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IACM-Bulletin of 19 January 2020

IACM: IACM on Facebook and LinkedIn

The IACM has opened a new Facebook page. There you will find the latest information on the medical use of cannabis and cannabinoids in the period between the bi-weekly IACM bulletins.

We are currently working hard to update the new IACM website. This concerns first of all the possibility of membership, the donation and the member areas. We will have it ready in February. Then it will be possible to become a new member, get access to the members exclusive site with presentations from our November 2019 conference in Berlin, and get free access to the journal Cannabis and Cannabinoid Research. We thank you for your patience

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Science/Human: CBD reduces stress in people with a high risk for psychosis

In a study 32 patients with a high risk for psychosis and 26 healthy people administration of 600 mg of CBD daily for one week CBD significantly reduced signs of stress. The results by researchers of the Department of Psychosis Studies at King.s College London, UK, recently published in `Psychopharmacology. Half of the patients received the CBD and the other half a placebo. They all took part in the Trier Social Stress Test (TSST).

CBD reduced the blood levels of the stress hormone cortisol during a public speaking test. Across the three participant groups the public speaking test resulted in the highest anxiety in the placebo group and the lowest in the healthy control group with patients receiving CBD “demonstrating an intermediate level of change.” Authors concluded that their findings “show that it is worthwhile to design further well powered studies which investigate whether CBD may be used to affect cortisol response in clinical high risk for psychosis patients and any effect this may have on symptoms.”

Appiah-Kusi E, Petros N, Wilson R, Colizzi M, Bossong MG, Valmaggia L, Mondelli V, McGuire P, Bhattacharyya S. Effects of short-term cannabidiol treatment on response to social stress in subjects at clinical high risk of developing psychosis. Psychopharmacology (Berl). 2020 Jan 8. [in press]

Science/Human: Tobacco use but not cannabis use during pregnancy was associated with reduced birth weight

Researchers of the Department of Women and Children's Health of the Faculty of Life Sciences and Medicine of King's College London, UK, analysed data of 4465 infants, whose mothers delivered during 2017 and 2018. 205 women reported smoking cigarettes (4.7%) and 106 were using cannabis (2.4%). Women were most likely to smoke if young (15-19 years old) or from a mixed-race or White background.

Cigarette smoking was associated with a lower mean score for birthweight and head circumference. The combination of cannabis and tobacco use resulted in a lower birthweight and head circumference then tobacco use alone. There study also found “that cannabis alone did not cause a significant reduction in birthweight or head circumference”.

Sturrock S, Williams E, Ambulkar H, Dassios T, Greenough A. Maternal smoking and cannabis use during pregnancy and infant outcomes. J Perinat Med. 2020 Jan 11. [in press]

Science/Human: CBD may be helpful in reducing seizures in refractory epilepsy

With or without concomitant administration of the antiepileptic medication clobazam, CBD can be effective in reducing seizure frequency in epilepsy of children and adults. Scientists of Massachusetts General Hospital in Boston, USA, analysed data from 47 subjects between the ages of 2.5 and 51 years. Of these, 32 had received the CBD extract Epidiolex together with clobazam and 15 had only received Epidiolex.

There was no significant difference in reduction of mean weekly seizure frequency between those who took concomitant clobazam and those who did not at either time point of the investigation. There was a significantly greater responder rate for subjects taking CBD and clobazam than those taking CBD without clobazam only at the point of best seizure control within the first year of CBD treatment.

Savage TE, Sourbron J, Bruno PL, Skirvin LA, Wolper ES, Anagnos CJ, Thiele EA. Efficacy of cannabidiol in subjects with refractory epilepsy relative to concomitant use of clobazam. Epilepsy Res. 2019;160:106263.

Science/Human: CBD was reported to reduce pain and concomitant mood disorder in a patient with neurofibromatosis

CBD rarely was reported to reduce pain, but some reports suggest, that it may be helpful in some cases. Now doctors from Toronto, Canada, presented a report of a 25-year-old woman of African descent with neurofibromatosis, which was presented to the clinic complaining of chronic pain, depression, and anxiety. She used a cannabis extract containing 20 mg of CBD and 1 mg of THC per mL. She slowly increased doses up to 0.4 mL twice-daily.

During this period, the patient reported that her pain was significantly reduced (from an average of 6 out of 10 down to 1 out of 10 on a visual analogue scale ). She reported being less emotional and feeling calmer, that her anxiety reduced and that her mood had stabilized. She was able to reduce her pain medication. It is unclear from the case report, whether CBD or THC or both were responsible for the effect.

Hegazy O, Platnick H. Cannabidiol (CBD) for Treatment of Neurofibromatosis-related Pain and Concomitant Mood Disorder: A Case Report. Cureus. 2019;11(12):e6312.

News in brief

Science/Human: CBD reduces anxiety and tremors induced by stress in patients with Parkinson’s disease
A single dose of 300 mg CBD reduced anxiety and tremors caused by a Simulated Public Speaking Test in 24 patients with Parkinson’s disease. Participants underwent a placebo-controlled crossover clinical trial.
Department of Gerontology, Federal University of São Carlos, Brazil.
de Faria SM. J Psychopharmacol. 2020 Jan 7:269881119895536.

