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IACM-Bulletin of 03 January 2010

Science: Nabilone improved sleep in patients with fibromyalgia

At the Pain Clinic of McGill University, Montreal, Canada, the effects of low doses of the THC derivative nabilone (0.5-1.0 mg before bedtime) and the anti-depressant amitriptyline (10-20 mg before bedtime) on sleep were investigated in 31 patients with fibromyalgia and chronic insomnia. Fibromyalgia is a disease characterized by widespread chronic pain and insomnia. Subjects received each drug for 2 weeks with a 2-week period without medications between the two treatment phases.

The study was terminated by 29 participants. Sleep was improved by both amitriptyline and nabilone, but nabilone was superior to amitriptyline. No effects on pain, mood, or quality of life were observed. Adverse events were mostly mild to moderate and were more frequent with nabilone. Researchers concluded that "nabilone is effective in improving sleep in patients with FM and is well tolerated. Low-dose nabilone given once daily at bedtime may be considered as an alternative to amitriptyline."

(Source: Ware MA, Fitzcharles MA, Joseph L, Shir Y. The Effects of Nabilone on Sleep in Fibromyalgia: Results of a Randomized Controlled Trial. Anesth Analg. [Electronic publication ahead of print])

USA: Patients in Colorado who have the right to use cannabis for medicinal purposes also have the right to buy the drug

Patients who are allowed to use cannabis in Colorado have a constitutional right to buy cannabis, not just use it, according to a ruling on 30 December. Judge Christopher Cross of the Arapahoe County District Court supported the CannaMart dispensary, which sued the city of Centennial after it was shut down in October. Cross granted the dispensary's request for an injunction, which will prevent the city from keeping the dispensary closed while CannaMart challenges the city's argument that it can ban cannabis shops because they violated federal drug laws.

Colorado in 2000 passed a constitutional amendment allowing medical cannabis. Recent decisions by state health authorities, along with a declaration by the U.S. attorney general in 2009 that federal prosecutors won't interfere with state cannabis rules, have led to an explosion of commercial cannabis stores across Colorado. Judge Cross said the city violated the rights of three medical cannabis patients who joined the lawsuit. One of these patients said CannaMart's closure made it difficult for him to obtain medical cannabis recommended for a debilitating nerve ailment.

More at:
hosted.ap.org/dynamic/stories/U/US_MEDICAL_MARIJUANA_COLORADO?SITE=FLTAM&SECTION=HOME&TEMPLATE=news_generic.htm

(Source: Associated Press of 30 December 2009)

News in brief

USA: Colorado
There are about 30,000 patients state-wide, who are allowed to use cannabis for medicinal purposes. As of mid-August, three quarters of these recommendations came from 15 doctors. (Source: Denver Post of 18 December 2009)

USA: New Mexico
There are 899 patients with an approval of the medical use of cannabis, of whom more than half remain without adequate access to their medicine. (Source: Santa Fe Reporter of 23 December 2009)

Science: Multiple sclerosis
According to research at a university hospital near Madrid, Spain, there were significant differences in the distribution of types of the gene that encodes the CB1 receptor in patients suffering from primary progressive multiple sclerosis compared to healthy controls. There was no relation of genotypes to disease severity. (Source: Ramil E, et al. Mult Scler. [Electronic publication ahead of print])

Science: Detection of THC
Researchers from the University of Trondheim, Norway, reported of a pregnant woman, who was a heavy regular cannabis user. THC metabolites (THC-COOH) were detectable in urine for 84 days after last use. She was suspected to continue using cannabis despite denying any further use. Finally, her THC-COOH excretion profile supported her story. (Source: Westin AA, et al. J Anal Toxicol 2009;33(9):610-4.)

Science: Schizophrenia
There is uncertainty concerning the effects of cannabis use on cognition of schizophrenic patients. According to research from Australia there was little difference in cognitive performance between cannabis users and non-users amongst both healthy individuals and patients with schizophrenia, suggesting "that cannabis use has only subtle effects on the neurocognitive performance indices assessed." (Source: Scholes KE, et al. Psychol Med 2009 Dec 17. [Electronic publication ahead of print])

Science: Cannabigerol
The mechanism of action of the plant cannabinoid cannabigerol (CBG) is unknown. Researchers at the University of Aberdeen, UK, found out that CBG can activate alpha2-adrenoceptors, bind to cannabinoid CB1 and CB2 receptors and block CB1 and 5-HT1A receptors. (Source: Cascio MG, et al. Br J Pharmacol [Electronic publication ahead of print])

Science: Cannabidiol
So far, several mechanisms of action of cannabidiol (CBD) have been demonstrated including antagonism at the CB1 receptor. Researchers of the University of Sao Paulo, Brazil, demonstrated antidepressant effects of CBD in mice, which were possibly mediated by activation of 5-HT1A receptors. (Source: Zanelati T, et al. Br J Pharmacol. [Electronic publication ahead of print])

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