasing chemicals in the brain that act similarly to marijuana can help repair the debilitating symptoms associated with fragile X syndrome.

The overall success of this study could lead to future treatments for the condition, which has been identified as the most common genetic basis for autism spectrum disorders.  The research was published in Nature Communications.

The marijuana-like compound, called 2-AG, is a part of a class of chemicals called endocannabinoid transmitters.    These compounds are naturally made by the brain, and they act by combining to receptor proteins in the brain that marijuana chemicals also bind with.

Fragile X syndrome is the result of a mutation of the FMR1 gene in the X chromosome passed on by the mother.   The condition occurs mostly in males because females typically have another X chromosome to compensate for the faulty X chromosome.  Symptoms of fragile X often include mental disability, walking and language delays and hyperactivity – as well as certain physical characteristics such as an elongated face and large ears.”

Read more: http://www.foxnews.com/health/2012/09/25/marijuana-like-brain-chemicals-could-be-key-to-treating-fragile-x-syndrome/#ixzz2DStbqb00

Marijuana- Like Compound in Brain Reduces Anxiety Associated With Fragile X Syndrome

“Increasing levels of a marijuana-like compound in the brain may help reduce some behavioral problems seen in people with Fragile X Syndrome.
Researchers say that the marijuana-like compound may help reduce some of the anxiety and learning-related issues in people with this condition. The compound, called 2-AG, falls under a class of chemicals in the brain called endocannabinoids transmitters.

 Fragile X syndrome is a genetic disorder that causes learning disabilities. Children with this condition have characteristic physical features like long and narrow face, large forehead and ears, flexible fingers and flat feet that become more apparent as the child ages. The condition is caused by a change in the FMR1 gene that codes for a protein that helps the brain grow properly.”

Read more at http://www.medicaldaily.com/articles/12334/20120926/marijuana-compound-brain-reduces-anxiety-associated-fragile.htm#tFdDDvKazcBZ1gFG.99

  • mike

    “YES, finally its time… i have autistic spectrum and i have incorrect behaviors that cannot be fixed unless you tell yourself 24/7 and behaviors and thought process that is incorrect that you will never even know is incorrect. Ive tried marijuana before and the first time ive tried it ive done some self explaining to myself that was very different and i didnt know why. after using marijuana several times which i find relaxing if not used too much at once, i started realizing the difference in thought process and realizing the off things that i do and it got to the point where i actually started figuring out my problems with cannabis and i cant believe the correction in thought process when using this significant plant. there was never a cure for autism but this is the CLOSEST to it. i have a lot more things to say about this but it would take too long to write but all i have to say is this is THE best medication for personality disorders and autistic behaviors and correction to the thought process of such.”

Marijuana-Like Chemical May Help Autism And Fragile X Syndrome Symptoms

“American and European researchers have found that increasing natural marijuana-like chemicals in the brain may help correct behavioral issues related to autism.

Daniele Piomelli of UC Irvine and Olivier Manzoni of INSERM, the French national research agency, led the study, which could result in treatments of anxiety and cognitive defects in individuals with fragile X syndrome, the most common known genetic cause of autism, according to a press release by UC Irvine.

The study examined 2-AG, which naturally occurs in the brain and is in a class of chemicals called endocannabinoid transmitters. These transmitters allow for the efficient transport of electrical signals at synapses, which is severely limited in people with fragile X syndrome.

The researchers treated mice that exhibited symptoms of fragile X syndrome with novel compounds that correct 2-AG protein signaling in the brain. And the results were promising–the mice showed “dramatic behavioral improvements in maze tests measuring anxiety and open-space acceptance,” UCI reports.

Piomelli said this is the first study to identify the role of naturally-occuring endocannabinoids, which share a similar chemical structure with THC, the primary psychoactive component of marijuana. “What we hope is to one day increase the ability of people with fragile X syndrome to socialize and engage in normal cognitive functions,” said Piomelli, a UCI professor of anatomy and neurobiology.

“It would be either an oral or injected drug but that’s at the very end stage of drug discovery, and we are at the very early stage of drug discovery,” Kwang Mook Jung, a researcher on the study and UCI professor, told The Huffington Post.

