Medical marijuana in neurology

Abstract

Constituents of the Cannabis plant, cannabinoids, may be of therapeutic value in neurologic diseases. The most abundant cannabinoids are Δ(9)-tetrahydrocannabinol, which possesses psychoactive properties, and cannabidiol, which has no intrinsic psychoactive effects, but exhibits neuroprotective properties in preclinical studies. A small number of high-quality clinical trials support the safety and efficacy of cannabinoids for treatment of spasticity of multiple sclerosis, pain refractory to opioids, glaucoma, nausea and vomiting. Lower level clinical evidence indicates that cannabinoids may be useful for dystonia, tics, tremors, epilepsy, migraine and weight loss. Data are also limited in regards to adverse events and safety. Common nonspecific adverse events are similar to those of other CNS 'depressants' and include weakness, mood changes and dizziness. Cannabinoids can have cardiovascular adverse events and, when smoked chronically, may affect pulmonary function. Fatalities are rare even with recreational use. There is a concern about psychological dependence, but physical dependence is less well documented. Cannabis preparations may presently offer an option for compassionate use in severe neurologic diseases, but at this point, only when standard-of-care therapy is ineffective. As more high-quality clinical data are gathered, the therapeutic application of cannabinoids will likely expand.

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics

“…The plethora of endocannabinoid receptors in the basal ganglia, especially the globus pallidus interna, pars reticulata, and cerebellum indicate they must be playing a role in regulating tone and motor function through the effect of the endogenous cannabinoid ligand, arachidonylethanolamide (anadamide), on modulation of GABA transmission [12]. Many studies have been done with primate or rat models to determine if cannabinoid agonists or antagonists could act to suppress dyskinesias without exacerbating hypokinesis; however, translation to patients has proved difficult.…”

The Contribution of Studies with Canabidiol and Synthetic Analogues in the Design of New Drug Candidates for Neuropsychiatric Disorders and Neurodegenerative Diseases

“…Mais recentemente, vários estudos sugerem uma série de efeitos terapêuticos no sistema nervoso central (SNC), 7 auxiliando no tratamento de doenças psiquiátricas e neurodegenerativas, tais como a esquizofrenia, epilepsia, doença de Parkinson, de Alzheimer e ansiedade.…”

Cannabinoids in child neurology

“…Receptory CB1, z locus genowym w obrębie chromosomu 6:6q14-q15, występują głównie presynaptycznie na powierzchni neuronów ośrodkowego (układ limbiczny, hipokamp, kora mózgowa, móżdżek, zwoje podstawy, rdzeń kręgowy, ciała migdałowate) i obwodowego układu nerwowego oraz w tkance tłuszczowej, przewodzie pokarmowym, mięśniach, także w mięśniu sercowym, płucach, wątrobie, nerkach, jajnikach, jądrach, prostacie [22,32,33]. W korze mózgowej, prążkowiu oraz w hipokampie przeważa ekspre-sja receptorów CB1 w zakończeniach neuronów GABA--ergicznych.…”

“…Olej CBD z marihuany Charlotte's Web nie zawiera THC. Wstępne badania wskazują na wysoką skuteczność preparatów przygotowanych na bazie tej odmiany w leczeniu padaczki lekoopornej u dzieci po zastosowaniu terapii z CBD [3,[31][32][33]. W tabelach I i II przestawiono preparaty na bazie kannabinoidów naturalnych i syntetycznych.…”