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IACM-Bulletin of 17 May 2015

Science/Human: Children with epilepsy may profit from a treatment with CBD according to a survey

According to a survey with 117 children with epilepsy 85% of their parents reported a reduction in seizure frequency, and 14% reported complete seizure freedom. These results by researchers of David Geffen School of Medicine in Los Angeles were published in the journal Epilepsy & Behavior. They conducted a brief online survey of parents who administered CBD-enriched cannabis preparations for the treatment of their children's epilepsy. Survey respondents included 53 parents of children with infantile spasms and/or Lennox-Gastaut syndrome.

Perceived efficacy and tolerability were similar across etiologic subgroups. Epilepsy was characterized as highly refractory to standard treatment with median latency from epilepsy onset to CBD initiation of five years, during which the patient's seizures failed to improve after a median of eight anti-epileptic medication trials. The median duration and the median dosage of CBD exposure were 6.8months and 4.3mg/kg/day, respectively. Reported side effects were far less common during CBD treatment, with the exception of increased appetite (30%). A high proportion of respondents reported improvement in sleep (53%), alertness (71%), and mood (63%) during CBD therapy.

Hussain SA, Zhou R, Jacobson C, Weng J, Cheng E, Lay J, Hung P, Lerner JT, Sankar R. Perceived efficacy of cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy: A potential role for infantile spasms and Lennox-Gastaut syndrome. Epilepsy Behav. 2015 Apr 29. [in press]

Germany: The Bundesrat supports the use of cannabis in pain patients and in palliative care

During its session on 9 May 2015 the Bundesrat, a legislative body that represents the sixteen Länder (federal states) of Germany at the national level, approved a measure, which reads: “The Bundesrat asks the Federal Government to initiate a legislative procedure to change the narcotics law (Betäubungsmittelgesetz) and the regulations on the prescription of narcotics with the aim to make cannabis extract and cannabis flowers available for standard medical care of pain and palliative patients.”

The Bundestag argued: „Patients, who have received all treatment options according to medical guidelines and whose suffering could be alleviated or improved by the use of cannabis extracts or cannabis flowers according to medical judgement should be allowed access to cannabis preparations by standard medical care. (…)” All currently available possibilities for the treatment with cannabis products “do not ensure an adequate supply, in the case a therapy is indicated according to medical diagnosis and treatment requirements.”

Bundesrat Printing 135/15 (Enactment) 08.05.15

Italy: The army has started to grow cannabis for medicinal purposes

At a highly secure lab in Florence, the military has planted its very own cannabis farm, all in an effort to curtail the high cost of medical cannabis. For two years now the medical use of cannabis has been legal in Italy. When deemed appropriate, Italian doctors can prescribe the drug to patients. But even with that approval, cannabis can be hard to come by. With the nation’s entire stockpile imported – mostly from the Netherlands – one gram can cost as much as 35 EURos.

The Italian government hopes to cut those prices in half, and to that end the army has begun growing its first batch of the green. "The aim of this operation is to make available to a growing number of patients a medical product which isn’t always readily available on the market, at a much better price for the user," Colonel Antonio Medica told Italian website Corriere della Sera.

Sputnik International of 1 May 2015

Science/Human: THC effective in a woman, who was unable to maintain weight after multiple surgeries

Doctors from Harvard Medical School in Boston presented a case report of a 58-year-old female with a history of nausea, vomiting, abdominal pain, and inability to maintain oral intake after multiple abdominal surgeries. After eight years of unsuccessful trials of medicines, dietary modifications, and a partial colectomy, she began a trial of oral THC (dronabinol capsules), which caused almost complete remission of her symptoms. When this medication was discontinued by her health insurance, she was unable to maintain oral intake and therefore, was admitted to the hospital for fluid resuscitation and resumption of THC.

Authors noted: “The use of dronabinol in this patient with severe intestinal dysmotility allowed her to maintain her nutritional status orally and obviated the need for enteral or parenteral feeding. Unfortunately, it was not covered by her insurance company for this indication.” They concluded: “Dronabinol has the potential to improve quality of life for patients beyond those undergoing chemotherapy or suffering from AIDS.”

