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IACM-Bulletin of 17 March 2024

Science/Human: Cannabis may be very effective in the treatment of migraine

In an online survey with 1373 patients from a tertiary headache center 56% reported the use of cannabis-based products in the past 3 years and 33% indicated current use. Investigators of Hartford HealthCare Headache Center of the Ayer Neuroscience Institute in West Hartford, USA, noted that this is the largest study to date to document cannabis product usage patterns and perceived benefits for migraine management in a clinical headache patient sample.

The most frequently cited reasons for cannabis-based product use were treating headache (69%) and sleep concerns (51%). A majority of participants reported cannabis-related improvements in migraine headache characteristics (intensity: 78%; duration: 73%; frequency: 62%), nausea (56.3%), and risk factors (sleep disturbance: 81%; anxiety: 71%; depression: 57%). Over half (58.0%) of the respondents reported only using cannabis products when experiencing a headache, while 42.0% used cannabis most days/daily for prevention. Nearly half (49%) of the respondents reported that cannabis use contributed to a reduction in medication amount for headache treatment.

Starkey B, Pearlson GD, Bond D, Glaser C, Bhargava A, Grosberg BM, Verhaak A. Characterizing Cannabis Use and Perceived Benefit in a Tertiary Headache Center Patient Sample. Neurol Clin Pract. 2024;14(2):e200285.

Science/Human: Many cancer patients use cannabis to cope with symptoms

Investigators of the Department of Radiation Oncology at the City of Hope National Cancer Center in Duarte, USA, conducted a survey among cancer patients, who were undergoing or recently completed radiation treatment at the center.

Of the 431 respondents, 111 (26%) patients reported cannabinoid use since their cancer diagnosis. Among the cannabinoid users, a majority (74%) experienced improvement in symptoms. 39% had better relief of cancer-treatment symptoms from cannabinoids in comparison to their prescription medications, and 16% lowered the amount of prescription pain medications needed after using cannabinoids. Cannabinoids appeared to be most effective in helping patients manage sleep (77%) and anxiety (72%).

Tam A, Novak J, Ladbury C, Abuali T, Loscalzo M, Sun V, Amini A. Perception and Utilization of Cannabinoids in Patients Undergoing Radiation Treatment: Our Patients Are Curious. Int J Radiat Oncol Biol Phys. 2024:S0360-3016(24)00353-5.

Science/Human: No evidence that specific cannabis strains are more effective than others depending on disease

According to a survey of 1028 medical cannabis patients in Germany there was no evidence that specific cannabis strains may be superior to others in efficacy depending on disease or symptom. Investigators of the Clinic of Psychiatry, Social Psychiatry and Psychotherapy at Hannover Medical School, Germany, conducted an online survey to get information on treatment effects in different diseases.

Participants had used an average of 5.9 different strains. The most frequent conditions were different pain disorders, psychiatric and neurological diseases, and gastrointestinal symptoms. Overall, the mean patient-reported effectiveness was 80.1%. There was no association between the patient-reported effectiveness and the variety. Furthermore, no influence of the disease on the choice of the cannabis strain was detected.

Szejko N, Becher E, Heimann F, Grotenhermen F, Müller-Vahl KR. Medicinal Use of Different Cannabis Strains: Results from a Large Prospective Survey in Germany. Pharmacopsychiatry. 2024 Mar 12. [in press]

News in brief

Science/Human: Cannabis legalization resulted in reduced beer sales in Canada

Canada-wide beer sales fell by 96 hectoliters per 100,000 populations immediately after non-medical cannabis legalization and by 4 hectoliters per 100,000 populations each month thereafter for an average monthly reduction of 136 hectoliters per 100,000 populations post-legalization. However, legalization was associated with no change in spirits sales.

College of Pharmacy, University of Manitoba, Winnipeg, Canada.

Mital S, et al. Drug Alcohol Depend. 2024;257:111137.

Science/Animal: THC protects heart tissue against damage due to hyperinsulinaemia

THC treatment in rats with hyperinsulinaemia exhibited a significant effect in ameliorating cardiac tissue damage by improving the antioxidant defense system, inflammation, apoptosis, endoplasmic reticulum stress, and oxidative stress.

Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Demiroglu Bilim University, Istanbul, Turkey.

Coskun Yazici ZM, et al. J Pharm Pharmacol. 2024:rgae023.

Science/Animal: CBD exhibits anti-psychotic-like effects

In a study with mice CBD induced antipsychotic-like effects. Investigators concluded from their research that the 5-HT1A receptor mediates CBD's anxiolytic-like effects. Additionally, CBD's effects on the negative symptoms of schizophrenia may be linked to changes in GABA and norepinephrine levels in the hippocampus.

College of Pharmacy, Gannan Medical University, Ganzhou, China.

Shu G, et al. Neurosci Lett. 2024:137723.

Science/Human: Dissatisfaction with conventional treatment of psychiatric diseases is a major motivation for cannabis use

According to a qualitative interview with 36 adults diagnosed with mood or anxiety disorders, obsessive-compulsive disorder or traumatic stress disorder, motivations for initiation of cannabis use included curiosity, peer pressure, and dissatisfaction with conventional treatments. Factors such as psychotropic effects and coping with mental health symptoms and insomnia contributed to the continuation of cannabis use.

