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IACM-Bulletin of July 1, 2012

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Science/Human — Cannabis effective in a patient with stiff person syndrome

The cannabis extract Sativex was effective in the treatment of a patient suffering from stiff person syndrome (or stiff-man syndrome). Physicians at the Neurology Department of the University Hospital of Ribera in Alzira, Spain, presented the case of a 40-year-old man with progressive muscle stiffness and intermittent spasms for 6-years. The cannabis spray was introduced after a series of unsatisfactory traditional medical treatments. Considerable improvement was verified after 14 months.

Authors noted that Sativex is used in spasticity due to multiple sclerosis. “Because MS and SPS share some neurological symptoms such as spasticity and rigidity, it is thought that THC-CBD can be an option for SPS patients.” Stiff person syndrome' (SPS) is a rare neurologic disorder of unknown aetiology characterized by progressive rigidity, stiffness, and spasms.

Vicente-Valor MI, Garcia-Llopis P, Mejia Andujar L, Antonino de la Camara G, García Del Busto N, Lopez Tinoco M, Quintana Vergara B, Peiro Vilaplana C, Dominguez Moran JA, Sánchez Alcaraz A. Cannabis derivatives therapy for a seronegative stiff-person syndrome: a case report. J Clin Pharm Ther. 2012 Jun 21. [in press]

Uruguay's government plans to start growing cannabis soon after a law legalizing sales of the drug passes Congress, but a ban on selling to foreigners will stop the country becoming a drug tourism hot-spot, officials say. The leftist government announced plans in June to legalize the cannabis market to stop rising crime, arguing that the drug is less harmful than the black market where it currently trades.

The use of cannabis and other drugs is already legal in Uruguay, one of Latin America's safest countries. The reform being sent to Congress would legalize and regulate its sale and production. Meeting the needs of the nation of 3.3 million people will require annual production of about 29.8 tons, the government estimates, and cannabis will be cultivated in a plantation of roughly 100 hectares. It is not yet clear whether the drug would be grown by the state or by private contractors under license. "By regulating the marijuana market in the way we're proposing, we're going to undermine the development of trafficking of other drugs," Julio Calzada, secretary general of the National Drugs Board, said.

Reuters of 24 June 2012.

News in brief

Science — Symposium on Cannabinoids and Pain

The Canadian Consortium for the Investigation of Cannabinoids (CCIC) is pleased to invite you to a one-day event showcasing internationally renowned speakers: Roger Pertwee, Vincenzo Di Marzo, Karen Ethans, Paul Daeninck, William Notcutt, Mark Ware. This event also features: Industry updates from GW Pharmaceuticals, Bedrocan BV and Prairie Plant Systems, a poster session and a round-table discussion.

Cannabinoids and Pain: 2012 Official Satellite Symposium of the 14th World Congress on Pain, August 25, 2012, Milan, Italy.

Science/Human — Many patients with fibromyalgia use cannabis

A survey with 457 patients suffering from fibromyalgia revealed that 13 per cent used cannabinoids for treatment, of whom 80 per cent used herbal cannabis, 24 per cent prescription cannabinoids and 3 per cent used both. Cannabinoid users were more likely to be male (26 per cent of all male patients compared to 7 per cent of female patients).

Alan Edwards Pain Management Unit, McGill University Health Center, Montreal, Quebec, Canada.

Ste-Marie PA, et al. Arthritis Care Res (Hoboken). 2012 Jun 21. [in press]

Science/Human — FAAH inhibitor not effective against arthritis pain in clinical study

In a study with 74 patients suffering from pain due to osteoarthritis of the knee a synthetic inhibitor of FAAH (fatty acid amide hydrolase) was not more effective than a placebo. Patients received either 4 mg of PF-04457845 for 2 weeks followed by placebo for 2 weeks or vice versa. Another group received the pain killer naproxen, which was more effective than placebo. The drug decreased FAAH activity by more than 96 per cent and substantially increased 4 endocannabinoids. Authors wrote: “The lack of analgesic effect of FAAH1 inhibition in humans is in contrast to data from animal models.”

Pfizer Global Research and Development, Sandwich, UK.

Huggins JP, et al. Pain. 2012 Jun 20. [in press]

Science/Human — The activity of FAAH is increased in Alzheimer’s disease

An increase in fatty acid amide hydrolase (FAAH) gene expression and activity was observed in patients with Alzheimer’s. The enzyme FAAH is responsible for the degradation of endocannabinoids. Authors concluded that “present findings suggest the involvement of FAAH in the pathogenesis of AD (…). They also point to FAAH as a new potential biomarker for AD in easily accessible peripheral cells.”

Department of Biomedical Sciences, University of Teramo, Italy.

D'Addario C, et al. PLoS One. 2012;7(6):e39186.

Science/Human — Effects of CBD in healthy subjects

The effects of 10 mg oral THC and 600 mg oral CBD were investigated in 16 healthy male subjects. The administration of THC was associated with cannabis-typical effects after 2 hours. There were no differences between CBD and placebo on any variable. Authors concluded that “CBD has proven to be safe and well tolerated.”

MartĂ­n-Satos R, et al. Curr Pharm Des. 2012 Jun 7. [in press]

Science/Animal — Insufficient intake of omega-3 fatty acids impair the function of the endocannabinoid system

Long-term feeding of a diet deficient in omega-3 fatty acids to mice resulted in a reduced level of the important omega-3 fatty acid DHA (docosahexaenoic acid) in the brain and impaired the cannabinoid receptor signalling pathway in mood-controlling structures. Researchers concluded that their data “suggest that behavioral changes linked to an n-3 dietary deficiency are due to an alteration in the endocannabinoid system in specific brain areas.”

Nutrition et Neurobiologie Intégrée, INRA UMR 1286, Université Victor Ségalen, Bordeaux Cedex, France.

Larrieu T, et al. J Physiol Biochem. 2012 Jun 16. [in press]

Science/Human — Acetylcysteine effective in cannabis dependency

In an 8-week placebo-controlled trial with 116 treatment-seeking cannabis-dependent adolescents (ages 15-21 years) N-acetylcysteine (1200 mg) twice daily resulted in a twice more likely negative urine cannabinoid test result compared to placebo. Researchers concluded that “this is the first randomized controlled trial of pharmacotherapy for cannabis dependence in any age group to yield a positive primary cessation outcome.”

Gray KM, et al. Am J Psychiatry. 2012 Jun 15. [in press]