Cannabinoids therapeutic use: what is our current understanding following the introduction of THC, THC:CBD oromucosal spray and others?

Abstract

The complexity of the endocannabinoid (eCB) system is becoming better understood and new drivers of eCB signaling are emerging. Modulation of the activities of the eCB system can be therapeutic in a number of diseases. Research into the eCB system has been paralleled by the development of agents that interact with cannabinoid receptors. In this regard it should be remembered that herbal cannabis contains a myriad of active ingredients, and the individual cannabinoids have quite distinct biological activities requiring independent studies. Areas covered: This article reviews the most important current data involving the eCB system in relation to human diseases, to reflect the present (based mainly on the most used prescription cannabinoid medicine, THC/CBD oromucosal spray) and potential future uses of cannabinoid-based therapy. Expert commentary: From the different therapeutic possibilities, THC/CBD oromucosal spray has been in clinical use for approximately five years in numerous countries world-wide for the management of multiple sclerosis (MS)-related moderate to severe resistant spasticity. Clinical trials have confirmed its efficacy and tolerability. Other diseases in which different cannabinoids are currently being investigated include various pain states, Alzheimer's disease, Parkinson's disease, Huntington's disease and epilepsy. The continued characterization of individual cannabinoids in different diseases remains important.

<p>A Review of Scientific Evidence for THC:CBD Oromucosal Spray (Nabiximols) in the Management of Chronic Pain</p>

“…Aside from practical issues such as restricted availability as regulated by national or regional health authorities, risks of herbal cannabis include variability in cannabinoid type and potency, potential for misuse/dependency, and possible future mental health-related consequences in young people. 57 Numerous studies have investigated cannabis and its derivatives to treat myriad conditions, including chronic pain. As a discussion of the full range of cannabis and cannabis-based products is beyond the scope of this review, interested readers are directed to recent comprehensive reviews on the subject.…”

Pharmacokinetics of Sativex® in Dogs: Towards a Potential Cannabinoid-Based Therapy for Canine Disorders

“…A key step in this process was the formulation and approval of the phytocannabinoid-based medicine Sativex ® (GW Pharmaceuticals, Cambridge, UK) for the first time in 2005 [12]. It was marketed for the treatment of spasticity and pain in multiple sclerosis patients [12][13][14], and it is being investigated for other central and peripheral pathological conditions in humans [15][16][17][18]. It may also serve in Veterinary Medicine for the treatment of domestic animals, in particular for dogs affected by different pathological conditions.…”

Single‐Dose Pharmacokinetics of Oral Cannabidiol Following Administration of PTL101: A New Formulation Based on Gelatin Matrix Pellets Technology

“…[1][2][3] The cannabis plant contains numerous ingredients with pharmacological activities, 4 and it is often difficult to isolate particular compounds that exert a unique therapeutic effect on specific medical conditions. [1][2][3] The cannabis plant contains numerous ingredients with pharmacological activities, 4 and it is often difficult to isolate particular compounds that exert a unique therapeutic effect on specific medical conditions.…”

“…The use of cannabinoids for medical purposes has drawn increasing interest in recent years. [1][2][3] The cannabis plant contains numerous ingredients with pharmacological activities, 4 and it is often difficult to isolate particular compounds that exert a unique therapeutic effect on specific medical conditions. Nevertheless, 2 major cannabinoids, cannabidiol (CBD) and delta-9-tertrahydrocannabinol (THC) have become the main focus of clinical research and development activity.…”