All posts tagged: CB1

Pregnant women are using more cannabis over time

Statistics show that in the past 15 years, the number of pregnant women using marijuana, especially in their first trimester, has risen greatly. These numbers may be slightly skewed, but they show the importance of more research being done on the effect of cannabis on pregnant women. https://cnn.it/2WWQV1e

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Benjamin Caplan, MDPregnant women are using more cannabis over time
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Safety and Efficacy of Medical Cannabis in Fibromyalgia

In a study of 367 patients, researchers investigated the safety and effectiveness of cannabis consumption to treat fibromyalgia symptoms. After treatment with cannabis, pain intensity (scale 0–10) reports reduced from a median of 9.0 to a median of 5.0. Interestingly, patients who had previously used cannabis were more likely to have treatment success, whereas patients who shared concerns about cannabis treatment were more likely to have treatment failure. A patient’s mindset can directly affect their treatment outcome.

At CED Clinic, we use the power of education to help patients feel comfortable and confident with their treatment plan.

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Benjamin Caplan, MDSafety and Efficacy of Medical Cannabis in Fibromyalgia
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Cannabinoid Receptors Working with Opioid Receptors

The locus coeruleus is a spot in the human brainstem that is integral to our responses to stress, panic, wakefulness, and sleep-wake transitions. Both the cannabinoid receptors and opioid receptors in the locus coeruleus have a synergistic relationship that, once the medical system begins to incorporate more education about cannabinoids, just might change how physicians prescribe pain medication. The interactions of the two receptor types provide a mechanism that could easily and conveniently improve pain control, provide treatments for addiction, and will likely aid those experiencing symptoms of withdrawal. Research focusing on the treatment of opioid addiction with cannabis is ongoing… but hindered by the legal status of cannabis.

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Benjamin Caplan, MDCannabinoid Receptors Working with Opioid Receptors
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Capsaicin Cream Treats Cannabinoid Hyperemesis Syndrome in Adolescents

Capsaicin Cream for Treatment of CHS adolescent

Researchers have found that capsaicin cream is an effective and safe method of treating cannabinoid hyperemesis syndrome (CHS) in adolescents. Capsaicin cream has previously been shown to be effective at treating CHS in adults but adolescents have previously been treated with haloperidol, a drug known to have serious side effects. Capsaicin cream offers a much safer and more cost-effective method of treatment for adolescents.

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Benjamin Caplan, MDCapsaicin Cream Treats Cannabinoid Hyperemesis Syndrome in Adolescents
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“Liver toxicity” of mice force-fed with unreasonable amounts CBD

Here, an excellent example of how valuable it is for scientific literature to be read critically and thoughtfully. When reporters read, or extract, or convey only partial conclusions, it is all-too-easy for consumers to absorb an incomplete, undigested message. As consumers of journalism, the public deserves a more knowledgeable understanding. Here (http://bit.ly/2KV0jeG), Forbes (Mike Adams) conveys an unfortunate lack of deep consideration in the reporting. Thankfully, a brief quote is conveyed by Dr. Koturbash, who “was quick to point out that the CBD products coming to market may not pose this particular risk” – but this stone-throw of even-handedness falls short to appropriately balance an article already dripping with misgivings and incomplete evaluation of the material at hand.

For a more layered view of the science, the word “gavage,” as was applied to the mice in the study, describes force-feeding animals with a tube down their throats, often taped to mouths which are then kept gaping open. This is meant to simulate the biological processes of eating (different from giving meds IV, for example.) There is no regard to the stress that this process causes the animals, as they are treated as though they are biological CBD-processing machines. In the days where many people are taking 10mg pills of CBD per day, the amounts of CBD that were force-fed to these animals in this study, if translated to humans, would be 4,305mg, 12,915mg, and 43,050mg over 10 days, or 17,220mg, 51,660mg, and 172,200mg in one-shot doses.) For reference, these days, most dispensaries sell CBD in doses of 10mg, 20mg, up to 2-300mg.)

In the study, the authors suggest that they allow animals to eat “ad libitum,” as if to convey that they are treated with a buffet. And yet, the animals being stuffed with 43,050mg (human equivalent) of CBD still lost weight, while others (given 172,200mg (human equivalent) had uneven weight distribution.) To any reader considering these values critically, it must seem absurd to make conclusions about the actions of CBD as what is causing these effects, as if the fact of over-stuffing itself has no impact at all.

An analogy to this study: If you add 17,000 cars (or 172,000!) to a tunnel on the way to the airport, and stuff each car full of way too many people, there might be problematic levels of concern inside that tunnel.

Let’s hope to see more even-handed consideration and reporting from Forbes, in the future.