Taylor GH, Schwaitzberg SD. The successful use of dronabinol for failure to thrive secondary to intestinal dysmotility. Int J Surg Case Rep 2015;11:121-123.

News in brief

Science: New online journal on cannabis and cannabinoid research
Cannabis and Cannabinoid Research, a new online journal dedicated to the scientific, medical, and psychosocial exploration of clinical cannabis, cannabinoids, and the biochemical mechanisms of endocannabinoids, will be launched in fall 2015.
Press release by Mary Ann Liebert publishers

Science/Human: THC not effective in reducing neuropsychiatric symptoms in patients with dementia
In a controlled study THC (1.5 mg 3 times daily for 21 days) did not reduce neuropsychiatric symptoms in 24 patients with dementia compared to the control group of 26 patients, who received a placebo. There were no differences in scores for agitation, quality of life, or activities of daily living between the two groups.
Radboud University Medical Center, Nijmegen, The Netherlands.
van den Elsen GA, et al. Neurology. 2015 May 13. [in press]

Science/Human: Endocannabinoid levels increase in unpleasant ambiance
Blood concentrations of the endocannabinoids palmitoylethanolamide (PEA) and stearoylethanolamide (SEA) increased in 28 healthy women after 30 min of an evening dinner in an unpleasant ambiance, while they decreased in a pleasant ambiance. Changes in endocannabinoids correlated with mood states, such as happiness and fatigue.
The Netherlands Organization for Applied Scientific Research, Zeist, The Netherlands.
Schrieks IC, et al. PLoS One 2015;10(5):e0126421.

Science/Human: Increased intake of omega-3 fatty acids changes endocannabinoid concentrations and reduces headache
A study with 55 chronic headache patients demonstrated that changes in diet (increase of omega-3 fatty acids) can alter endocannabinoids derived from omega-3 and omega-6 fatty acids, and that these changes are related to reductions in headache pain and psychological distress. Authors concluded that “These findings suggest that dietary interventions could provide an effective, complementary approach for managing chronic pain and related conditions.”
National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, USA.
Ramsden CE, et al. J Pain. 2015 May 6. [in press]

Science/Human: Nutraceuticals, which influence the endocannabinoid system, have positive effects on carpal tunnel syndrome
Alpha lipoic acid (ALA) based nutraceutical, conjugated linoleic acid (GLA), quercetin and echinacea improved carpal tunnel syndrome. It is known that several alkylamides of echinacea bind to the CB2-receptor, and that quercetin activates the CB1 receptor.
Faculty of Medicine and Surgery, University of Study of Bari, Italy.
Notarnicola A, et al. Int J Immunopathol Pharmacol. 2015 May 7. [in press]

UK/USA: GW Pharmaceuticals starts two new studies in patients with epilepsy
The British company GW Pharmaceuticals announced that it has commenced a Phase 3 clinical trial of the CBD extract Epidiolex for the treatment of Lennox-Gastaut syndrome, a severe form of childhood epilepsy, and a Phase 2 clinical trial of cannabidivarin (CBDV) in adult patients with epilepsy.
Press release of 11 May 2015
Press release of 6 May 2015

Science/Animal: Activation of the CB2 receptor reduced damage after bleeding in the immature brain of preterm newborns
The activation of the cannabinoid-2 receptor attenuated inflammation-induced secondary brain injury after bleeding into the immature preterm brain of rats by reducing microglia accumulation. Microglia are immune cells in the brain.
Third Military Medical University, Chongqing, China.
Tang J, et al. Neuropharmacology. 2015 May 8. [in press]

Science/Animal: PEA reduced inflammation in uveitis
In a model of uveitis in rats the endocannabinoid palmitoylethanolamide (PEA) reduced inflammation. The uvea is a part of the eye.
Department of Biological and Environmental Sciences, University of Messina, Italy.
Impellizzeri D, et al. EUR J Pharmacol. 2015;761:28-35.

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