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Cannabis for neuropathic pain

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https://www.readbyqxmd.com/read/27757048/medical-cannabis-the-canadian-perspective
#1
Gordon D Ko, Sara L Bober, Sean Mindra, Jason M Moreau
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol - the principal psychoactive component of cannabis...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27621666/a-preliminary-evaluation-of-the-relationship-of-cannabinoid-blood-concentrations-with-the-analgesic-response-to-vaporized-cannabis
#2
Barth L Wilsey, Reena Deutsch, Emil Samara, Thomas D Marcotte, Allan J Barnes, Marilyn A Huestis, Danny Le
A randomized, placebo-controlled crossover trial utilizing vaporized cannabis containing placebo and 6.7% and 2.9% delta-9-tetrahydrocannabinol (THC) was performed in 42 subjects with central neuropathic pain related to spinal cord injury and disease. Subjects received two administrations of the study medication in a 4-hour interval. Blood samples for pharmacokinetic evaluation were collected, and pain assessment tests were performed immediately after the second administration and 3 hours later. Pharmacokinetic data, although limited, were consistent with literature reports, namely dose-dependent increase in systemic exposure followed by rapid disappearance of THC...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27171490/the-role-of-medicinal-cannabis-in-clinical-therapy-pharmacists-perspectives
#3
Sami Isaac, Bandana Saini, Betty B Chaar
BACKGROUND: Medicinal cannabis has recently attracted much media attention in Australia and across the world. With the exception of a few countries, cannabinoids remain illegal-known for their adverse effects rather than their medicinal application and therapeutic benefit. However, there is mounting evidence demonstrating the therapeutic benefits of cannabis in alleviating neuropathic pain, improving multiple sclerosis spasticity, reducing chemotherapy induced nausea and vomiting, and many other chronic conditions...
2016: PloS One
https://www.readbyqxmd.com/read/27079840/toll-like-receptor-signalling-as-a-cannabinoid-target-in-multiple-sclerosis
#4
John-Mark K Fitzpatrick, Eric J Downer
Toll-like receptors (TLRs) are the sensors of pathogen-associated molecules that trigger tailored innate immune intracellular signalling responses to initiate innate immune reactions. Data from the experimental autoimmune encephalomyelitis (EAE) model indicates that TLR signalling machinery is a pivotal player in the development of murine EAE. To compound this, data from human studies indicate that complex interplay exists between TLR signalling and Multiple Sclerosis (MS) pathogenesis. Cannabis-based therapies are in clinical development for the management of a variety of medical conditions, including MS...
April 11, 2016: Neuropharmacology
https://www.readbyqxmd.com/read/26912385/cannabinoids-medical-implications
#5
Richard J Schrot, John R Hubbard
Herbal cannabis has been used for thousands of years for medical purposes. With elucidation of the chemical structures of tetrahydrocannabinol (THC) and cannabidiol (CBD) and with discovery of the human endocannabinoid system, the medical usefulness of cannabinoids has been more intensively explored. While more randomized clinical trials are needed for some medical conditions, other medical disorders, like chronic cancer and neuropathic pain and certain symptoms of multiple sclerosis, have substantial evidence supporting cannabinoid efficacy...
2016: Annals of Medicine
https://www.readbyqxmd.com/read/26830780/-efficacy-tolerability-and-safety-of-cannabinoids-for-chronic-neuropathic-pain-a-systematic-review-of-randomized-controlled-studies
#6
F Petzke, E K Enax-Krumova, W Häuser
BACKGROUND: Recently published systematic reviews came to different conclusions with respect to the efficacy, tolerability and safety of cannabinoids for treatment of chronic neuropathic pain. MATERIAL AND METHODS: A systematic search of the literature was carried out in MEDLINE, the Cochrane central register of controlled trials (CENTRAL) and clinicaltrials.gov up until November 2015. We included double-blind randomized placebo-controlled studies (RCT) of at least 2 weeks duration and with at least 9 patients per treatment arm comparing medicinal cannabis, plant-based or synthetic cannabinoids with placebo or any other active drug treatment in patients with chronic neuropathic pain...