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This paper is also stored here:    http://bit.ly/2WWNOGA     inside the CED Foundation Archive

Here, another study that shows very different results. Instead of overstuffing mice w/ unrealistic amounts, if one administers CBD at sensible doses in the same population of mice, it turns out that CBD could directly reduce alcohol drinking, improve healthy processes in the liver, and alcohol-related brain damage…

“CBD reduces alcohol-related steatosis & fibrosis in the liver by reducing lipid accumulation, stimulating autophagy, modulating inflammation, reducing oxidative stress, & by inducing death of activated hepatic stellate cells” This new study:

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Benjamin Caplan, MD“Liver toxicity” of mice force-fed with unreasonable amounts CBD
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Medical Marijuana and Treatment of Pediatric Epilepsy Patients

Medical Marijuana in the Pediatric Population With Epilepsy—What You Should Know

A recent review has discussed the known benefits of treating children who are suffering from epilepsy with cannabis-based medicine. Medical marijuana (MM) is a viable option for treating this population that comes with risks due to the high that comes from THC and its legal status as a Schedule 1 drug. The legal status is currently preventing larger scale research to be done so that physicians can better educate parents on how to care for a child taking MM.

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Benjamin Caplan, MDMedical Marijuana and Treatment of Pediatric Epilepsy Patients
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Video: Cannabis, Cannabinoids, and Sleep: a Review of the Literature

Researchers published a literature review that investigates the relationship between cannabis and sleep. They examined six major sleeping disorders: insomnia, sleep apnea, REM behavior disorder, nightmares, sleep with chronic pain, and daytime sleepiness.

They found that THC might worsen daytime sleepiness and delayed onset of sleep; however, THC might help patients who suffer from sleep apnea and nightmares. Meanwhile, CBD might reduce daytime sleepiness and insomnia while increasing the total amount of sleep.

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Benjamin Caplan, MDVideo: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
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Video: Cannabidiol as a suggested candidate for treatment of Autism Spectrum Disorder

This 2018 review summarizes the available data regarding the safety and effectiveness of medical cannabis in young ASD patients. Here’s our video adaptation:

