IACM-Bulletin of June 19, 2011

Science — THC improves driving ability in a patient with Tourette syndrome

Physicians at the Ludwig-Maximilians University in Munich and the Inn-Salzach Hospital, Germany, presented the case of a 42-year-old truck driver with Tourette syndrome since the age of 6. He exhibited multiple tics and repeatedly standing up and down. Mostly, he was suffering from obsessive thoughts. All standard medications for tic disorders had proven ineffective. After two weeks of a treatment with increasing doses of THC (up to 15 mg a day) tics were significantly reduced.

Since the patient required daily driving his driving ability was assessed with computerized tests, according to the German guidelines for road and traffic safety. Both in the drug-free phase and during THC therapy, the criteria according to German regulations were met in all functional domains investigated (visual perception, capacity of reaction, concentration and stress-tolerance). In comparison with the drug-free phase, there was a clear improvement in concentration and visual perception during the treatment with THC.

(Source: Brunnauer A, Segmiller FM, Volkamer T, Laux G, Müller N, Dehning S. Cannabinoids improve driving ability in a Tourette's patient. Psychiatry Res. 2011 Jun 9. [in press])

News in brief

A Norwegian citizen suffering from post traumatic stress disorder (PTSD) and attention deficit hyperactivity disorder (ADHD) is allowed to import cannabis of the Dutch company Bedrocan from a Dutch pharmacy to Norway. The cannabis was confiscated by the border police in March. However, the police has now finally closed the case of Svein Berg since he was acting in agreement with article 75 of the Schengen agreement. Mr. Berg is now free to import cannabis from the Netherlands for one month of personal use. (Source: Personal communication by Mr. Berg)

The health authorities in Denmark have granted approval for the cannabis extract Sativex for the treatment of spasticity due to multiple sclerosis in patients who have not responded adequately to other anti-spasticity medication. The product, which is already available in the UK and Spain is expected to be launched in July. In addition to Germany and Denmark, launch is also expected in Sweden before the end of 2011. Launches in Italy, Czech Republic and Austria are expected in 2012. (Source: Press release by GW Pharmaceuticals and Almirall of 8 June 2011)

USA — Washington

Medical cannabis patients can be fired from their jobs in Washington State even if they only use the drug outside the workplace, the Washington Supreme Court ruled on 9 June. It concluded that, regardless of voter intent, it would be contrary to public policy to force employers to sanction criminal activity, the use of cannabis for medical purposes is still a federal crime. (Source: Reuters of 11 June 2011)

USA — Cannabis dispensaries

On 2 June Governor Peter Shumlin signed into law a bill that allows up to four medical cannabis dispensaries in Vermont. There are now eight states that allow dispensaries for cannabis for medical use (Arizona, Colorado, Delaware, Maine, New Jersey, New Mexico, Rhode Island, Vermont). (Source: Rutland Herald of 3 June 2011)

Science — Huntington's disease

Spanish researchers investigated the effects of cannabis extracts with varying CBD and THC contents on a rat model of Huntington's disease. The extracts were neuroprotective and this effect was not mediated by cannabinoid receptors. The authors suggested antioxidant properties to be responsible for the beneficial effects. (Source: Sagredo O, et al. J Neurosci Res. 2011 Jun 14. [in press])

Science — Transplantation

According to research from the University of South Carolina, USA, THC reduced graft-versus-host disease in a mouse model of blood cell transplantation, which is used in malignant blood diseases. Graft-versus-host disease is characterized by an attack of T cells of the donor to tissues of the recipient, which causes significant toxicity in the treated patient. Scientists concluded that their "results demonstrate for the first time that targeting cannabinoid receptors may constitute a novel treatment modality against acute GVHD." (Source: Pandey R, et al. J Pharmacol Exp Ther. 2011 Jun 14. [in press])

Science — Impulsive behaviour

According to a group of Spanish researchers activation of the CB2 receptor reduced impulsive-like behaviour in mice. They suggest "that the CB2 receptor might play an important role in the regulation of impulsive behaviours and should be considered a promising therapeutic target in the treatment of impulsivity-related disorders." (Source: Navarrete F, et al. Br J Pharmacol. 2011 Jun 15. [in press])

