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IACM-Bulletin of 07 February 2016

Science/Human: CBD rich cannabis was beneficial in children with epilepsy in retrospective study

Cannabis rich in CBD showed promising therapeutic effects in 74 patients with epilepsy aged 1-18 years, who did not respond to other treatments. Several centres in Israel participated in this study published in the journal Seizure. Patients were resistant to standard anti-epileptic drugs and 66% also failed a ketogenic diet, vagal nerve stimulator implantation, or both. They all started medical cannabis oil treatment in 2014 and were treated for at least 3 months (average 6 months). The selected formula contained CBD and tetrahydrocannabinol at a ratio of 20:1 dissolved in olive oil. The CBD dose ranged from 1 to 20mg per kg body weight daily.

CBD treatment yielded a significant positive effect on seizure load. Most of the children (89%) reported reduction in seizure frequency. 13 participants reported 75-100% reduction, 25 reported 50-75% reduction, 9 reported 25-50% reduction, and 19 reported <25% reduction. Five patients reported aggravation of seizures which led to CBD withdrawal. In addition, the authors observed improvement in behaviour and alertness, language, communication, motor skills and sleep. Adverse reactions included somnolence, fatigue, gastrointestinal disturbances and irritability leading to withdrawal of cannabis use in 5 patients.

Tzadok M, Uliel-Siboni S, Linder I, Kramer U, Epstein O, Menascu S, Nissenkorn A, Yosef OB, Hyman E, Granot D, Dor M, Lerman-Sagie T, Ben-Zeev B. CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience. Seizure 2016;35:41-44.

Science/Human: THC reduced chest pain, which was not caused by heart disease, in a small controlled study

THC (dronabinol) reduced pain intensity in patients suffering from functional chest pain. This is the result of a study with 13 patients conducted by researchers of the Section of Gastroenterology of Temple University Hospital in Philadelphia, USA. Seven patients received 5 mg THC twice daily and six received a placebo. Chest pain, general health, and anxiety/depression questionnaires were assessed at baseline and at 4 weeks.

THC reduced pain intensity and odynophagia (painful swallowing, in the mouth or oesophagus). Depression and anxiety scores did not differ between the groups at baseline or after treatment. No significant adverse effects were observed

Malik Z, Bayman L, Valestin J, Rizvi-Toner A, Hashmi S, Schey R. Dronabinol increases pain threshold in patients with functional chest pain: a pilot double-blind placebo-controlled trial. Dis Esophagus. 2016 Jan 29. [in press]

News in brief

Puerto Rico: Rules for the medical use of cannabis adopted
Health Department officials issued regulations overseeing the licensed production and distribution of cannabis for medicinal purposes within the US territory of Puerto Rico. The new program is anticipated to be operational by year’s end.
The Daily Chronic of 4 February 2016

Science/Human: Cannabis users presented with higher forced vital capacity
In a study with 10,327 adults, of whom 4,084 where past cannabis users, 555 participants had used cannabis 5-30 days prior to the exam and 891 participants had used cannabis 0-4 days prior, current cannabis use was associated with impaired airflow through the small airways. FVC (forced vital capacity), the amount of air a person can expire after a maximum inspiration, was higher in past (75 ml) and current users in the past 5-30 days (159 ml) and in users within 0-4 days from the exam (204 ml) compared to never users.
Cyprus International Institute for Environmental and Public Health, Cyprus.
Papatheodorou SI, et al. Chest. 2016 Jan 16. [in press]

Science: Cannabis varieties differ by their terpene content
For this research seven different cannabis plants were selected. Plants of different chemotypes were clearly differentiated by their terpene content, and characteristic terpenes of each chemotype were identified.
Aifame GmbH, Wald-Schönengrund, Switzerland.
Aizpurua-Olaizola O, et al. J Nat Prod. 2016 Feb 2. [in press]

Science/Animal: Activation of the CB2 receptor reduced altered blood-spinal cord barrier permeability
In rats a transient spinal cord ischemia (reduced blood supply for 20 minutes) was caused, which increased the permeability between blood and spinal cord. This increased permeability was reduced by activation of the CB2 receptor by the synthetic cannabinoid JWH-015.
Department of Sports Medicine and Joint Surgery, China Medical University, Shenyang, China.
Yang MC, et al. Brain Res. 2016 Jan 30. [in press]

Science/Animal: CBD may be helpful in the prevention of drug relapse
In studies with rats CBD (cannabidiol) was shown to be of “therapeutic potential to attenuate contextual memories associated with drugs of abuse and consequently to reduce the risk of relapse.”
Universidade Federal de Santa Catarina, Florianópolis, Brazil.
de Carvalho CR, et al. Addict Biol. 2016 Feb 1. [in press]

Science/Human: Cannabis use is associated with reduced verbal memory but not with a reduction of other aspects of cognitive performance
In a study with 5,115 men and women aged 18-30 years, who were examined 25 years later past exposure to cannabis was associated with worse verbal memory but did not appear to affect other domains of cognitive function.
Department of Epidemiology and Biostatistics, University of California-San Francisco, USA.
Auer R, et al. JAMA Intern Med. 2016 Feb 1. [in press]

Science/Animal: Beta-caryophyllene shows anticonvulsant activity in experimental epilepsy
The terpene beta-caryophyllene reduced myoclonic seizures in mice, in which myoclonic and generalized seizures were induced by a chemical (pentylenetetrazole). Authors wrote that beta-caryophyllene “should be further evaluated in future development of new anticonvulsant drugs.” Beta-caryophyllene is present in many plants including cannabis and spices such as pepper.
Federal University of Santa Maria, Brazil.
Oliveira CC, et al. Epilepsy Behav 2016;56:26-31.

Science/Animal: Activation of the CB1 receptor improved the function of mitochondria after reduced blood supply
Ischemia of the brain (reduced blood supply) was caused in rats. A synthetic cannabinoid (ACEA), which activates the cannabinoid receptor 1, improved neurological behaviour, reduced infarct volume, and inhibited programmed cell death. Further investigation showed that the cannabinoid could induce mitochondrial biogenesis and improve mitochondrial function at the beginning of cerebral ischemia. Mitochondria are the “powerhouses” of the cells.
Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Bai F, et al. Mol Neurobiol. 2016 Jan 28. [in press]

Science/Animal: Stress increases the concentration of 2-AG and decreases the number of CB1 receptors
In mice, which were exposed to chronic psychosocial stress, the amount of the endocannabinoid 2-AG increased while the expression of the CB1 receptor decreased.
Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
Tomas-Roig J, et al. Behav Brain Res 2016;303:34-43.

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