  • Autism spectrum disorder (ASD) defines a group of neurodevelopmental disorders that are frequently associated with general cognitive deficits
    • DSM-5 criteria of ASD include:
      • A. Persistent deficits in social communication and social interaction
      • B. Restricted, repetitive patterns of behavior, interests, or activities
      • C. Symptoms must be present in the early developmental period
      • D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
      • E. These disturbances are not better explained by intellectual disability or global developmental delay
    • ASD is frequently accompanied by co-morbidities:
      • sleep disorders
      • attention-deficit/hyperactivity disorder (ADHD)
      • Psychosis
      • Anxiety
      • mood and cognitive disorders
      • epilepsy
    • Despite it being one of the most severe chronic childhood disorders with relatively high prevalence, morbidity and impact on the society, no effective treatment for the core symptoms of ASD is available yet.
    • There is increasing interest in cannabinoids, especially cannabidiol (CBD), as monotherapy or add-on treatment for the core symptoms and co-morbidities of ASD.
  • CBD Use for Epilepsy
    • 20-30% of people with ASD also suffer from epilepsy
    • Surveys conducted among parents of children suffering from epilepsy suggest improvement following treatment with CBD-enriched cannabis extracts. These results however, do not necessarily apply when it comes to treating adults with epilepsy (Alexander et al., 2009).
    • Still, in a retrospective study that examined the effect of CBD enriched medical cannabis oil on children with intractable epilepsy, the treatment caused a reduction in seizure frequency in 89% of patients (Tzadok et al., 2016).
  • CBD Use in Psychiatry
    • CBD in Psychosis
      • In some cases, psychosis can be a comorbidity of ASD, with the simultaneous onset of schizophrenia at adolescence or early adulthood (Sagar et al., 2013).
      • Ineffective
        • A 2006 study that investigated the influence of CBD as monotherapy in treatment-resistant schizophrenia found that it was ineffective (Zuardi et al., 2006).
      • Effective
        • But a 2018 study showed that, in patients with schizophrenia, adding CBD to ongoing antipsychotic treatment resulted in greater antipsychotic activity and beneficial effects, as compared to placebo add-on (Mcguire et al., 2018).
    • CBD and Anxiety
      • Many ASD patients suffer from anxiety disorders that harm their quality of life (Gu, 2017; Haan et al., 2008; Perrin, 2011).
      • CBD may possess anxiolytic effects both in animals and humans (Bergamaschi et al., 2011).
      • When tested in humans, CBD showed an anxiolytic effect in patients that suffer from social anxiety disorder (SAD), contrary to THC that may induce anxiety (Devinsky et al., 2014).
    • CBD, mood and cognitive disorders
      • It was previously shown that a variety of psychiatric co-morbidities may occur in ASD patients, the most common one being mood disorders (Ghaziddin and Zafar, 2008).
      • Risks of THC
        • THC use may be associated with onset or aggravation of depression, bipolar disorder, mania and psychosis (Rong et al., 2017).
        • THC administration may also result in memory impairment (Ranganathan and Souza, 2006; Rong et al., 2017).
      • Benefits of CBD
        • On the other hand, CBD possesses agonistic activity at the 5-HT1A serotonin receptor and shares similar mechanisms with lithium. These pharmacological properties may indicate its potential role in the treatment of mood disorders (Rong et al., 2017).
        • Therapeutic CBD properties were investigated for cognitive deficits as well. In a preclinical study that tested the effect of CBD on cognition in an Alzheimer’s Disease mouse model (APPxPS1), chronic CBD treatment reversed the cognitive deficits without affecting anxiety-related behaviors (Cheng et al., 2014).
    • CBD and sleep disorders
      • Sleep disorders are highly prevalent among children with ASD.
      • In the general population insomnia is the most common sleep complaint, and treatment with medical cannabis may be effective, especially when the insomnia is associated with pain (Gates et al., 2014).
      • It has been claimed that long term use of cannabis may induce sleep disturbances (Gates et al., 2014). however, a case series indicated that CBD treatment may actually improve the quality of sleep in Parkinson’s disease (Chagas et al., 2014).
    • CBD and ADHD
      • ADHD is one of the most common psychiatric co-morbidities in young ASD patients (Ghaziddin and Zafar, 2008), with comorbidity rates in the range of 40-70% (Antshel et al., 2016).
      • In a pilot randomized placebo-controlled experimental study of a cannabinoid medication (an oral spray containing 1:1 ratio of THC:CBD) in adults who suffer from ADHD, there was no significant improvement in the cognitive performance, but there was a significant improvement in the hyperactivity, impulsivity and inhibition measures after the treatment with the medical cannabis (Cooper et al., 2017).
    • The role of cannabis use for social behavior
      • Risks
        • Some studies show that THC administration may lead as well to a reduction in social interaction in rats, while co-administration of CBD seems to attenuate this effect (Malone et al., 2009).
      • Benefits
        • On the other hand, in a study that tested the influence of marijuana smoking on healthy human volunteers, subjects reported retrospectively that while smoking marijuana they were happier, friendlier and calmer, responded more warmly to others, seemed to have a better understanding of their peers’ state of mind and were less likely to respond angrily or defensively. However, they had a harder time focusing and paying attention to what others said (Galanter et al., 1974).
        • CBD Use for Children
    • The administration of cannabinoids for children and adolescents suffering from ASD is a controversial legal and ethical issue (Khalil, 2012).
      • Risks
        • Those who oppose the use of medical cannabis in pediatrics claim that this treatment might harm young children and adolescents’ brain development.
      • Benefits
        • In the field of pediatric mental illnesses, CBD is sometimes used as a treatment for anxiety disorders. In a case report describing a 10-year-old girl who suffered from PTSD after being sexually abused, it was reported that CBD treatment reduced her anxiety and improved her sleep (Shannon, 2016).
  • Conclusions
    • The use of cannabinoids in general and CBD in particular in the treatment of numerous medical and mental conditions, including ASD, is growing rapidly.
    • There certainly is a big gap in the field and such studies are needed before drawing any conclusions on the potential therapeutic applications of cannabinoids in ASD.
    • Further pre-clinical and clinical studies are needed in order to examine the pros and cons of CBD and other cannabinoids in ASD, before they are established as a treatment for ASD symptoms and co-morbidities.

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Benjamin Caplan, MDVideo: Cannabidiol as a suggested candidate for treatment of Autism Spectrum Disorder
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Evidence for Therapeutic Benefits of Cannabidiol, Including Treatment of Ischemic Strokes

Therapeutic Potential of Non-Psychotropic Cannabidiol in Ischemic Stroke

Cannabidiol (CBD) has a unique therapeutic profile as it has a cannabinoid receptor-independent mechanism, limited side-effects, and patients do not seem to develop an insurmountable tolerance. Research currently focussed on the therapeutic benefits of CBD has demonstrated long-lasting neuroprotective properties against global and focal ischemic injury, such as ischemic stroke. This piece points to CBD as a major component of cannabis-based medicine as a non-psychoactive component. Further research is needed to evaluate the full clinical capabilities of CBD, including its neuroprotective effect.

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The US patent on Cannabinoids as Antioxidants and Neuroprotectants, from 1999: https://patents.google.com/patent/US6630507B1/en

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Benjamin Caplan, MDEvidence for Therapeutic Benefits of Cannabidiol, Including Treatment of Ischemic Strokes
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Recent Study Finds that Astragalin Prevents Tumor Growth

A Kaempferol-3-O-β-D-glucoside, Intervention Effect of Astragalin on Estradiol Metabolism

A recent study found that a flavonoid known as astragalin possesses a strong anti-tumor effect. High levels of a metabolite formed from the hormone estradiol have been found in tumor tissues leading researchers to search for an inhibitor to prevent estradiol from forming the metabolite. This study has found that astragalin, which is a naturally occurring substance found in a variety of plants and wine, has an effective antitumor mechanism that inhibits the formation of the metabolite.

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Benjamin Caplan, MDRecent Study Finds that Astragalin Prevents Tumor Growth
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