IACM-Bulletin of April 11, 2010

Science — Cannabis effective in tadive dystonia in a case report

In a letter to a journal for psychiatry doctors from a hospital in Izmir, Turkey, reported of a patient with paranoid schizophrenia, who developed tardive dyskinesia and tadive dystonia eight months after beginning an anti-psychotic treatment. There were involuntary movements of the face and mouth with difficulty swallowing and chewing foods (tardive dyskinesia) as well as involuntary sustained contraction of the neck muscles (tardive dystonia). He noted a significant reduction of these involuntary movements following the use of cannabis and therefore smoked it three or four times a week for two weeks until he was arrested due to smuggling. His symptoms then reappeared with the original severity during the seven months he was in prison.

Tardive dyskinesia presents with involuntary movements of the face or the limbs. These symptoms are often irreversible after a treatment with neuroleptics or other psychotropic medical drugs, which means that they may persist after stopping the medication, and are often difficult to treat. By changing the medication the physicians were able to nearly make disappear the involuntary movements in the facial region, however, the troubles in the neck persisted and could not be treated successfully with conventional drugs (diazepam, baclofen, gabapentin, etc.). The authors were not able to administer cannabinoids to the patient since cannabinoid-based medications are not legally available in Turkey, however they noted that "we think that cannabinoid agonists might be an appropriate choice in the treatment of intractable tardive dystonia."

(Source: Beckmann Y, Seçil Y, Güngör B, Yiğit T. Tardive Dystonia and the Use of Cannabis. Turk Psikiyatri Derg 2010;21(1):90-91.)

USA — A little known Illinois law on the medical use of cannabis

A Chicago journal reported of the status of the laws on the medical use of cannabis in Illinois. Cannabis can be used for medicinal purposes under the laws of 14 US states (Alaska, California, Colorado, Hawaii, Maine, Maryland, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, and Washington). "Here's a little known fact: technically it's legal in Illinois too - and has been for 32 years." In 1978 the Illinois legislature passed a law (Cannabis Control Act) to try to bring common sense to the state's drug laws.

In the name of "research," the act gave the Illinois Department of Human Services permission to "authorize" physicians to use cannabis to treat "glaucoma, the side effects of chemotherapy or radiation therapy in cancer patients or such other procedure certified to be medically necessary."

But there were two obstacles. The first was that Human Services was merely allowed to give doctors this authority - not required to. The second was that it could act only "with the written approval of the Department of State Police." In other words, two state departments had to create new policies before medical cannabis could actually be prescribed and provided. To this day neither has.

More at:

http://www.chicagoreader.com/chicago/medical-marijuana-pot-illinois-cannabis-control-act-legalization/Content?oid=1629059

(Source: Chicago Reader of 8 April 2010)

News in brief

Science — Online survey

Scientists of the University of Calgary, Canada, are conducting a study on the benefits of cannabis for the treatment of nausea/vomiting or the occurrence of nausea/vomiting as a side effect of cannabis use by an online survey. People who would like to participate in this anonymous survey are invited to visit the following website:

http://ibd-cannabis-survey.limequery.com/index.php?sid=64184&lang=en (Source: Personal communication by Dr. Martin Storr)

USA — Washington

More medical professionals will be allowed to authorize the medicinal use of cannabis for patients in the state of Washington. Governor Chris Gregoire signed a bill on 1 April, which takes effect on 10 June. It adds naturopaths, certain nurses and others to the list of those who can officially recommend cannabis for patients. As in the other states that allow the medical use of cannabis, under previous law, only physicians were allowed to write the recommendation. (Source: Seattle Times of 1 April 2010)

Science — Appetite

Researchers of the University of Reading, UK, investigated the effects of dronabinol (THC) and a cannabis extract rich in dronabinol on food consumption in rats. They noted "significant, albeit subtle, differences in pattern of effects" between the pure dronabinol and the cannabis extract and added that other compounds of the cannabis plant "can modulate delta-9-THC induced hyperphagia, making them worth further investigation for their therapeutic potential." (Source: Farrimond JA, et al. Psychopharmacology (Berl) 2010 Mar 27. [Electronic publication ahead of print])

Science — THC preparation

According to research at the University of Mississippi, USA, the solubility of THC in water could be increased by forming complexes of a THC hemisuccinate ester with beta-cyclodextrins. The scientists intend to develop oral formulations of THC with enhanced bioavailability. (Source: Upadhye SB, et al. AAPS PharmSciTech 2010 Mar 24. [Electronic publication ahead of print])

Science — Sports

Scientists at the University of Heidelberg, Germany, investigated the importance of the endocannabinoid system for the well-being during physical activity. They concluded that "while endocannabinoids seem to contribute to the motivational aspects of voluntary running in rodents, influencing the total distance covered most likely via CB1 receptors, they are less involved in the long-term changes of emotional behavior induced by voluntary exercise." (Source: Fuss J, Gass P. Exp Neurol 2010 Mar 27. [Electronic publication ahead of print])