Stable dose cannabinoid medicine (Sativex®, THC+CBD) can provide sustained efficacy in the treatment of refractory painful diabetic neuropathy or other peripheral neuropathic pain associated with allodynia [poster]

No abstract available

Double-blind, randomised, placebo controlled, parallel group study of sativex® in the treatment of patients with peripheral neuropathic pain, associated with allodynia [poster]

No abstract available

Evaluation of the Effects of Sativex (THC BDS: CBD BDS) on Inhibition of Spasticity in a Chronic Relapsing Experimental Allergic Autoimmune Encephalomyelitis: A Model of Multiple Sclerosis.

This study investigated the antispasticity potential of Sativex in mice. Chronic relapsing experimental allergic encephalomyelitis was induced in adult ABH mice resulting in hind limb spasticity development. Vehicle, Sativex, and baclofen (as a positive control) were injected intravenously and the "stiffness" of limbs assessed by the resistance force against hind limb flexion. Vehicle alone caused no significant change in spasticity. Baclofen (5 mg/kg) induced approximately a 40% peak reduction in spasticity. Sativex dose dependently reduced spasticity; 5 mg/kg THC + 5 mg/kg CBD induced approximately a 20% peak reduction; 10 mg/kg THC + 10 mg/kg CBD produced approximately a 40% peak reduction in spasticity. Sativex has the potential to reduce spasticity in an experimental mouse model of multiple sclerosis (MS). Baclofen reduced spasticity and served as a positive control. Sativex (10 mg/kg) was just as effective as baclofen, providing supportive evidence for Sativex use in the treatment of spasticity in MS

The Medicalization of Cannabis

Annotated and edited transcript of a Witness Seminar held on 24 March 2009. Introduction by Professor Leslie Iversen.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2010.©The Trustee of the Wellcome Trust, London, 2010. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 24 March 2009. Introduction by Professor Leslie Iversen.Annotated and edited transcript of a Witness Seminar held on 24 March 2009. Introduction by Professor Leslie Iversen.Annotated and edited transcript of a Witness Seminar held on 24 March 2009. Introduction by Professor Leslie Iversen.Annotated and edited transcript of a Witness Seminar held on 24 March 2009. Introduction by Professor Leslie Iversen.Annotated and edited transcript of a Witness Seminar held on 24 March 2009. Introduction by Professor Leslie Iversen.Annotated and edited transcript of a Witness Seminar held on 24 March 2009. Introduction by Professor Leslie Iversen.Cannabis has been considered as both an illicit drug and a medicine throughout its history. Introduced to the UK as a medicine in the nineteenth century, its medical utility was limited and it was not until tetrahydrocannabinol (THC), one of the principal active components in cannabis, was isolated in 1964 by Raphael Mechoulam and his team in Israel that scientific research on the drug expanded. Further major developments came in the 1980s, when the cannabinoid receptors in the brain were discovered. Scientists, clinicians, policy makers and patients interested in exploring and utilizing cannabis as an orthodox medication attended this seminar. Several were involved with the early elucidation of the structures of the components of the cannabis plant, or with the two MRC-funded trials in the 1990s into the therapeutic effect of cannabis on multiple sclerosis (MS) and postoperative pain. The founding director of GW Pharmaceuticals discussed the problems of growing cannabis plants and standardizing extracts to produce a medicine that could gain regulatory approval. Two MS patients related their experiences of cannabinoid medications and the significance of patient activism and self-medication in renewing research interest in the potential medical benefits of cannabis, against the backdrop of increasing recreational use, was also considered. The meeting was suggested by Professor Virginia Berridge, who chaired the meeting jointly with Professor E. M. Tansey. Contributors include: Professor David Baker, Professor Virginia Berridge Dr Vincenzo Di Marzo, Professor Griffith Edwards, Professor John Galloway, Dr Edward Gill, Dr Geoffrey Guy, Dr Clare Hodges, Dr Anita Holdcroft, Ms Victoria Hutchins, Professor Raphael Mechoulam, Professor Anthony Moffat, Dr William Notcutt, Professor Roger Pertwee, Dr Philip Robson, Dr Ethan Russo, Professor Tilli Tansey, Ms Suzanne Taylor. One appendix gives diagrams of the structures of the major plant cannabinoids and structurally-related synthetic cannabinoids. Crowther S M, Reynolds L A, Tansey E M. (eds) (2010) The Medicalization of Cannabis, Wellcome Witnesses to Twentieth Century Medicine, vol. 40. London: The Wellcome Trust Centre for the History of Medicine at UCL. ISBN 978 085484 129 5The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Phytocannabinoids as novel therapeutic agents in CNS disorders

