S-adenosyl-L-methionine (SAMe), cannabidiol (CBD), and kratom in psychiatric disorders: Clinical and mechanistic considerations
Researchers have recently unveiled the benefits and challenges of utilizing cannabidiol (CBD) in the treatment of psychiatric disorders. CBD has been FDA approved for rare epileptic disorders in the United States and has been recognized for its anxiolytic effects. Dosing CBD can be difficult due to various consumption methods, different products offering ratios of CBD: THC (tetrahydrocannabinol) and terpene contents, all of which cause different effects. Along with anxiolytic effects, the anti-inflammatory effects of CBD have also been well documented, acting through various biological mechanisms. Although THC may not be positively recognized for its psychoactive properties, CBD has been documented by major studies to have anxiolytic and antipsychotic effects with added neuroprotective and anticonvulsant effects. The author concludes that due to the minimal side-effects associated with CBD psychiatrists should seriously consider recommending CBD to patients.
CBD has fallen into a more of a gray area than THC or cannabis in general as it appears to be widely accepted due to its wide availability yet some overarching associations still think poorly of its use. For example, the National Collegiate Athletic Association (NCAA) explicitly prohibits the use of THC and explains that, while not banned, student-athletes should be hesitant to use CBD products as it increases their risk of testing positive for THC and a healthy athlete should have no reason to utilize CBD anyway. Patients are recommended to seriously discuss their CBD use with a physician and do their research to determine how CBD is received by their places of work or other regulatory bodies they engage in.
The study is available for review or download here
Parasitic pharmacology- A plausible mechanism of action for cannabidiol
A recent editorial questions the efficacy of utilizing cannabidiol (CBD) as an anti-epileptic and proposes a plausible mechanism of action for previously seen anti-epileptic effects. While discussing the issues within the two randomized-placebo controlled studies published in the New England Journal of Medicine (NEJM) that led to the eventual FDA approval of Edioplex for the treatment of seizures, the author raises concerns about the quality of content published by the NEJM. The author claims that the two studies claiming that CBD was a novel therapy for Dravets Syndrome and Lennox-Gastaut Syndrome did not examine or publish the pharmacokinetic properties of CBD within their study and that all benefits found were actually due to the drug-drug interaction between CBD and clobazam, a known anti-epileptic. As this hypothesis was only examined as a simulation further testing is needed.
Cannabinoids, like all drugs, should continue to be questioned and retested for efficiency. Cannabis is not omnipotent and just because it holds promise for a myriad of ailments and disorders does not mean it may be the most efficient or ethical treatment available. Cannabinoids and terpenes deserve to be examined based on their potential as the medical community continues to search for novel cancer treatment, anti-emetics, appetite modulating drugs, and more which can then be fully developed for maximum pharmacological efficiency and compared to the current treatment. It seems irresponsible to not compare or develop cannabis-based medicine considering the promise seen in countless studies.
The study is available for review or download here
Effects of Cannabidiol on Alcohol-Related Outcomes- A Review of Preclinical and Human Research
A review of preclinical research studies has revealed to possible beneficial effects of cannabidiol on alcohol-related outcomes. It was found that cannabidiol (CBD) is able to lessen alcohol consumption although the mechanism is not well understood. CBD may also protect consumers from the negative effects of alcohol use such as liver and brain damage. It is likely that CBD provides these protective effects through its modulation of inflammatory processes. It is recommended that further research is conducted in order to validate these findings and expand upon the knowledge of how CBD interacts with other common substances.
As cannabis-based products become more widely accepted among the medical community and within society it is imperative that the interactions between cannabis and other drugs are known. Those who wish to use cannabis for certain ailments but are already on other medications may consume cannabis and experience negative side-effects due to the interaction of those drugs. Cannabinoids, terpenes, and flavonoids need to be modeled alongside other common medications so that physicians can safely recommend medications and so that pharmacists are able to accurately advise customers when they pick up prescriptions. Research is needed to ensure public safety in this time of evolving medications.
