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IACM-Bulletin of 12 July 2015

Science/Human: Cannabidiol increases clobazam concentrations in children with epilepsy

Patients, who receive cannabidiol (CBD) in combination with clobazam (a well-known brand name is Frisium) may experience an increase in clobazam (CLB) levels. Doctors at the Massachusetts General Hospital, USA, treated 13 children with refractory epilepsy with CBD in addition to clobazam and found elevated blood levels of the latter. Both medications are degraded in the liver by the CYP2C19 enzyme and thus compete for the function of this protein.

The mean increase in clobazam levels after 4 weeks of treatment was 60% with great variation. Sometimes clobazam levels were increased much more. Nine of the 13 subjects had a greater than 50% decrease in seizures, corresponding to a responder rate of 70%. The increased clobazam levels and decreases in seizure frequency occurred even though, over the course of CBD treatment, clobazam doses were reduced for 10 (77%) of the 13 subjects. Side effects were reported in 10 (77%) of the 13 subjects, but were alleviated with clobazam dose reduction. Authors noted that monitoring of clobazam levels “is necessary for clinical care of patients concomitantly on CLB and CBD. Nonetheless, CBD is a safe and effective treatment of refractory epilepsy in patients receiving CLB treatment.”

Geffrey AL, Pollack SF, Bruno PL, Thiele EA. Drug-drug interaction between clobazam and cannabidiol in children with refractory epilepsy. Epilepsia. 2015 Jun 26. [in press]

News in brief

USA: Recreational use of cannabis now legal in Oregon
Recreational cannabis use became legal in Oregon on 1 July as it is in Colorado, Alaska and Washington D.C. This is the first step in a voter-approved initiative that will usher in retail weed stores in 2016 like those operating in the capital Washington (District of Columbia) and Colorado.
Reuters of 1 July 2015

Science/Human: Cannabis with high CBD content is preferred by users, who want to improve sleep
Associations between sleep characteristics and the type of cannabis used were observed in 163 adults purchasing medical cannabis for a physical or mental health condition. The 81 individuals with current insomnia and greater difficulties to fall asleep were more likely to report using strains of cannabis with significantly higher concentrations of CBD. 14 participants reported using cannabis to reduce nightmares. They preferred sativa to indica strains.
University of California at Berkeley Institute of Human Development, USA.
Belendiuk KA, et al. Addict Behav 2015;50:178-181.

Science/Human: THC blood concentrations above 8 ng/ml decreased driving performance similar to a blood alcohol concentration of 0.05%
In a simulated driving test with 18 occasional cannabis users the effects of alcohol and cannabis were compared with regard to lane weave (standard deviations of lateral position, SDLP). Blood THC concentrations of 8.2 and 13.1 ng/ml during driving increased SDLP similar to 0.05 and 0.08% blood alcohol concentrations measured by breath tests.
National Institute on Drug Abuse, Baltimore, USA.
Hartman RL, et al. Drug Alcohol Depend. 2015 Jun 23. [in press]

Science/Human: Hemp seeds extract cream may be helpful in acne
In a study with healthy men a cream base plus 3% hemp seeds extract and the cream base were compared with regard to their effects on cheek skin sebum. They applied the creams twice daily for 12 weeks. Measurements demonstrated that skin sebum and erythema content were lowered by the hemp cream. Authors wrote that these results suggest a possible “treatment of acne vulgaris, seborrhoea, papules and pustules to get attractive facial appearance.”
COMSATS Institute of Information Technology, Abbottabad, Pakistan.
Ali A, et al. Pak J Pharm Sci 2015;28(4):1389-95.

Science/Animal: Cannabinoids reduce hyperexitability in nerve cells of the brain
Researchers evaluated the antiepileptic effects of a synthetic cannabinoid (WIN 55,212-2) in rats and found that it decreased neuronal hyperexcitability. This research added to the evidence of “neuroprotective properties of cannabinoids, with a view” to better understand antiepileptic therapy.
University of Palermo, Italy.
Carletti F, et al. Neuroscience. 2015 Jun 29. [in press]

Science: Illegal but not legal cannabis cultivation is hurting the environment
According to a study by researchers at the University of California, Berkeley, cannabis farmers are poisoning local food chains and wastefully diverting previous water. The blame doesn't fall on legal growers with legitimate growing operations; instead, the ecological damage is being done by farmers who stealthily cultivate crops on unmonitored rural properties.
UPI of 24 June 2015

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