The Cannabis sativa herb contains over 100 phytocannabinoid (pCB) compounds and has been used for thousands of years for both recreational and medicinal purposes. In the past two decades, characterisation of the body's endogenous cannabinoid (CB) (endocannabinoid, eCB) system (ECS) has highlighted activation of central CB1 receptors by the major pCB, Δ9-tetrahydrocannabinol (Δ9-THC) as the primary mediator of the psychoactive, hyperphagic and some of the potentially therapeutic properties of ingested cannabis. Whilst Δ9-THC is the most prevalent and widely studied pCB, it is also the predominant psychotropic component of cannabis, a property that likely limits its widespread therapeutic use as an isolated agent. In this regard, research focus has recently widened to include other pCBs including cannabidiol (CBD), cannabigerol (CBG), Δ9tetrahydrocannabivarin (Δ9-THCV) and cannabidivarin (CBDV), some of which show potential as therapeutic agents in preclinical models of CNS disease. Moreover, it is becoming evident that these non-Δ9-THC pCBs act at a wide range of pharmacological targets, not solely limited to CB receptors. Disorders that could be targeted include epilepsy, neurodegenerative diseases, affective disorders and the central modulation of feeding behaviour. Here, we review pCB effects in preclinical models of CNS disease and, where available, clinical trial data that support therapeutic effects. Such developments may soon yield the first non-Δ9-THC pCB-based medicines

RISPOSTA TERAPEUTICA A TETRAIDROCANNABINOLO/CANNABIDIOLO NELLA SPASTICITA' ASSOCIATA A SCLEROSI MULTIPLA

Sativex® è un spray oromucosale atto alla terapia della spasticità in corso di sclerosi multipla. Esso contiene due principi attivi, il Δ9-tetraidrocannabinolo (THC) e il cannabidiolo (CBD), entrambi derivati dalla pianta di Cannabis Sativa, i quali agiscono modulando il sistema endocannabinoide umano. L'obiettivo della nostra analisi retrospettiva è stato quello di valutare la risposta terapeutica a tale farmaco in 35 pazienti, che non avevano precedentemente risposto ad altri trattamenti antispastici. Per tale valutazione, ci siamo avvalsi di 4 parametri (NRS per la spasticità, EDSS, Ambulation Index, test dei 10 metri), valutati prima e dopo un periodo di terapia di 4 settimane. Tale analisi ha mostrato efficacia nel ridurre l'NRS per la spasticità (riduzione del 26,6% nei responders), ma scarsa efficacia sugli altri paramentri. Il farmaco ha inoltre dimostrato una discreta efficacia sul dolore associato alla spasticità. Inoltre, valutando la terapia nel lungo termine, si è notato che tale trattamento mantiene la sua efficacia anche dopo molti cicli di terapia. Sativex® is a oromucosal spray for the treatment of spasticity in course of multiple sclerosis. It contains Δ9 - tetrahydrocannabinol (THC) and cannabidiol (CBD) , both derived from the plant "Cannabis sativa". The aim of our retrospective analysis was to evaluate the therapeutic response to Sativex® in 35 patients , who had not previously responded to other antispasticity agents .For this evaluation , we used four parameters ( NRS for spasticity , EDSS , Ambulation Index, tests of 10 meters ) , checked before and after a treatment period of 4 weeks .This analysis has shown effectiveness in reducing NRS for spasticity (26.6% reduction in responders) , but little effect on other parameters . The drug also showed a fairly effective on pain, associated with spasticity. Moreover , considering the long-term therapy , it has been noted that such treatment remains effective

Medicinal use of cannabis: background and information paper

Provides an overview of what is known about medicinal cannabis use in Australia, the current state of the scientific and medical evidence for its use, and problems with the current situation in Australia. Introduction The use of any medication should be based on the clinical evidence of safety and efficacy. To know whether cannabis should be used medicinally, we need to know whether cannabis is a safe and effective treatment for particular conditions, whether it is associated with significant adverse effects, and how it compares to other treatments for those specified conditions. There are a number of different pharmaceutical cannabis products as well as crude cannabis which can also be administered in a range of ways. However, at present, the evidence on the medicinal uses of most cannabis products is incomplete. In addition to the question of therapeutic effectiveness, using cannabis for medicinal purposes raises legal, regulatory, and other practical issues. If the evidence does support medicinal use of cannabis, enabling patient access raises complex issues of supply and its organisation within the usual processes of the healthcare system, as well as issues of legally distinguishing medicinal from non-medicinal usage. While these questions and issues continue to raise debate, in Australia there are currently people using illicit cannabis for medicinal purposes. Potentially this means possibly seriously ill patients are being exposed to the risks associated with engaging with an illicit market, including arrest and prosecution, and the resultant stress and worry. Some argue that patients are being blocked from accessing a product which could be beneficial, by the legal status which is actually aimed at prohibiting non-medicinal, rather than medicinal use. They believe this is itself problematic. Yet, despite continued media and government attention over the last few decades, the current state of the evidence, combined with the legal and regulatory difficulties, continue to prohibit any progress in addressing this issue. The paper provides an overview of what is known about medicinal cannabis use in Australia, the current state of the scientific and medical evidence for its use, and problems with the current situation in Australia. We then explore some current responses. Given the complexities of this issue we are not yet seeking to provide specific guidance on how to resolve the problems, but rather to identify areas that require further action or investigation. To achieve this, there is a need to disentangle medical and scientific questions from legal and ideological ones in considering whether and how medicinal cannabis should be used in Australia. This is difficult to achieve, since the range of acts and regulations that control non- medicinal uses of cannabis will necessarily impact on medicinal use. In this background paper we seek to begin disentangling these issues. Whilst the background paper includes a discussion of laws aimed at the control of non-medicinal cannabis use, the ANCD takes no view on issues of legalisation or decriminalisation of cannabis for non-medicinal purposes.   &nbsp

