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IACM-Bulletin of 24 January 2016

Science/Human: Patients with migraine may profit from cannabis according to an observational study

The frequency of migraine headache can be decreased by the medical use of cannabis according to research by scientists of the Department of Clinical Pharmacy of the University of Colorado in Aurora and other medical institutions of Colorado. They conducted a retrospective chart review of 121 adults with the primary diagnosis of migraine headache, who were recommended migraine treatment or prophylaxis with cannabis by a physician, between January 2010 and September 2014, and had at least one follow-up visit.

Migraine headache frequency on average decreased from 10.4 to 4.6 headaches per month with the use of cannabis. Most patients used more than one form of cannabis and used it daily for prevention of migraine headache. Positive effects were reported in 48 patients (39.7%), with the most common effects reported being prevention of migraine headache with decreased frequency of migraine headache (24 patients [19.8%]) and aborted migraine headache (14 patients [11.6%]).

Rhyne DN, Anderson SL, Gedde M, Borgelt LM. Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. Pharmacotherapy. 2016 Jan 9. [in press]

Science/Human: Cannabis oil may help in the treatment of symptoms of Alzheimer’s disease

Delusions, aggression, irritability and other symptoms may be reduced in patients with dementia by cannabis oil, researchers of the Abarbanel Mental Health Center in Bat-Yam, and Sackler Faculty of Medicine of Tel-Aviv University, Israel, wrote in the Journal of Alzheimer Disease. Eleven patients with Alzheimer’s disease were recruited to an open label, 4 weeks, prospective trial.

Ten patients completed the trial. Significant reduction in the score of Clinical Global Impression (6.5 to 5.7) and the Neuropsychiatric Inventory score were recorded (44.4 to 12.8). In the Neuropsychiatric Inventory scale the following aspects significantly decreased: Delusions, agitation/aggression, irritability, apathy, and sleep and caregiver distress. Authors concluded that adding cannabis oil to Alzheimer disease patients' “pharmacotherapy is safe and a promising treatment option.”

Shelef A, Barak Y, Berger U, Paleacu D, Tadger S, Plopsky I, Baruch Y. Safety and Efficacy of Medical Cannabis Oil for Behavioral and Psychological Symptoms of Dementia: An-Open Label, Add-On, Pilot Study. J Alzheimers Dis. 2016 Jan 12. [in press]

Science/Human: Cannabis reduced neuropathic pain in patients with multiple sclerosis in an open study

A treatment with the cannabis extract Sativex resulted in pain reduction of multiple sclerosis sufferers. This is a result of research at the IRCCS Centro Neurolesi "Bonino-Pulejo" in Messina, Italy. Scientists enrolled 20 MS patients (10 with and 10 without neuropathic pain) into the study, who underwent a specific clinical and neurophysiological assessment, before and after 4 weeks of Sativex administration.

One month of drug administration in MS patients with neuropathic pain successfully reduced pain rating and improved quality of life. Interestingly, such effects were paralleled by certain changes in nerve cell communication. Authors concluded that their data suggest that “Sativex may be effective in improving MS-related neuropathic pain, maybe through its action on specific cortical pathways.”

Russo M, Naro A, Leo A, Sessa E, D'Aleo G, Bramanti P, Calabrò RS. Evaluating Sativex® in Neuropathic Pain Management: A Clinical and Neurophysiological Assessment in Multiple Sclerosis. Pain Med. 2016 Jan 13. [in press]

Science/France: FAAH inhibitor caused death of a man in a phase I trial

Johnson & Johnson has suspended international trials of the experimental drug BIA 10-2474 of the Portuguese pharmaceutical company Bial, whose phase I study in healthy subjects in France left one person brain dead and five others hospitalized. Officials in France have said 90 people have taken part in the Bial trial, taking some dosage of the drug aimed at tackling mood and anxiety issues, as well as movement coordination disorders linked to neurological issues. BIA 10-2474 is a FAAH inhibitor. These synthetic modulators of the endocannabinoid system inhibit the activity of FAAH (fatty acid amide hydrolase), which is responsible for the degradation of the endocannabinoid anandamide (AEA, arachidonoyl ethanolamide), thus increasing its concentration to stimulate the endocannabinoid system.

"FAAH is also responsible for the degradation of many other fatty acid amides,” says Dr Franjo Grotenhermen, Executive Director of the IACM. “It will not only increase the concentration of anandamide, but also the concentrations of other fatty acid amides. The mechanism of action is different from that of THC, which binds to cannabinoid receptors. Synthetic modulators of the endocannabinoid system are different to cannabinoids or cannabis in terms of their potential side effects.” “Without adequate information it is impossible to advance any realistic theory about causes of toxicity," says Dr Daniele Pomelo, a Professor for Anatomy & Neurobiology of the University of California. "Several structurally different FAAH inhibitors have been previously tested for human safety in rigorous Phase 1 clinical trials. These include compounds from Sanofi, Pfizer, Merck, Johnson and Johnson, and others. All these FAAH inhibitors were shown to be safe in humans."

