“Conventional drugs have only a limited impact on spasticity associated with multiple sclerosis and are rarely satisfactory. A solution for oral transmucosal delivery (spray) containing a mixture of cannabis extracts (2.7 mg of delta-9-tetrahydrocannabinol + 2.5 mg of cannabidiol per spray) has been granted marketing authorisation in France for patients who are inadequately relieved by standard treatments. Three double-blind, placebo-controlled trials in a total of about 300 patients tested this combination, in addition to ongoing treatment, for periods of 6 to 14 weeks. Individually, none of these trials showed any tangible anti-spastic efficacy, but two combined analyses showed “response rates” of about 35% with the mixture versus about 25% with placebo. In a trial with 572 patients, the 241 patients who “responded” after 4 weeks of treatment were randomised to either continue using the cannabis extract or receive placebo. Twelve weeks later, 75% of patients using the extract were still “responders”, versus 51% of patients switched to placebo. The principal adverse effects of the cannabis extracts consist of neuropsychiatric disorders that resolve on treatment withdrawal. The potential for abuse increases with the dose and is tangible from 16 sprays per day. Pharmacokinetic interactions due to P-glycoprotein inhibition are likely. Treatment during pregnancy may lead to neonatal withdrawal symptoms. In practice, about 10% of patients in whom standard anti-spastic medications are unsatisfactory benefit from a specific effect of the cannabis extracts contained in this oral spray.”
Tag Archives: cannabis
The Pharmacokinetics, Efficacy, Safety, and Ease of Use of a Novel Portable Metered-Dose Cannabis Inhaler in Patients With Chronic Neuropathic Pain: A Phase 1a Study.
“Chronic neuropathic pain is often refractory to standard pharmacological treatments.
Although growing evidence supports the use of inhaled cannabis for neuropathic pain, the lack of standard inhaled dosing plays a major obstacle in cannabis becoming a “main stream” pharmacological treatment for neuropathic pain.
The objective of this study was to explore the pharmacokinetics, safety, tolerability, efficacy, and ease of use of a novel portable thermal-metered-dose inhaler (tMDI) for cannabis in a cohort of eight patients suffering from chronic neuropathic pain and on a stable analgesic regimen including medicinal cannabis…
This trial suggests the potential use of the Syqe Inhaler device as a smokeless delivery system of medicinal cannabis, producing a Δ9-THC pharmacokinetic profile with low interindividual variation of Cmax, achieving pharmaceutical standards for inhaled drugs.”
http://www.ncbi.nlm.nih.gov/pubmed/25118789
http://www.thctotalhealthcare.com/category/neuropathic-pain/
Cannabinoids as therapeutic agents in cancer: current status and future implications
“Cannabinoids… active compounds of the Cannabis sativa plant… cannabinoids are clinically used for anti-palliative effects, recent studies open a promising possibility as anti-cancer agents.
They have been shown to possess anti-proliferative and anti-angiogenic effects in vitro as well as in vivo in different cancer models…” http://www.ncbi.nlm.nih.gov/pubmed/25115386
“Cannabinoids… the active compounds of the Cannabis sativa plant… anti-cancer agents… anti-proliferative… anti-angiogenic… anti-migratory and anti-invasive… The administration of single cannabinoids might produce limited relief compared to the administration of crude extract of plant containing multiple cannabinoids, terpenes and flavanoids.” Full-text: http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B0%5D=2233&path%5B1%5D=3664
Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes
“Acne vulgaris is the most common human skin disease, affecting quality of life of millions worldwide…
Investigation of the cutaneous cannabinoid system seems to be a promising choice when searching for novel therapeutic possibilities…
“Collectively, our findings suggest that, due to the combined lipostatic, antiproliferative, and antiinflammatory effects, CBD has potential as a promising therapeutic agent for the treatment of acne vulgaris…
These data, together with our current findings, point to a promising, cost-effective, and, likely, well-tolerated new strategy for treating acne vulgaris, the most common human skin disease…
…given the extensively documented accumulation of phytocannabinoids from smoked marijuana in the pilosebaceous unit (where they become incorporated into the hair shaft), it is very likely that CBD can reach the sebaceous glands as well, can accumulate, and may well reach “therapeutically sufficient” concentrations there.
Moreover, it is very important to note that, besides the systemic application, one should keep in mind the possibility of the topical administration.”
http://www.jci.org/articles/view/64628
“Schematic overview of the cellular “anti-acne trinity” of CBD and its proposed mechanism of action.”