February 2016: Der Schmerz
https://www.readbyqxmd.com/read/26791602/the-selective-monoacylglycerol-lipase-inhibitor-mjn110-produces-opioid-sparing-effects-in-a-mouse-neuropathic-pain-model
#7
Jenny L Wilkerson, Micah J Niphakis, Travis W Grim, Mohammed A Mustafa, Rehab A Abdullah, Justin L Poklis, William L Dewey, Hamid Akbarali, Matthew L Banks, Laura E Wise, Benjamin F Cravatt, Aron H Lichtman
Serious clinical liabilities associated with the prescription of opiates for pain control include constipation, respiratory depression, pruritus, tolerance, abuse, and addiction. A recognized strategy to circumvent these side effects is to combine opioids with other antinociceptive agents. The combination of opiates with the primary active constituent of cannabis (Δ(9)-tetrahydrocannabinol) produces enhanced antinociceptive actions, suggesting that cannabinoid receptor agonists can be opioid sparing. Here, we tested whether elevating the endogenous cannabinoid 2-arachidonoylglycerol through the inhibition of its primary hydrolytic enzyme monoacylglycerol lipase (MAGL), will produce opioid-sparing effects in the mouse chronic constriction injury (CCI) of the sciatic nerve model of neuropathic pain...
April 2016: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/26451996/prescribing-medical-cannabis-in-canada-are-we-being-too-cautious
#8
Stephanie Lake, Thomas Kerr, Julio Montaner
There has been much recent discussion and debate surrounding cannabis in Canada, including the prescribing of medical cannabis for therapeutic purposes. Certain commentators - including the Canadian Medical Association (CMA) - have denounced the prescribing of cannabis for medical purposes due to a perceived lack of evidence related to the drug's efficacy, harms, and mechanism of action. In this commentary, we present arguments in favour of prescribing medical cannabis in Canada. We believe the anti-cannabis position taken by CMA and other commentators is not entirely evidence-based...
July 2015: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/26443472/medical-marijuana-patient-counseling-points-for-health-care-professionals-based-on-trends-in-the-medical-uses-efficacy-and-adverse-effects-of-cannabis-based-pharmaceutical-drugs
#9
Jayesh R Parmar, Benjamin D Forrest, Robert A Freeman
The purpose of this report is to present a review of the medical uses, efficacy, and adverse effects of the three approved cannabis-based medications and ingested marijuana. A literature review was conducted utilizing key search terms: dronabinol, nabilone, nabiximols, cannabis, marijuana, smoke, efficacy, toxicity, cancer, multiple sclerosis, nausea, vomiting, appetite, pain, glaucoma, and side effects. Abstracts of the included literature were reviewed, analyzed, and organized to identify the strength of evidence in medical use, efficacy, and adverse effects of the approved cannabis-based medications and medical marijuana...
July 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/26362106/inhaled-cannabis-for-chronic-neuropathic-pain-a-meta-analysis-of-individual-patient-data
#10
REVIEW
Michael H Andreae, George M Carter, Naum Shaparin, Kathryn Suslov, Ronald J Ellis, Mark A Ware, Donald I Abrams, Hannah Prasad, Barth Wilsey, Debbie Indyk, Matthew Johnson, Henry S Sacks
UNLABELLED: Chronic neuropathic pain, the most frequent condition affecting the peripheral nervous system, remains underdiagnosed and difficult to treat. Inhaled cannabis may alleviate chronic neuropathic pain. Our objective was to synthesize the evidence on the use of inhaled cannabis for chronic neuropathic pain. We performed a systematic review and a meta-analysis of individual patient data. We registered our protocol with PROSPERO CRD42011001182. We searched in Cochrane Central, PubMed, EMBASE, and AMED...