The study is available for review or download only from the original publisher
Current Status and Prospects for Cannabidiol Preparations as New Therapeutic Agents
As of 2016, upwards of 60 clinical trials relating to the use of medical cannabis were in progress. The scope of clinical trials included conditions such as anxiety, cocaine dependence, infantile spasms, schizophrenia, solid tumor, and many more. The status of cannabis as a Schedule I drug, under the Controlled Substance Act, limits researchers’ ability to freely collect data if they require support from NIH funding. While there are opportunities for researchers to study cannabis and its derivatives with the support of private funds, this typically risks an appearance of sacrificed scientific integrity and independence. Very few private entities would condone research which might shed an unfavorable light on their products. On the other hand, current NIH-funded research requires the use of the national supply of cannabis, a crop well-known to be very limited in quality. Increasingly, more states have been legalizing the medical and recreational use of cannabis in recent years, allowing scientists with more opportunities for private funding in which to shed more light on the vast medicinal benefits of cannabis. Animal models and human trials have pointed toward clinical applications of medical cannabis including anxiety, nausea, seizures, and inflammation, although the array of competing and synergistic compounds within the plant seem to continually open new doors to relief from a large array of illnesses.
Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series
Preliminary findings from a study conducted on PTSD patients open a new door for cannabidiol (CBD) as a potential supplementary treatment option. CBD indirectly activates receptors linked to behavioral responses to aversive memories, a major component of the suffering involved in PTSD. The majority of participants in this review reported a decrease in the prevalence and severity of PTSD symptoms, both in the short-, and long-term. It should be taken into consideration that this study was performed with a small sample size that lacked a placebo or control group; however, this tells a familiar story to what we see in clinic. Further research will likely support cannabinoids as a legitimate treatment option for PTSD. Under the guidance of a knowledgeable Cannabis Medicine provider, PTSD patients may also consider supplementing their current treatment plan with CBD
Over the years, CBD has shown that it may play a therapeutic role in sleep regulation, adjusting sleep cycles, inducing sedative effects, increasing total sleep time and less frequent awakenings, reducing dream recall, and it has even been shown to REM sleep. Some of these studies have been levied against comparison with placebo medications, and some studies have been done looking very closely at individuals’ physiology as they sleep. Some studies even document a return of sleep disturbances once the CBD is removed from treatment. Doses have been explored ranging from 40, 80, or 160 mg per day, up to 600mg. CBD has been tried both alone and in combination with other cannabinoids.
Here, a study of 26 participants, were tried with CBD once, and then placebo once, after 2 weeks, and they found no significant impact of the CBD on sleep. The authors note that the small window (of personnel studied and of episodes of dosing CBD) is a concerning limitation. Another interpretation of these results is that CBD is not acting as an acute sedative. Its function may be situational (for certain states of mind, CBD may work in a quieting way) or it may be impacting the body at a much more basic level (for example, if it is reducing levels of stress or depression hormones, the effect of improving sleep may have a more gradual impact.
A related point – it is important for us to take note of studies that don’t necessarily have fireworks associated. Not every study will show amazing effects or overwhelming results. This helps us consider what is good or what is missing from the papers we read – and helps create a more realistic research culture. Every study helps teach, even if it’s not showing breathtaking results.
CBD Shows Promise for Schizophrenia, Alzheimer’s, and Brain Injury Patients
A meta-analysis of previous studies investigating cannabidiol’s (CBD) potential to improve cognitive function among schizophrenia and brain injury patients offers hope to doctors and patients. In experiments on both human patients and rat models of schizophrenia, Alzheimer’s Disease, hypoxic-ischemic brain injury, hepatic encephalopathy, sepsis, pneumococcal meningitis, and cerebral malaria, the administration of CBD reduced neuroinflammation and resulting deficits in spatial learning and memory, recognition memory, and associative learning. Read more or download PDF on the CED Foundation Archive: http://bit.ly/2W1PpW8
In this same review, further investigating the effect of the non-psychoactive cannabidiol (CBD) on cognitive function suggests CBD counteracts the cognitive deficiencies induced by the psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC). Studies performed on humans and rat models demonstrated that CBD can improve episodic and recognition memory, verbal and visual learning and memory, and working memory, all skills which are usually impaired by THC content. For patients looking to reduce the aforementioned undesirable effects of cannabis, strains or products with high CBD and low THC content may be a viable solution.
Benjamin Caplan, MDA systematic review of the effect of cannabidiol on cognitive function: Relevance to schizophrenia