Science — Multiple sclerosis

According to scientists of the University of Copenhagen, Denmark, treatment with a synthetic cannabinoid (WIN55,212-2) caused neuroprotection in a rat model of multiple sclerosis, associated with reduced inflammatory activity and pro-inflammatory cytokines, such as interleukin-2, interleukin-6 and interleukin-10. They noted that their "study implies that long-term low-dose cannabinoid administration to multiple sclerosis (MS) patients could result in some degree of neuroprotection, and thereby slow down the atrophy associated with this disease." (Source: Hasseldam H, et al. Int J Neurosci. 2011 Jun 15. [in press])

Science — Cannabis abuse

Canadian researchers conducted a double-blind, placebo-controlled, crossover study with cannabis users, who at different occasions received a single dose of either THC (20 and 40 mg) or the cannabis extract Sativex (containing 10.8, 21.6 and 43.2 mg THC) or placebo. The administration of Sativex was associated with slightly lower subjective and cognitive effects than THC. Researchers concluded that Sativex "showed similar or slightly less abuse potential compared with dronabinol." (Source: Schoedel KA, et al. Hum Psychopharmacol. 2011 Jun 13. [in press])

Science — AIDS

According to research with nerve cells of a certain brain region (hippocampus) at Dankook University, South Korea, the synthetic cannabinoid WIN55,212-2 prevented synaptic damage of the cells. Scientists concluded that "these results indicate that cannabinoids prevent the impairment of network function" and might have therapeutic potential in HIV associated dementia." (Source: Kim HJ, et al. Mol Pharmacol. 2011 Jun 13. [in press])

Science — Cannabidiol

According to research at the University of Sydney, Australia, pre-treatment with CBD increased THC effects in rats. With both acute and chronic administration, CBD pre-treatment potentiated blood and brain THC levels. Researcher concluded that "CBD can potentiate the psychoactive and physiological effects of THC in rats, most likely by delaying the metabolism and elimination of THC." In contrast, simultaneous administration of CBD reduces psychoactive THC effects. (Source: Klein C, et al. Psychopharmacology (Berl). 2011 Jun 11. [in press])

Science — Gastric bleeding

According to research at the Virginia Commonwealth University, USA, THC prevented gastric bleeding caused by diclofenac, a non-steroidal anti-inflammatory drug in mice. Gastric bleeding is a common side effect of long-term administration of such drugs. The THC effect was mediated by the CB1 receptor. (Source: Kinsey SG, et al. J Pharmacol Exp Ther. 2011 Jun 9. [in press])

Science — Liver cirrhosis

The major cellular event in the development and progression of liver cirrhosis is the activation of hepatic stellate cells. Researchers at the Mount Sinai School of Medicine in New York, USA, demonstrated that cannabidiol (CBD) selectively induced death of these activated liver cells and that it "represents a potential therapeutic agent for the treatment of liver fibrosis." (Source: Lim MP, et al. Cell Death Dis 2011;2:e170.)

Science — Brain damage

According to a group of Spanish researchers cannabidiol (CBD) reduced brain damage due to reduced blood supply in newborn pigs. Three days after acute ischemia brains in non-treated animals had recovered to 43 per cent of normal brain activity, while brains of pigs who also received CBD had recovered to 87 per cent. (Source: Lafuente H, et al. Pediatr Res. 2011 Jun 7. [in press])

Science — Osteoporosis

According to research at the University of Aberdeen, UK, cannabinoids activate human osteoclasts (bone cells that remove bone tissue) in cell experiments. There is a dynamic regulation of the expression of the CB2 receptor and the production of endocannabinoids during the differentiation of human bone cells. (Source: Whyte LS, et al. Br J Pharmacol. 2011 Jun 7. [in press])

Science — Glaucoma

Researchers at the University of Mississippi, USA, improved the solubility of delta-8-THC and its transportation through the cornea of the eye by adding cyclodextrins. They concluded that "topical ophthalmic formulations containing delta-8-THC and modified beta-cyclodextrins may show markedly improved ocular bioavailability." (Source: Hippalgaonkar K, et al. AAPS PharmSciTech. 2011 Jun 3. [in press])

Science — Schizophrenia

Researchers at the Charité Hospital in Berlin, Germany, investigated the effects of chronic cannabis use on cognitive performance in schizophrenic patients and healthy subjects. They compared 27 chronic cannabis users with schizophrenia, 32 cannabis users without schizophrenia, 26 patients with schizophrenia and 34 healthy controls without chronic drug use. Healthy cannabis users showed reduced neurocognitive performance. In contrast, cannabis-using schizophrenic patients showed increased performance compared to schizophrenic patients without cannabis use. (Source: Rentzsch J, et al. Schizophr Res. 2011 May 28. [in press])