In addition, his study of endocannabinoids could result in new treatments for anxiety, pain, depression and obesity, according to UCI.”

http://www.huffingtonpost.com/2012/09/27/marijuana-chemical-autism-fragile-x_n_1920320.html

 

Boosting Natural Marijuana-Like Brain Chemicals Treats Fragile X Syndrome Symptoms

“ScienceDaily (Sep. 25, 2012) — American and European scientists have found that increasing natural marijuana-like chemicals in the brain can help correct behavioral issues related to fragile X syndrome, the most common known genetic cause of autism.

The work indicates potential treatments for anxiety and cognitive defects in people with this condition. Results appear online in Nature Communications.

Daniele Piomelli of UC Irvine and Olivier Manzoni of INSERM, the French national research agency, led the study, which identified compounds that inhibit enzymes blocking endocannabinoid transmitters called 2-AG in the striatum and cortex regions of the brain.

These transmitters allow for the efficient transport of electrical signals at synapses, structures through which information passes between neurons. In fragile X syndrome, regional synapse communication is severely limited, giving rise to certain cognitive and behavioral problems.

Fragile X syndrome is caused by a mutation of the FMR1 gene on the X chromosome. People born with it are mentally disabled; generally experience crawling, walking and language delays; tend to avoid eye contact; may be hyperactive or impulsive; and have such notable physical characteristics as an elongated face, flat feet and large ears.

The researchers stress that their findings, while promising, do not point to a cure for the condition.

“What we hope is to one day increase the ability of people with fragile X syndrome to socialize and engage in normal cognitive functions,” said Piomelli, a UCI professor of anatomy & neurobiology and the Louise Turner Arnold Chair in the Neurosciences.

The study involved mice genetically altered with FMR1 mutations that exhibited symptoms of fragile X syndrome. Treated with novel compounds that correct 2-AG protein signaling in brain cells, these mice showed dramatic behavioral improvements in maze tests measuring anxiety and open-space acceptance.

While other work has focused on pharmacological treatments for behavioral issues associated with fragile X syndrome, Piomelli noted that this is the first to identify the role endocannabinoids play in the neurobiology of the condition.

About endocannabinoids

Endocannabinoid compounds are created naturally in the body and share a similar chemical structure with THC, the primary psychoactive component of the marijuana plant, Cannabis. Endocannabinoids are distinctive because they link with protein molecule receptors — called cannabinoid receptors — on the surface of cells. For instance, when a person smokes marijuana, the cannabinoid THC activates these receptors. Because the body’s natural cannabinoids control a variety of factors — such as pain, mood and appetite — they’re attractive targets for drug discovery and development. Piomelli is one of the world’s leading endocannabinoid researchers. His groundbreaking work is showing that this system can be exploited by new treatments to combat anxiety, pain, depression and obesity.”

http://www.sciencedaily.com/releases/2012/09/120925121349.htm

Toward Fulfilling the Promise of Molecular Medicine in Fragile X Syndrome

“Fragile X syndrome (FXS) is the most common inherited form of mental retardation and a leading known cause of autism. It is caused by loss of expression of the fragile X mental retardation protein (FMRP), an RNA-binding protein that negatively regulates protein synthesis. In neurons, multiple lines of evidence suggest that protein synthesis at synapses is triggered by activation of group 1 metabotropic glutamate receptors (Gp1 mGluRs) and that many functional consequences of activating these receptors are altered in the absence of FMRP. These observations have led to the theory that exaggerated protein synthesis downstream of Gp1 mGluRs is a core pathogenic mechanism in FXS. This excess can be corrected by reducing signaling by Gp1 mGluRs, and numerous studies have shown that inhibition of mGluR5, in particular, can ameliorate multiple mutant phenotypes in animal models of FXS. Clinical trials based on this therapeutic strategy are currently under way. FXS is therefore poised to be the first neurobehavioral disorder in which corrective treatments have been developed from the bottom up: from gene identification to pathophysiology in animals to novel therapeutics in humans. The insights gained from FXS and other autism-related single-gene disorders may also assist in identifying molecular mechanisms and potential treatment approaches for idiopathic autism…

It is already clear that diverse molecular mechanisms can contribute to the synaptic abnormalities that underlie ASDs. In order to design appropriate therapeutic strategies for idiopathic autism, it will be critical to identify biomarkers that report the pathophysiological processes at work in the brains of the affected individuals.

