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IACM-Bulletin of 7 January 2024
The IACM Bulletin has been published every two weeks since 2000. The number of publications has increased considerably during this time. To ensure that the information in each newsletter remains manageable, we want to increase the frequency of publication. The content will also be adapted. In future, there will be references to interesting review articles. On the other hand, there will be fewer articles on basic research, particularly on studies with few new findings. In this way, the real news will be emphasized. We hope that you find this helpful.
In a study with 302 patients with generalized anxiety disorder and sleep disruption baseline anxiety severity was associated with an increased likelihood of significant improvements in anxiety. Data were published by the Medical Cannabis Research Group of Imperial College London, UK. Changes were recorded from baseline to 1, 3, 6, and 12 months between those with impaired or unimpaired sleep.
A relationship between sleep impairment and clinically significant changes in generalized anxiety disorder at 1 and 3 months was identified. On multivariate regression, only baseline generalized anxiety disorder severity was associated with an increased likelihood of observing a clinically significant improvement in anxiety.
Murphy M, Erridge S, Holvey C, Coomber R, Rucker JJ, Sodergren MH. A cohort study comparing the effects of medical cannabis for anxiety patients with and without comorbid sleep disturbance. Neuropsychopharmacol Rep. 2023 Dec 28. [in press]
According to an anonymous online survey with 227 patients with neuropathic pain about 88% experienced significant pain relief. Investigators of the Miami Project to Cure Paralysis, USA, observed average pain intensity in the past week of 6.8 on a scale from 0 to 10.
“87.9% noted that cannabis reduced their neuropathic pain intensity by more than 30%, and 92.3% reported that cannabis helped them to better deal with their neuropathic pain symptoms. Most participants (83.3%) also reported substituting their pain medications with cannabis, with the most substituted medication categories being opioids (47.0%), gabapentinoids (42.8%) and over-the-counter pain medications (42.2%).”
Kinnunen K, Robayo LE, Cherup NP, Frank SI, Widerström-Noga E. A preliminary study evaluating self-reported effects of cannabis and cannabinoids on neuropathic pain and pain medication use in people with spinal cord injury.Front. Pain Res., 2023:(4).
A total of 2991 patients from the Quebec Cannabis Registry were enrolled in an analysis by investigators of the Center for PharmacoEpidemiology and Treatment Science, New Brunswick, USA.
During follow-up, 108 patients (3.6%) experienced moderate or severe adverse effects. The most common adverse effects for ingested medical cannabis (62 reports) were dizziness (12.9%), nausea (11.3%), somnolence (9.7%), and vomiting (8.1%), and for inhaled cannabis (23 reports), headache (13.0%) was the most common.
Hachem Y, Moride Y, Castilloux AM, Castillon G, Kalaba M, Néron A, Gamaoun R, Martel MO, Beaulieu P, Ware M, Vigano A. A Descriptive Analysis of Adverse Event Reports from the Quebec Cannabis Registry. Drug Saf 2023 Nov 23. [in press]
Science/Human: CBD may have a moderate effect on sleep efficiency and well-being according to a placebo controlled study
Investigators of the Centre for Mental Health & Brain Sciences at Swinburne University of Technology in Hawthorn, Australia, found some improvement in sleep in 15 patients, who received 150 mg of CBD compared to 15 patients, who received placebo. Participants consumed the assigned treatment sublingually 60 minutes before bed nightly. Wrist-actigraphy and sleep diaries measured daily sleep for 2 weeks.
Insomnia severity, subjective sleep onset latency, sleep efficiency and wake after sleep onset did not differ between treatments throughout the trial. Compared to placebo, the CBD group reported greater well-being scores throughout the trial, transient elevated behavior following wakefulness scores after 1 week of treatment and had superior objective sleep efficiency after 2 weeks of treatment.
Narayan AJ, Downey LA, Rose S, Di Natale L, Hayley AC. Cannabidiol for moderate-severe insomnia: a randomized controlled pilot trial of 150 mg of nightly dosing. J Clin Sleep Med. 2024 Jan 4.[in press]
An update of the medical indications procedure (procedure 106) by the Ministry of Health introduces the elimination of the definition of cannabis as a "last line treatment." In other words, Unlike in the past, prior treatment with other medicines is no longer required as a prerequisite for obtaining a licence for medicinal cannabis.
“An association with the clinical-high-risk state for psychosis, attenuated psychosis symptoms and transition to psychosis in this population could not be confirmed. An association between cannabis use and psychosis outcomes in patients with psychotic disorder could solely be confirmed regarding relapse. Whether causal effects underlie those associations has not sufficiently been addressed in the evidence synthesis to date.”