Canada: The legalisation of cannabis was associated with reduced beer consumption
In the first full year of legal cannabis, beer volumes fell by 3%, according to data by Beer Canada. “This is far worse than the trends seen between 2014 and 2018, where beer industry volumes fell an average 0.3%,” and appears to be related to Canada’s legalization of cannabis in late 2018, said Cowen analyst Vivien Azer. There’s some debate about how much impact cannabis legalization has on alcohol consumption, although surveys of cannabis users indicate that they tend to drink less when they’re high.
Bloomberg of 7 January 2020

Thailand: First clinic specialised on cannabis-based medicine opened
On 6 January Thailand opened its first full-time clinic specializing in traditional and alternative cannabis-based medicine, as part of a move by the government towards developing a medicinal cannabis industry. “This is a pilot clinic, because we cannot produce enough doctors with expertise in cannabis,” Public Health Minister, Anutin Charnvirakul, told reporters at the opening ceremony in Bangkok. Patients will receive treatment free of charge for the first two weeks, he added.
Reuters of 6 January 2020

Science/Human: Reduced driving abilities in heavy cannabis users starting use before the age of 16
Heavy recreational cannabis users had worse driving performance during a driving simulator test than nonuser even when not under the influence. The study was conducted at Marijuana Investigations for Neuroscientific Discovery (MIND) at McLean Hospital, a Harvard Medical School affiliate in Belmont, USA. Authors noted, that not all heavy cannabis users had reduced driving abilities, but for a sample of participants, there were still differences in those who use cannabis relative to those who don't. Mainly, start of cannabis use before age 16 was associated with worse performance on the driving stimulator.
Reuters of 15 January 2020

Science: CBD helped to reduce the formation of bacterial biofilm formation on soft contact lenses
A new study showed that garlic extract and and a CBD extract had good effects on inhibition of biofilm formation and removal of preformed biofilms, caused by the bacterium Pseudomonas aeruginosa and makes them promising agents that could be exploited to develop more effective care solutions against this aggressive bacterium.
Department of Sciences and Technologies, University of Naples "Parthenope", Naples, Italy.
Di Onofrio V. Antibiotics (Basel). 2019;8(4).

Science: The proposed mechanism of action in epilepsy
CBD possesses affinity for multiple targets, across a range of target classes, resulting in functional modulation of neuronal excitability, relevant to the pathophysiology of many disease types, including epilepsy. Authors present the pharmacological data supporting the role of three such targets, namely Transient receptor potential vanilloid-1 (TRPV1), the orphan G protein-coupled receptor-55 (GPR55) and the equilibrative nucleoside transporter 1 (ENT-1).
GW Research Ltd, Chivers Way, Histon, Cambridge, UK.
Gray RA. Epileptic Disord. 2020 Jan 10. [in press]

Science/Human: High concentrations of the endocannabinoide 2-AG was associated with lower mortality in patients with haemodialysis
Mortality in patients with end-stage renal disease on maintenance hemodialysis remains exceptionally high. An analysis of patients revealed that 2-AG blood levels positively correlated with body mass index, serum triglycerides and body anthropometric measures. 2-AG levels were also associated with reduced risk of all-cause mortality.
Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, USA.
Moradi H. Am J Nephrol. 2020 Jan 14:1-10.

Science/Animal: Cannabinoids promote progression of HPV head and neck cancer
In cell and animal models researchers found that cannabinoids may promote the progression of a certain form of cancer, that is human papilloma virus (HPV) related head and neck squamous cell carcinoma.
Moores Cancer Center, University of California, San Diego, USA.
Liu C. Clin Cancer Res. 2020 Jan 13. [in press]

Science/Human: THC reduces pain in endometriosis
In a mouse model of endometriosis, THC (2 mg/kg) animated pain, and modified innervation. Authors wrote that “strikingly, THC also inhibits the development of endometrial cysts. These data highlight the interest of scheduled clinical trials designed to investigate possible benefits of THC for women with endometriosis.”
Laboratory of Neuropharmacology, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
Escudero-Lara A. Elife. 2020 Jan 14;9.

Science/Animal: CBD reduces panic attack-like states, which is mediated by the CB1 receptor
In studies with rats CBD was shown to reduce panic attack-like states and fear-induced pain reduction when administered in the ventromedial hypothalamus, and these effects were mediated by the CB1 receptor.
Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo, Brazil.
Khan AU. Psychopharmacology (Berl). 2020 Jan 9. [in press]

Science/Cells: Cannabinoids may counteract alterations in lymphoblasts associated with Alzheimer’s disease
Scientists found that the activation of cannabinoid receptors by two new synthetic cannabinoids (NP137 and NP148) showed positive effects on cellular models of Alzheimer’s disease, including lymphocytes from late onset Alzheimer’s disease patients. They wrote that it is “suggested that NP137 could be a good drug candidate for future treatment of AD.”
Centro de Investigaciones Biológicas (CSIC), Madrid, Spain.
Nuñez-Borque E. Mol Neurobiol. 2020 Jan 3. [in press]

Science/Animal: Very low doses of THC and CBD may be helpful in nausea
Studies with rats suggest that the combination of very low doses of CBD and THC or of CBDA (CBD acid) and THCA (THC acid) reduce nausea. Authors wrote that “clinical trials are necessary to determine the efficacy of using single or combined cannabinoids as adjunct treatments with existing anti-emetic regimens to manage chemotherapy-induced nausea.”
Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Canada.
Rock EM. Psychopharmacology (Berl). 2020 Jan 2. [in press]

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