Impact of efficacy at the mu opioid receptor on antinociceptive effects of combinations of mu opioid receptor agonists and cannabinoid receptor agonists.

“Cannabinoid receptor agonists, such as delta-9-tetrahydrocannabinol (Δ9-THC),  have antinociceptive effects and, are increasingly used to treat pain, and medications including cannabinoid receptor agonists are approved for use in humans.

Cannabinoid receptor agonists [e.g. Δ9-tetrahydrocannabinol (Δ9-THC)] enhance the antinociceptive effects of mu opioid receptor agonists, suggesting that combining cannabinoids with opioids would improve pain treatment.

…these results provide additional support for combining opioids with cannabinoids to treat pain.”

http://jpet.aspetjournals.org/content/early/2014/09/05/jpet.114.216648.long

http://www.thctotalhealthcare.com/category/pain-2/

Delta-9-tetrahydrocannabinol + cannabidiol. A reasonable option for some patients with multiple sclerosis.

“Conventional drugs have only a limited impact on spasticity associated with multiple sclerosis and are rarely satisfactory. A solution for oral transmucosal delivery (spray) containing a mixture of cannabis extracts (2.7 mg of delta-9-tetrahydrocannabinol + 2.5 mg of cannabidiol per spray) has been granted marketing authorisation in France for patients who are inadequately relieved by standard treatments. Three double-blind, placebo-controlled trials in a total of about 300 patients tested this combination, in addition to ongoing treatment, for periods of 6 to 14 weeks. Individually, none of these trials showed any tangible anti-spastic efficacy, but two combined analyses showed “response rates” of about 35% with the mixture versus about 25% with placebo. In a trial with 572 patients, the 241 patients who “responded” after 4 weeks of treatment were randomised to either continue using the cannabis extract or receive placebo. Twelve weeks later, 75% of patients using the extract were still “responders”, versus 51% of patients switched to placebo. The principal adverse effects of the cannabis extracts consist of neuropsychiatric disorders that resolve on treatment withdrawal. The potential for abuse increases with the dose and is tangible from 16 sprays per day. Pharmacokinetic interactions due to P-glycoprotein inhibition are likely. Treatment during pregnancy may lead to neonatal withdrawal symptoms. In practice, about 10% of patients in whom standard anti-spastic medications are unsatisfactory benefit from a specific effect of the cannabis extracts contained in this oral spray.”

http://www.ncbi.nlm.nih.gov/pubmed/25121144

Cannabis as painkiller

ScienceDaily: Your source for the latest research news

“Cannabis-based medications have been demonstrated to relieve pain.

Cannabis medications can be used in patients whose symptoms are not adequately alleviated by conventional treatment.

The clinical effect of the various cannabis-based medications rests primarily on activation of endogenous cannabinoid receptors.

Consumption of therapeutic amounts by adults does not lead to irreversible cognitive impairment.”

http://www.sciencedaily.com/releases/2012/08/120807101232.htm

http://www.thctotalhealthcare.com/category/pain-2/

Nabiximols (THC/CBD Oromucosal Spray, Sativex®) in Clinical Practice – Results of a Multicenter, Non-Interventional Study (MOVE 2) in Patients with Multiple Sclerosis Spasticity.

“Nabiximols (Sativex®), a cannabinoid-based oromucosal spray, is an add-on therapy for patients with moderate to severe multiple sclerosis spasticity (MSS) resistant to other medications. The primary objective was to provide real-life observational data of clinical experience of nabiximols in contrast to formal clinical trials of effectiveness…

Conclusion: Real-life data confirm nabiximols as an effective and well-tolerated treatment option for resistant MSS in clinical practice.”

http://www.ncbi.nlm.nih.gov/pubmed/24525548

Dronabinol for the Treatment of Cannabis Dependence: A Randomized, Double-Blind, Placebo-Controlled Trial

“… there are no effective medications for cannabis dependence. The purpose of this study was to evaluate the safety and efficacy of dronabinol, a synthetic form of delta-9-tetrahydrocannabinol, a naturally occurring pharmacologically active component of marijuana, in treating cannabis dependence.

This is the first trial using an agonist substitution strategy for treatment of cannabis dependence. Dronabinol showed promise, it was well-tolerated, and improved treatment retention and withdrawal symptoms…

In conclusion, agonist substitution pharmacotherapy with dronabinol, a synthetic form of THC, showed promise for treatment of cannabis dependence, reducing withdrawal symptoms and improving retention in treatment…

The trial showed that among adult cannabis-dependent patients, dronabinol was well accepted, with good adherence and few adverse events.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154755/

 

Repositioning therapy for thyroid cancer: new insights on established medications.