The endocannabinoid system: a putative role in neurodegenerative diseases.
“Scientific evidence shows that an hypofunction or a dysregulation of the endocannabinoid system may be responsible for some of the symptoms of diseases such as multiple sclerosis, amyotrophic lateral sclerosis, Huntington’s, Parkinson’s and Alzheimer’s diseases.
The aim of this review is to highlight the role of endocannabinoid system in neurodegenerative diseases
Scientific evidence shows that cannabis can provide symptomatic relief in several neurodegenerative diseases such as multiple sclerosis, Huntington’s, Parkinson’s and Alzheimer’s diseases, and amyotrophic lateral sclerosis. These findings imply that a hypofunction or a dysregulation of the endocannabinoid system may be responsible for some of the symptoms of these diseases. Moreover, given the abundance of CB1 receptors in areas associated with movement and executive thought, researchers’ interest has often focused on endocannabinoid levels in patients with motor degenerative disorders.
CONCLUSIONS:
The important role played by endocannabinoid system promises interesting developments, in particular to evaluate the effectiveness of new drugs in both psychiatry and neurology.”
Clinical endocannabinoid deficiency (CECD) revisited: Can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?
“Ethan B. Russo’s paper of December 1, 2003 explored the concept of a clinical endocannabinoid deficiency (CECD) underlying the pathophysiology of migraine, fibromyalgia, irritable bowel syndrome and other functional conditions alleviated by clinical cannabis.
Available literature was reviewed, including searches via the National Library of medicine database and other sources.
A review of the literature indicates that significant progress has been made since Dr. Ethan B. Russo’s landmark paper, just ten years ago (February 2, 2004). Investigation at that time suggested that cannabinoids can block spinal, peripheral and gastrointestional mechanisms that promote pain in headache, fibromyalgia, irritable bowel syndrome and muscle spasm.
CONCLUSION:
Subsequent research has confirmed that underlying endocannabinoid deficiencies indeed play a role in migraine, fibromyalgia, irritable bowel syndrome and a growing list of other medical conditions. Clinical experience is bearing this out. Further research and especially, clinical trials will further demonstrate the usefulness of medical cannabis. As legal barriers fall and scientific bias fades this will become more apparent.” http://www.ncbi.nlm.nih.gov/pubmed/24977967
“Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Migraine, fibromyalgia, IBS and related conditions display common clinical, biochemical and pathophysiological patterns that suggest an underlying clinical endocannabinoid deficiency that may be suitably treated with cannabinoid medicines.” http://www.ncbi.nlm.nih.gov/pubmed/15159679
Cannabis for inflammatory bowel disease.
“The marijuana plant Cannabis sativa has been used for centuries as a treatment for a variety of ailments. It contains over 60 different cannabinoid compounds.
Studies have revealed that the endocannabinoid system is involved in almost all major immune events. Cannabinoids may, therefore, be beneficial in inflammatory disorders.In murine colitis, cannabinoids decrease histologic and microscopic inflammation.
In humans, cannabis has been used to treat a plethora of gastrointestinal problems, including anorexia, emesis, abdominal pain, diarrhea, and diabetic gastroparesis.
Despite anecdotal reports on medical cannabis in inflammatory bowel disease (IBD), there are few controlled studies. In an observational study in 30 patients with Crohn’s disease (CD), we found that medical cannabis was associated with improvement in disease activity and reduction in the use of other medications.
In a more recent placebo-controlled study in 21 chronic CD patients, we showed a decrease in the CD activity index >100 in 10 of 11 subjects on cannabis compared to 4 of 10 on placebo. Complete remission was achieved in 5 of 11 subjects in the cannabis group and 1 of 10 in the placebo group. Yet, in an additional study, low-dose cannabidiol did not have an effect on CD activity.
In summary, evidence is gathering that manipulating the endocannabinoid system can have beneficial effects in IBD, but further research is required to declare cannabinoids a medicine. We need to establish the specific cannabinoids, as well as appropriate medical conditions, optimal dose, and mode of administration, to maximize the beneficial effects while avoiding any potential harmful effects of cannabinoid use”
Researchers study neuroprotective properties in cannabis
“With more states opting to legalize the sale of medical marijuana, researchers are taking a closer look at the use of cannabis to treat chronic illnesses.
Dr. Manny Alvarez, senior managing health editor of FoxNews.com, recently sat down with the Medicine Hunter, Chris Kilham, to find out how it’s being studied.
