Constituyentes psicoactivos del cannabis y sus implicaciones clínicas: una revisión sistemática

Abstract

Objective This systematic review aims to summarize current evidence on which naturally present cannabinoids contribute to cannabis psychoactivity, considering their reported concentrations and pharmacodynamics in humans.Design Following PRISMA guidelines, papers published before March 2016 in Medline, Scopus-Elsevier, Scopus, ISI-Web of Knowledge and COCHRANE, and fulfilling established a-priori selection criteria have been included. ResultsIn 40 original papers, three naturally present cannabinoids and one human metabolite (11-OH-THC) had clinical relevance.Of these, the metabolite produces the greatest psychoactive effects. Cannabidiol (CBD) is not psychoactive but plays a modulating role on cannabis psychoactive effects. The proportion of 9-THC in plant material is higher (up to 40%) than in other cannabinoids (up to 9%). Pharmacodynamic reports vary due to differences in methodological aspects (doses, administration route and volunteers' previous experience with cannabis). (CBD) no es psicoactivo, pero sí ejerce un efecto modulador sobre los efectos psicoactivos del cannabis. La concentración 9-THC en derivados cannábicos (hasta 40%) supera en gran medida la de otros cannabinoides (hasta 9%). La farmacodinamia descrita varía, dada la heterogeneidad en aspectos clave de la metodología (dosis, rutas de administración y experiencia previa con cannabis de los participantes). ConclusionsConclusiones Los resultados evidencian que el 9-THC es el cannabinoide que más contribuye al efecto psicoactivo del cannabis.Otros cannabinoides psicoactivos contribuirían mínimamente, dada su menor potencia psicoactiva y su baja concentración en los derivados cannábicos. La falta de estándares metodológicos dificulta el avance en los conocimientos sobre los efectos del cannabis en la salud. Establecer una unidad estándar de cannabis basada en 9-THC ayudaría a superar estas limitaciones.

Cannabinoids-Promising Antimicrobial Drugs or Intoxicants with Benefits?

“…To date, over 120 natural cannabinoids are known, which can be classified into 11 types of general structural frameworks, as outlined in Figure 1 [30][31][32]. The class of ∆ 9 -THC-type cannabinoids [32] share a tricyclic 6a,7,8,10a-tetrahydro-6H-benzo[c]chromen-1-ol core structure, its major representatives (−)-∆ 9 -trans-tetrahydrocannabinol (∆ 9 -THC) (1) and (−)-∆ 9 -trans-tetrahydrocannabinolic acid (∆ 9 -THCA) (21) belong to the cannabinoids with high abundance in Cannabis sativa [33,34].…”

“…The two main subclasses of CBRs are CB1R, which predominates in the central nervous system, and the principally peripheral cannabinoid receptor CB2R [65,66,70,72,73]. ∆ 9 -THC (1) is the primary psychotropic compound in Cannabis sativa [33,34], displaying a binding affinity to CB1R in the low nanomolar range acting as a partial agonist ( Figure 2). In addition, 11-hydroxy-∆ 9 -THC (26) (Figure 3), a primary metabolite in human produced upon cytochrome-P450 oxidation of ∆ 9 -THC (1) has been found to have psychotropic activity.…”

“…However, the follow up metabolite 11-nor-9-carboxy-∆ 9 -THC (27) (Figure 3) generated by further oxidation is non-psychotropic. Further psychotropic cannabinoids are ∆ 8 -THC (5), (−)-∆ 9 -trans-tetrahydrocannabivarin (∆ 9 -THCV) (3), (CBN) (7), Cannabivarin (CBV) (8), and CBND (16) (Red highlighting in Figure 1) [33,34,45]. In contrast, all biosynthetic acid precursor cannabinoids, such as ∆ 9 -THCA (2), ∆ 9 -THCVA (4) or ∆ 8 -THCA (6) do not possess psychotropic activity, similarly all CBC-type, CBD-type, CBG-type, CBL-type, and presumably also CBE-type cannabinoids, belong to the non-psychotropic representatives (green highlighting in Figures 1 and 2) [33,34,45].…”

Cannabinoids: from pot to lab

“…This global trend has been mainly attributed to the selection and introduction of variants with a high content of THC and the use of intensive production techniques 28 . In this regard, several studies have associated cannabis use with a high percentage of THC (herb or THC extracts) with a considerable increase in acute toxicity, and especially with an increased risk of psychosis 15 , 29 - 34 . It is important to note, as discussed later in the section of medical cannabis, that, for some years, cannabis products of different percentage composition of THC and CBD have been commercialized, so that one can get the desired THC and CBD percentage and adjust it to one's preferences or needs, especially for medicinal use.…”

Relación entre consumo de sustancias y rasgos esquizotípicos en adolescentes escolarizados

“…En las últimas décadas se han incrementado considerablemente las investigaciones que examinan la relación entre el consumo de drogas y problemas de salud mental (Casajuana Kögel, López-Pelayo, Balcells-Olivero, Colom y Gual, 2018;Cohn, Johnson, Ehlke y Villanti, 2016;Gonzalvo, Barral y Roncero, 2011;Rial et al, 2018). Uno de los grupos de trastornos mentales que mayor atención ha concitado ha sido el del espectro de psicosis.…”