December 2015: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/26325482/medical-marijuana-and-chronic-pain-a-review-of-basic-science-and-clinical-evidence
#11
REVIEW
Bjorn Jensen, Jeffrey Chen, Tim Furnish, Mark Wallace
Cannabinoid compounds include phytocannabinoids, endocannabinoids, and synthetics. The two primary phytocannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), with CB1 receptors in the brain and peripheral tissue and CB2 receptors in the immune and hematopoietic systems. The route of delivery of cannabis is important as the bioavailability and metabolism are very different for smoking versus oral/sublingual routes. Gold standard clinical trials are limited; however, some studies have thus far shown evidence to support the use of cannabinoids for some cancer, neuropathic, spasticity, acute pain, and chronic pain conditions...
October 2015: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/25843054/efficacy-of-inhaled-cannabis-on-painful-diabetic-neuropathy
#12
RANDOMIZED CONTROLLED TRIAL
Mark S Wallace, Thomas D Marcotte, Anya Umlauf, Ben Gouaux, Joseph H Atkinson
UNLABELLED: A randomized, double-blinded, placebo controlled crossover study was conducted in 16 patients with painful diabetic peripheral neuropathy to assess the short-term efficacy and tolerability of inhaled cannabis. In a crossover design, each participant was exposed to 4 single dosing sessions of placebo or to low (1% tetrahydrocannabinol [THC]), medium (4% THC), or high (7% THC) doses of cannabis. Baseline spontaneous pain, evoked pain, and cognitive testing were performed. Subjects were then administered aerosolized cannabis or placebo and the pain intensity and subjective "highness" score was measured at 5, 15, 30, 45, and 60 minutes and then every 30 minutes for an additional 3 hours...
July 2015: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/25777363/cannabis-in-cancer-care
#13
REVIEW
D I Abrams, M Guzman
Cannabis has been used in medicine for thousands of years prior to achieving its current illicit substance status. Cannabinoids, the active components of Cannabis sativa, mimic the effects of the endogenous cannabinoids (endocannabinoids), activating specific cannabinoid receptors, particularly CB1 found predominantly in the central nervous system and CB2 found predominantly in cells involved with immune function. Delta-9-tetrahydrocannabinol, the main bioactive cannabinoid in the plant, has been available as a prescription medication approved for treatment of cancer chemotherapy-induced nausea and vomiting and anorexia associated with the AIDS wasting syndrome...
June 2015: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/25635955/the-effectiveness-of-cannabinoids-in-the-management-of-chronic-nonmalignant-neuropathic-pain-a-systematic-review
#14
REVIEW
Darrell G Boychuk, Greg Goddard, Giovanni Mauro, Maria F Orellana
AIMS: To carry out a systematic review to assess the effectiveness of cannabis extracts and cannabinoids in the management of chronic nonmalignant neuropathic pain. METHODS: Electronic database searches were performed using Medline, PubMed, Embase, all evidence-based medicine reviews, and Web of Science, through communication with the Canadian Consortium for the Investigation of Cannabinoids (CCIC), and by searching printed indices from 1950. Terms used were marijuana, marihuana, cannabis, cannabinoids, nabilone, delta- 9-tetrahydrocannabinol, cannabidiol, ajulemic acid, dronabinol, pain, chronic, disease, and neuropathic...
2015: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/25500598/prescribing-smoked-cannabis-for-chronic-noncancer-pain-preliminary-recommendations
#15
REVIEW
Meldon Kahan, Anita Srivastava, Sheryl Spithoff, Lisa Bromley
OBJECTIVE: To offer preliminary guidance on prescribing smoked cannabis for chronic pain before the release of formal guidelines. QUALITY OF EVIDENCE: We reviewed the literature on the analgesic effectiveness of smoked cannabis and the harms of medical and recreational cannabis use. We developed recommendations on indications, contraindications, precautions, and dosing of smoked cannabis, and categorized the recommendations based on levels of evidence. Evidence is mostly level II (well conducted observational studies) and III (expert opinion)...