Dr. Manny: Now from the medical marijuana perspective, as far as the treatment of chronic illnesses, what is it about cannabis that makes it that special?
Medicine Hunter: Well, it seems that there are primarily two things – there’s the THC, that’s what people associated with getting high. And that appears to have a saliatory effect on the eyes in case of glaucoma. For people who are suffering from chemotherapy and can’t eat, it helps to get their appetite back. And we also know that it is a potent pain reliever – and science on that goes back to the 1890s.
But there’s another agent in cannabis that is getting more attention now, and that is called cannabidiol. And this is something that you can swallow by the bucket-full, and it won’t get you high at all. But it appears to have profound nerve-protective and brain-enhancing properties. And interestingly enough, it also induces an anti-anxiety effect.
So this appears to be a very important agent, perhaps useful in the treatment of neurodegenerative disorders.
DM: Are they extracting that particular chemical off the marijuana?
MH: There seem to be two pathways that people are taking. You’ve got G.W. pharmaceuticals in Britain that has come out with a whole cannabis fluid spray. You’ve got people also isolating cannabidiol and playing with that in the lab.
I don’t know how this is all going to settle out – I mean, as a whole-plant person, I’m inclined toward the whole extract. But it does appear that this may also have anti-cancer properties, and that’s very intriguing.
DM: Is marijuana addictive?
MH: I would say that people can absolutely become dependent upon it. But not physiologically addictive. And, as you know, that’s not just parsing terms – I mean physiological addiction, you go through very grave withdrawal.
But people can become dependent on it just as they can on any substance.
DM: Tell me about this study in the American Journal of Pediatrics talking about pregnant Jamaican women and the use of pot.
MH: Melanie Dreher, who is the dean of nursing at Rush Medical Center inChicago, did a study in Jamaica. It was actually published in the American Journal of Pediatrics in 1994, but now it’s re-circulating because of all the interest in the neuroprotective properties.
Basically, she studied women during their entire pregnancy, and then studied the babies about a year after birth. And what she studied was a group of women who did smoke cannabis during pregnancy and those who didn’t. She expected to see a difference in the babies as far as birth weight and neuro tests, but there was no difference whatsoever. The differences that the researchers did notice, that are unexplained and kind of curious are that the babies of the women who had smoked cannabis — and we’re talking about daily use during their pregnancy — socialized more quickly, made eye contact more quickly and were easier to engage.
We don’t know why this is so, but all the old saws of smoking during pregnancy will result in low birth weight did not show up — at least in the Jamaican study. In U.S. studies where we’ve seen a similar investigation, women have concurrently been abusing alcohol and other drugs as well.
Alvarez said it’s interesting to note that there may be neuroprotective properties present in cannabis and the cannibidiol extract, but that smoking of any kind in pregnant women is discouraged.”
More research is needed when it comes to medical marijuana, he added.”
http://www.foxnews.com/health/2012/03/20/researchers-study-neuroprotective-properties-in-cannabis/
“Study: Cannabis may prevent brain damage” http://www.foxnews.com/health/2013/06/06/study-cannabis-may-prevent-brain-damage/
[The cannabinoid system and its importance in the perinatal period].
“The cannabinoid system has been recently described, including the endogenous ligands, mainly arachidonic acid derivatives, and their specific receptors. Endocannabinoids are involved in the modulation of synaptic transmission, through which they exert their psychoactive, motor and antinociceptive effects, among others; they also exert extraneural effects, mainly immunomodulation and vasodilation.
Recent data suggest that the cannabinoid system might play an important role in human ontogeny and could participate in the implantation and early development of the embryo, in fetal brain development, and in the beginning of breast feeding after birth.
In addition, the vasodilatory effect of cannabinoids, together with inhibition of the release of excitotoxic amino acids and cytokines, as well as modulation of oxidative stress and the toxic production of nitric oxide, justify the growing evidence pointing to a possible neuroprotective effect of cannabinoids in perinatal asphyxia.”
Marijuana Compound CBD Can Effectively Treat Schizophrenia
“Cannabidiol (CBD) is a known marijuana compound, and might just be better than antipsychotics at treating schizophrenia.
A preliminary trial has shown this form of treatment to have fewer side effects than traditional methods of treatment…
Since CBD comes from the marijuana plant, political issues are likely to compromise its availability. Extracting the compound from the plant is also expensive.
But the biggest issue scientists face is that CBD is a natural compound, and can’t be patented the way new drugs are. Pharmaceutical companies are therefore not likely to develop it.”