Institute of Medical Sciences, University of Toronto, Canada.

Das A, et al. Pharmacopsychiatry. 2024 Mar 11. [in press]

Science/Human: No significant effect of CBD on seborrheic dermatitis in patients with Parkinson’s disease

Seborrheic dermatitis affects many persons with Parkinson disease. In a placebo-controlled study 27 participants received a placebo and 26 received CBD in a dose of 2.5 milligrams per kilogram bodyweight for 16 days. There was a trend for an improvement in the CBD group, but this was not statistically significant. Authors suggest the conduction of a larger study

Mercy Hopsital St. Louis, USA.

Weber I, et al. JMIR Dermatol. 2024;7:e49965.

Science/Animal: THC alters fetal development of the nervous system

In a study with 10 rhesus macaques, of whom 5 received daily THC edibles during pregnancy, THC exposure was associated with “brain growth, and differences in fetal brain histology suggestive of brain dysregulation.”

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, USA.

Ryan KS, et al. Sci Rep. 2024;14(1):5808.

Science/Animal: Cannabinoids induce cell death in leukemic cells

In a study with leukemic cells a synthetic cannabinoid (WIN-55), which activates both the CB1 and the CB2 receptor: exerted a potent antileukemic effect. WIN-treated mice, xenografted with acute myeloid leukemia cells, had better survival as compared to vehicle or cytarabine.

Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla, Spain.

Medrano M, et al. Br J Cancer. 2024 Mar 9. [in press]

Science/Cells: CBD exhibit significant therapeutic potential in traumatic brain injury

CBD pre-treatment may was shown to reduce the secretion of TNF-alpha induced astrocyte activation following traumatic brain injury. It decreased the release of neurotransmitters including glutamate thereby initiating synaptic remodeling.

Department of Anatomy and Histology/Embryology, Faculty of Basic Medical Sciences, Kunming Medical University, China.

Ling T, et al. Neuroscience. 2024:S0306-4522(24)00098-8.

Science/Human: Cannabis may increase congenital birth defects

In a cumulative meta-analysis, thirty-six observational studies, consisting of 18 case-control and 18 cohort studies, with 230,816 cases of birth defects and 18,049,013 controls (healthy babies) were included in the final analysis. Researcher found that offspring exposed to maternal prenatal cannabis are at greater risks of a wide range of structural birth defects: cardiovascular/heart (odds ratio = 2.35) gastrointestinal (OR = 2.42), central nervous system (OR = 2.87), genitourinary (OR = 2.39), and any (unclassified) birth defects (OR = 1.25).

School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia.

Tadesse AW, et al. Neurotoxicol Teratol. 2024;102:107340.

Science/Human: Cannabis use is not associated with the development of bipolar disorder onset

Using data from the 1993 Pelotas (Brazil) birth cohort (n = 5249), cannabis exposure was examined at age 18 by self-report, and bipolar disorder diagnosis was measured at age 22. Authors summarized that “contrary to schizophrenia, cannabis as a sole exposure was not associated with bipolar disorder onset after adjusting for control variables.”

Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.

Jorge ACR, et al. Acta Psychiatr Scand. 2024;149(4):340-349.

Science/Human: Cannabis use was not associated with an increased risk of cardiovascular events in patients with inflammatory bowel disease

Among 302,770 hospitalized adult inflammatory bowel disease patients, 3.1% (9,490) had cannabis use disorder. The group with cannabis use disorder had a lower rate of major adverse cardiac and cerebral vascular events (3.1% vs. 5.8%) and crude in-hospital mortality (0.7% vs. 2.2%), acute myocardial infarction (1.7% vs. 2.6%), cardiac arrest (0.3% vs. 0.7%), and acute ischemic stroke (0.6% vs. 1.2%).

Department of Internal Medicine, University of Texas Rio Grande Valley, Weslaco, USA.

Borra V, et al. Curr Med Res Opin. 2024:1-7.

Science/Animal: CBD may be used in the treatment of leukemia

In a study with rats “administration of CBD resulted in a significant improvement in the biochemical, antioxidant status, morphological, and molecular measures in DMBA-induced leukemia in adult male rats. The therapeutic use was more effective than the prophylactic one.”

Department of Zoology, Faculty of Science, Zagazig University, Egypt.

Soliman NA, et al. Naunyn Schmiedebergs Arch Pharmacol. 2024;397(4):2389-2400.

Science/Human: Cessation of cannabis use is associated with an increase in inflammatory markers in patients with psychosis

A dysbalance of the immune system in psychotic disorders has been well investigated. In a study with 102 patients cannabis cessation was “associated with an increase in inflammatory markers, including white blood cell, lymphocyte and monocyte levels, which correlates with symptomatology of patients with psychosis.”

APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.

Romeo B, et al. Acta Neuropsychiatr. 2024;36(2):118-127.