Based on these findings, treatments that successfully target protein synthesis pathways in the single-gene disorders mentioned above, including mGluR5 modulators, may very well have broader therapeutic applications in idiopathic autism.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100156/

 

Enhanced endocannabinoid signaling elevates neuronal excitability in Fragile X syndrome

 “Fragile X syndrome (FXS) results from deficiency of fragile X mental retardation protein (FMRP). FXS is the most common heritable form of mental retardation, and is associated with the occurrence of seizures. Factors responsible for initiating FXS-related hyperexcitability are poorly understood. Many protein-synthesis dependent functions of group I metabotropic glutamate receptors (Gp1 mGluRs) are exaggerated in FXS. Gp1 mGluR activation can mobilize endocannabinoids (eCBs) in the hippocampus and thereby increase excitability, but whether FMRP affects eCBs is unknown. We studied Fmr1 knockout (KO) mice lacking FMRP to test the hypothesis that eCB function is altered in FXS. Whole-cell, evoked inhibitory postsynaptic currents (eIPSCs), and field potentials were recorded in the CA1 region of acute hippocampal slices. Three eCB-mediated responses were examined: depolarization-induced suppression of inhibition (DSI), mGluR-initiated eCB short-term depression of eIPSCs (eCB-iSTD), and eCB-dependent inhibitory long-term depression (eCB-iLTD). Low concentrations of a Gp1 mGluR agonist produced larger eCB-mediated responses in Fmr1 KO mice than in WT mice, without affecting DSI. Western blots revealed that levels of mGluR1, mGluR5, or cannabinoid receptor (CB1R), were unchanged in Fmr1 KO animals, suggesting that the coupling between mGluR activation and eCB mobilization was enhanced by FMRP deletion. The increased susceptibility of Fmr1 KOslices to eCB-iLTD was physiologically relevant, since long-term potentiation of epsp-spike (E-S) coupling induced by the mGluR agonist was markedly larger in Fmr1 KO mice than in WT animals. Alterations in eCB signaling could contribute to the cognitive dysfunction associated with FXS…

The endocannabinoid system could represent another target for intervention in the treatment of FXS.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906112/

Abnormal mGlu 5 Receptor/Endocannabinoid Coupling in Mice Lacking FMRP and BC1 RNA

“Transcriptional silencing of the gene encoding the fragile X mental retardation protein (FMRP) causes fragile X syndrome (FXS)…

Our data indicate for the first time that mGlu5R-driven endocannabinoid signaling in the striatum is under the control of both FMRP and BC1 RNA. The abnormal mGlu5R/2-AG coupling found in FMRP-KO mice emphasizes the involvement of mGlu5Rs in the synaptic defects of FXSand identifies the modulation of the endocannabinoid system as a novel target for the treatment of this severe neuropsychiatric disorder.

In conclusion, this is the first study addressing endocannabinoid system in a model of FXS. Our results show that dysfunctional mGlu5R signaling leads to abnormal 2-AG metabolism and physiological activity, and indicate that inhibition of 2-AG synthesis or activity at CB1Rs might be a useful treatment option in FXS patients. In this respect, recent investigations suggest that this modulation could be achieved not only by direct pharmacological blockade of CB1Rs, but also indirectly, for example through the inhibition of anandamide degradation or the stimulation of transient receptor potential vanilloid 1 (TRPV1) channels. These two components of the endocannabinoid system, in fact, have been shown to selectively interact with mGlu5R/2-AG coupling in striatal neurons, and might interfere with the synaptic alterations seen after FMRP ablation with less side effects than those of widespread pharmacological inhibition of CB1Rs, which control not only GABA but also glutamate synapses.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055456/