“Experimental in vitro and in vivo evidence, as well as results of clinical studies, have indicated that molecular targets for medications currently available for the treatment of mood disorders, sexually transmitted diseases, metabolic disorders, and diabetes may be active and relevant in thyroid cancer.

For instance, the derivatives of cannabis and an anti-diabetic agent, metformin, are both able to inhibit extracellular signal-regulated protein kinase (ERK), which is commonly activated in thyroid cancer cells.

We present here several examples of well-known medications that have the potential to become new therapeutics for patients with thyroid cancer. Repositioning of established medications for the treatment of thyroid cancer could broaden the scope of current therapeutic strategies. These diverse treatment choices could allow physicians to provide an individualized approach to optimize treatment for patients with thyroid cancer.”

http://www.ncbi.nlm.nih.gov/pubmed/24446492

Nabiximols as an Agonist Replacement Therapy During Cannabis Withdrawal: A Randomized Clinical Trial.

“The cannabis extract nabiximols (Sativex), developed as a multiple sclerosis treatment, offers a potential agonist medication for cannabis withdrawal…

Nabiximols treatment significantly reduced the overall severity of cannabis withdrawal…

The data support further evaluation of nabiximols for management of cannabis dependence and withdrawal in treatment-seeking populations.”

http://www.ncbi.nlm.nih.gov/pubmed/24430917

Advances in the management of multiple sclerosis spasticity: experiences from recent studies and everyday clinical practice.

“Herbal (smoked) cannabis has long been recognized as a possible option for relief of spasticity and neuropathic pain… An innovative method of benefiting from the mode of action of cannabinoids while limiting their drawbacks is to reduce peak plasma levels of 9-delta-tetrahydrocannabinol and counteract psychoactivity with higher than naturally occurring proportions of a second cannabinoid, cannabidiol.

Sativex® oromucosal spray (1:1 ratio of 9-delta-tetrahydrocannabinol/cannabidiol) has recently been approved in a number of EU countries and elsewhere for use in patients with MS-related spasticity who are resistant to treatment with other antispasticity medications.

In clinical trials, Sativex provided initial relief of spasticity symptoms within the first 4 weeks of treatment (trial period) in up to about half of patients resistant to other available oral antispasticity medications and demonstrated clinically significant improvement in spasticity (30% or higher reduction from baseline) in three-quarters of the initial responders. Adverse events were limited mainly to mild or moderate cases of somnolence and dizziness.

Under everyday clinical practice conditions, Sativex at a mean daily dose of <7 sprays/day, was shown to relieve spasticity in about 70% of patients previously resistant to treatment.

Clear improvements were also noted in associated symptoms such as sleep disturbances, bladder problems, loss of mobility and cramps…

Follow-up studies in Sativex responders support continued benefit without the need to increase doses for at least 1 year.

Sativex appears to be a promising solution for a meaningful proportion of patients with MS-related spasticity who have inadequate response to current antispasticity medications.”

http://www.ncbi.nlm.nih.gov/pubmed/24289844

Study: Cannabis Compounds Can Kill Cancer Cells – US News & World Report

“Researcher says cannabinoids might treat cancer as well as billion-dollar drugs.”

A medical marijuana activist holds a sign during a rally Jan. 4, 2010, in Oakland, Calif. Research suggests marijuana may fight cancer itself, not just side-effects.“A British researcher has found that cannabinoids, a term for chemicals derived from marijuana, can kill leukemia cells, and he expects clinical trials for new medications to begin soon.

The findings, published in the October issue of Anticancer Research: International Journal of Cancer Research and Treatment, show that certain non-psychoactive cannabinoids “resulted in dramatic reductions in cell viability” and “caused a simultaneous arrest at all phases of the cell cycle,” according to an abstract posted online. 

The study tested six cannabinoids, together and independently, on leukemia cells. Study author Wai Liu, an oncologist at the University of London’s St. George’s medical school, told U.S. News the chemicals displayed “potent anti-cancer activity” and, significantly, “target and switch off” pathways that allow cancers to grow.”

More: http://www.usnews.com/news/articles/2013/10/24/study-cannabis-compounds-can-kill-cancer-cells

The use of cannabinoids in chronic pain.

“We present the case of a 56-year-old man who developed chronic pain following the excision of a facial cancer that was poorly controlled despite multiple analgesic medications. Following the starting of nabilone (a synthetic cannabinoid) his pain control was greatly improved and this had a huge impact on his quality of life.

We also managed to significantly reduce his doses of opioid analgesia and ketamine.

We review the current literature regarding the medicinal use of cannabinoids, with an emphasis on chronic pain, in an attempt to clarify their role and how to select patients who may benefit from this treatment.”

http://www.ncbi.nlm.nih.gov/pubmed/23893276