Uso terapéutico de los cannabinoides

[ES] Se revisan las pruebas clínicas disponibles de las indicaciones más evaluadas del uso de los cannabinoides. Igualmente, se explican los ensayos sobre las nuevas vías de administración de esta sustancia, para evitar los efectos perjudiciales del humo sobre los pulmones, puesto que los efectos adversos del cannabis dependen, sobre todo, de la vía de administración y la duración de la exposición.[EU] Kannabinoideek gaur egun dituzten indikazio ebaluatuenen froga klinikoak aztertzen dira. Era berean bide berriak azaltzen dira biriken gaineko kearen efektu kaltegarriak sahiesteko asmoz zeren eta kannabisaren kontrako efektuak administrazio bidearen araberakoak dira eta erabileraren iraupenaren araberakoak.[EN] This contribution revises the clinical evidence on the most evaluated indications related to the use of cannabinoids. At the same time the article refers to the essays on the new ways of administration of this substance in order to avoid the harmful effect of smoke in lungs, as the negative effects of cannabis are mainly dependent of the way of administration and the length of exposition.[FR] On examine les essais cliniques disponibles des indications les plus évaluées des usages des cannabinoïdes. De même, on explique les essais sur les nouvelles voies d’administration de cette substance, pour éviter les effets nocifs de la fumée sur les poumons, puisque les effets défavorables du cannabis dépendent, surtout, de la voie d’administration et de la durée de l’exposition

U.S. policy responses to calls for the medical use of Cannabis

This paper discusses the evolution of U.S. policy responses to calls to allow patients to use cannabis for medical purposes. It first summarizes the research evidence on the safety and efficacy of cannabinoids for various medical uses. It then outlines the challenges in developing new pharmaceutical cannabinoids that are safe, effective, and acceptable to patients. It briefly describes the strengths and limitations of the different ways in which U.S. states have allowed patients to use cannabis for medical purposes. These include allowing access for research trials only, allowing medical necessity as a defense against prosecution, and allowing commercial medical dispensaries to provide cannabis to approved patients. It argues that liberal definitions of indications for medical cannabis use and the commercialization of medical cannabis supply in California have produced the de facto legalization of recreational cannabis use

New Insights into Cannabis Consumption; Abuses and Possible Therapeutic Effects

Cannabis is one of the oldest psychotropic drugs known to humanity. The paper assesses the current knowledge on the cannabis, including the mechanisms of action and the therapeutic potential of cannabinoids. Three varieties of Cannabis plant are recognised: Cannabis sativa, Cannabis indica, and Cannabis ruderalis. The variety indica is used predominantly to obtain the drugs. Cannabis herb is usually named marijuana, while the cannabis oleoresin secreted by the glandular hairs found mainly on the flowering or fruiting tops of the plant is known as hashish. More than 400 known chemicals are present in cannabis, at least 70 of which are called cannabinoids. The major psychoactive constituent in cannabis is delta-9-tetrahydrocannabinol (Δ9-THC). It is now recognized that there are three types of cannabinoids: natural (phytocannabinoids), endogenous cannabinoids, and synthetic cannabioids. 2 (CB2) receptors, found predominantly in peripheral tissues with immune functions have been cloned. Therefore, the concept of endogenous cannabinoid system (endocannabinoid system, SEC) has been developed. Based on the current scientific evidence, there are several effects of cannabinoids with potential therapeutic use: antiemetic, analgesic in cancerous pains, and chronic neuropathic pain, in multiple sclerosis or spinal cord injuries. Cannabis consume can result in a state of drug dependency and cannabis withdrawal has been included in DSM-V. Cannabis plant remains controversial in the twenty-first century and the potential therapeutic of specific cannabinoid compounds and medical marijuana remains under active medical research