Department of Psychosis Studies, King's College London, United Kingdom.
“Cannabis for medical use may be similarly effective and result in fewer discontinuations than opioids for chronic non-cancer pain.”
Department of Health Research Methods, Ontario, Canada.
“This review provides insights on the various preclinical and clinical therapeutic applications of cannabidiol (CBD), cannabigerol (CBG), and cannabinol (CBN) in various diseases and the ongoing clinical trials for the treatment of chronic and acute pain with cannabinoids. Pharmacological and genetic experimental strategies have well demonstrated the potential neuroprotective effects of cannabinoids and also elaborated their mechanism of action for the therapy of neuropathic pain.”
College of Pharmacy and Pharmaceutical Sciences, Tallahassee, USA.
“Cannabinoids and endocannabinoids hold promise for use as disease modifiers and therapeutic agents for the prevention or treatment of neurodegenerative diseases and neurological disorders.”
Department of Ophthalmology, Kansas, USA.
“The findings indicate that CBD has anti-anxiety, anti-oxidation, and anti-inflammatory properties and can inhibit abnormal proliferation and apoptosis of vascular smooth muscle and endothelial cells; these effects suggest CBD as a therapeutic agent for atherosclerosis, stress-induced hypertension, diabetes-related vasculopathy, ischemia-reperfusion injury, and vascular damage caused by smoking and alcohol abuse. “
Medical School of Chinese PLA, Beijing, China.
In a study with mice, researchers investigated some cannabinoids on TRPM7 channel function. They found cannabigerolic acid (CBGA) had the strongest inhibitory effect on TRPM7. “In conclusion, we demonstrate that CBGA is the most potent cannabinoid in suppressing TRPM7 activity and possesses therapeutic potential for diseases in which TRPM7 is known to play an important role such as cancer, stroke, and kidney disease.”
Center for Biomedical Research, Honolulu, USA.
In a mouse model of schizophrenia “contrary to expectations, THC exhibited greater behavioural and morphometric benefits, despite promoting a pro-inflammatory state that CBD partially reverted.”
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Science/Human: Legalization of cannabis in Canada was not associated with increased numbers of psychotic disorders
“Our findings suggest that the initial period of tight market restriction following legalization of non-medical cannabis was not associated with an increase in health service use or frequency of psychotic disorders. A longer post-legalization observation period, which includes expansion of the commercial cannabis market, is needed to fully understand the population-level impacts of non-medical cannabis legalization.”
Department of Epidemiology and Biostatistics, Canada.
Science/Human: Cannabis use disorders in geriatric patients may be associated with an increased risk of stroke and a reduced risk of diabetes
According to an analysis of about 5.1 million admissions of geriatric patients with peripheral vascular disease to hospitals cannabis use disorder was associated with an increased risk of hospitalization due to an acute ischemic stroke by 34%, while cannabis users had a significant lower risk of diabetes compared to non-users.
Division of Cardiology, Decatur, USA.
Mice experiencing social defeat stress were used to model depression and anxiety behaviors. The study suggests hippocampal downregulation of CB2 receptors and anandamide contributes to depression. Upregulation of CB2 receptors and anandamide in response to electro acupuncture suggests their involvement in electro acupuncture antidepressant effects.
Department of Physiology, Shanxi, China.
According to a study with mice CB2 modulated orthodontic tooth movement and bone remodeling through regulating osteoclast activity and RANKL/OPG balance.
Department of Orthodontics, Shijiazhuang, China.
In a study with mice investigators “found that CBD produced a significant decrease in the number of nicotine rewards earned, and this effect was evidenced across CBD doses and with both the low and moderate levels of nicotine intake. (…) Taken together, these results demonstrate that modulation of cannabinoid signaling may be a viable therapeutic option as a smoking cessation aid.”
Department of Neurobiology and Behavior, University of California Irvine, USA.
“Dipeptidyl peptidase IV (DPP-IV) plays a key role in regulating glucose homeostasis, and inhibition of this enzyme has been used as a therapeutic approach to treat type 2 diabetes. (…) In this study, four cannabinoids (cannabidiol, cannabigerol, cannabinol and delta-9-tetrahydrocannabinol) were evaluated for their inhibitory effects against recombinant human DPP-IV and their potential inhibition mechanism was explored using both in vitro and in silico approaches. (…) These results demonstrated that cannabinoids may modulate DPP-IV activity and thereby potentially assist in improving glycaemic regulation in type 2 diabetes.”
Department of Biochemistry and Microbiology, Makhanda, South Africa.