Reuters of 21 January 2016

Press release by Cannabis and Cannabinoid Research of 19 January 2016

News in brief

Mexico: Medical cannabis bill should pass congress by May
A bill to allow the medical use of cannabis should be approved by Mexico's Congress by May. There is cross-party support and there were a series of public debates on cannabis that should win over lawmakers, the ruling party senator who proposed the measure said.
Reuters of 21 January 2016

IACM: Medical Cannabis Declaration
In order to promote the Medical Cannabis Declaration a short film will be prepared for the homepage of the Medical Cannabis Declaration, where some patients report about their experiences and what cannabis-based medicines mean for them, experts and doctors give information on the science and people from many countries say in their mother tongue "yes to cannabis as medicine". If you are from Eastern EURope, Asia or Africa and would like to express this sentence in your mother tongue in the film please contact info@medicalcannabisdeclaration.org"

Science/Human: Tobacco and alcohol use usually precede cannabis use
A study with 2835 students in the 12th class showed that alcohol is the most commonly used substance, and the majority of polysubstance using respondents consumed alcohol prior to tobacco or cannabis initiation.
Department of Health and Kinesiology, Texas A&M University, USA.
Barry AE, et al. J Sch Health 2016;86(1):31-8.

Science/Human: No effect of cannabis use on intelligence of adolescents according to twin study
The purpose of a new study was to examine the associations of cannabis use with changes in intellectual performance in two longitudinal studies of adolescent twins, one with 789 and the other with 2,277. Standardized measures of intelligence were administered at ages 9-12 years, before cannabis involvement, and again at ages 17-20 years. Authors concluded from their results that “evidence from these two samples suggests that observed declines in measured IQ may not be a direct result of marijuana exposure but rather attributable to familial factors that underlie both marijuana initiation and low intellectual attainment.”
Department of Psychology, University of Southern California, Los Angeles, USA.
Jackson NJ, et al. Proc Natl Acad Sci U S A. 2016 Jan 19. [in press]

Science/Human: Vaporization of cannabis constitutes an efficient administration of cannabis
Efficiency of four vaporizers (Volcano Medic, Plenty Vaporizer, Arizer Solo and DaVinci Vaporizer) was tested. Decarboxylation efficiency was excellent for THC (> 97%) and CBD (> 94%). Authors noted that “temperature-controlled, electrically-driven vaporizers efficiently decarboxylate inactive acidic cannabinoids and reliably release their corresponding neutral, active cannabinoids.”
Department of Clinical Research, University of Bern, Switzerland.
Lanz C, et al. PLoS One 2016;11(1):e0147286

Science/Animal: The endocannabinoid system is involved in the action of resveratrol
Resveratrol is a natural phenol, which may be found in several plants including grapes, blueberries, raspberries and mulberries. It may be beneficial in heart disease and cancer. Researchers found that resveratrol acts on the endocannabinoid system including the activation of the CB1 receptor.
Faculty of Pharmacy, Tehran University of Medical Sciences, Iran.
Hassanzadeh P, et al. Psychopharmacology (Berl). 2016 Jan 18. [in press]

Science/Human: No association between cannabis use and anxiety disorders
Results of a large 3-year prospective study with data of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) of the USA “suggest that cannabis use and CUDs [cannabis use disorders] are not associated with increased incidence of most anxiety disorders and inversely, most anxiety disorders are not associated with increased incidence of cannabis use or CUDs.”
Ariel University, Israel.
Feingold D, et al. EUR Neuropsychopharmacol. 2015 Dec 29. [in press]

Science/Cells: THC demonstrates anti-cancer effects in acute leukaemia cells
The efficacy of THC was investigated in several leukaemia cell lines. Meaningful anti-cancer effects were demonstrated in a subset of cases - with a preference of leukaemia cells from the lymphatic lineage or acute myeloid leukaemia cells expressing lymphatic markers. Induction of apoptosis (programmed cell death) was mediated by the CB1 and the CB2 receptor.
University Hospital Tübingen, Germany.
Kampa-Schittenhelm KM, et al. BMC Cancer 2016;16(1):25.

Science/Human: No relationship between cannabis use and anxiety or depression
In a longitudinal study with 8598 Swedish men and women aged 20-64 years there was “no longitudinal associations between cannabis use and incidence of depression/anxiety, or between depression/anxiety and later cannabis use onset.”
Karolinska Institute, Stockholm, Sweden.
Danielsson AK, et al. J Affect Disord 2015;193:103-108

Science/Animal: Cannabidiol may be helpful in inflammation of the heart
Myocarditis (inflammation of the heart muscle) is a major cause of heart failure and sudden cardiac death in young adults and adolescents. In a mouse model of myocarditis CBD (cannabidiol) was shown to be beneficial. Authors wrote that this cannabinoid “may represent a promising novel treatment for management of autoimmune myocarditis and possibly other autoimmune disorders, and organ transplantation.”
National Institute on Alcohol Abuse and Alcoholism, Bethesda, USA.
Lee WS, et al. Mol Med. 2016 Jan 8. [in press]

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