December 2014: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/25346628/cannabidiol-promise-and-pitfalls
#16
Timothy E Welty, Adrienne Luebke, Barry E Gidal
Over the past few years, increasing public and political pressure has supported legalization of medical marijuana. One of the main thrusts in this effort has related to the treatment of refractory epilepsy-especially in children with Dravet syndrome-using cannabidiol (CBD). Despite initiatives in numerous states to at least legalize possession of CBD oil for treating epilepsy, little published evidence is available to prove or disprove the efficacy and safety of CBD in patients with epilepsy. This review highlights some of the basic science theory behind the use of CBD, summarizes published data on clinical use of CBD for epilepsy, and highlights issues related to the use of currently available CBD products...
September 2014: Epilepsy Currents
https://www.readbyqxmd.com/read/25118789/the-pharmacokinetics-efficacy-safety-and-ease-of-use-of-a-novel-portable-metered-dose-cannabis-inhaler-in-patients-with-chronic-neuropathic-pain-a-phase-1a-study
#17
Elon Eisenberg, Miri Ogintz, Shlomo Almog
Chronic neuropathic pain is often refractory to standard pharmacological treatments. Although growing evidence supports the use of inhaled cannabis for neuropathic pain, the lack of standard inhaled dosing plays a major obstacle in cannabis becoming a "main stream" pharmacological treatment for neuropathic pain. The objective of this study was to explore the pharmacokinetics, safety, tolerability, efficacy, and ease of use of a novel portable thermal-metered-dose inhaler (tMDI) for cannabis in a cohort of eight patients suffering from chronic neuropathic pain and on a stable analgesic regimen including medicinal cannabis...
September 2014: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/24969360/understanding-the-etiology-and-management-of-hiv-associated-peripheral-neuropathy
#18
REVIEW
Kara Stavros, David M Simpson
HIV may cause several forms of peripheral neuropathy, the most common of which is distal symmetric polyneuropathy (DSP) characterized by pain and sensory deficits in a stocking-glove distribution. The pathophysiology of DSP remains largely unknown but is thought to be related both to the neurotoxicity of HIV-through indirect immunomodulatory mechanisms-and to the neurotoxic effects of anti-retroviral therapies, most notably the dideoxynucleoside reverse transcription inhibitors or so-called d-drugs. Determining whether symptoms arise from the virus or the treatment poses a challenge to the clinician who must decide if a patient's HAART regimen should be altered...
September 2014: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/24778283/systematic-review-efficacy-and-safety-of-medical-marijuana-in-selected-neurologic-disorders-report-of-the-guideline-development-subcommittee-of-the-american-academy-of-neurology
#19
REVIEW
Barbara S Koppel, John C M Brust, Terry Fife, Jeff Bronstein, Sarah Youssof, Gary Gronseth, David Gloss
OBJECTIVE: To determine the efficacy of medical marijuana in several neurologic conditions. METHODS: We performed a systematic review of medical marijuana (1948-November 2013) to address treatment of symptoms of multiple sclerosis (MS), epilepsy, and movement disorders. We graded the studies according to the American Academy of Neurology classification scheme for therapeutic articles. RESULTS: Thirty-four studies met inclusion criteria; 8 were rated as Class I...
April 29, 2014: Neurology
https://www.readbyqxmd.com/read/24663230/summary-of-evidence-based-guideline-complementary-and-alternative-medicine-in-multiple-sclerosis-report-of-the-guideline-development-subcommittee-of-the-american-academy-of-neurology
#20
Vijayshree Yadav, Christopher Bever, James Bowen, Allen Bowling, Bianca Weinstock-Guttman, Michelle Cameron, Dennis Bourdette, Gary S Gronseth, Pushpa Narayanaswami
OBJECTIVE: To develop evidence-based recommendations for complementary and alternative medicine (CAM) in multiple sclerosis (MS). METHODS: We searched the literature (1970-March 2011; March 2011-September 2013 MEDLINE search), classified articles, and linked recommendations to evidence. RESULTS AND RECOMMENDATIONS: Clinicians might offer oral cannabis extract for spasticity symptoms and pain (excluding central neuropathic pain) (Level A). Clinicians might offer tetrahydrocannabinol for spasticity symptoms and pain (excluding central neuropathic pain) (Level B)...
March 25, 2014: Neurology
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