1. In a letter to the editor of the Journal of Clinical Psychiatry
doctors of the Rockland Psychiatric Center in Orangeburg, New York,
USA, reported of four more patients with schizophrenia not responding
to other medication, who improved considerably with a treatment by
THC. The physicians had already published a similar experience with
four other patients in 2009. This time they tried dronabinol (THC)
for 8 further patients in the hospital. They all suffered from severe
psychosis refractory to standard medication and reported of a
positive previous experience with cannabis. There were four
responders with good improvement with THC and four non-responders.

One case was a 54-year-old man with schizoaffective disorder, who had
been aggressive, intrusive, and disorganized for years in spite of
multiple medication trials. Before the THC trial he received daily
clozapine, risperidone, lithium carbonate, and clonazepam for months
with no significant benefit. After adding 5 mg THC twice a day he
became calm, cooperative, and logical and was very much improved, as
did the other three responders. None of the four non-responders had a
worsening of their psychosis or other effects. Authors noted, that
they “simply had no change with the addition of dronabinol.” They
write: “We suspect that in a small subsect of these [psychotic]
patients, the etiology of their psychosis is low endogenous
endocannabinoid brain function, so that cannabinoid stimulation would
improve their behaviour.”

(Source: Schwarcz G, Karajgi B. Improvement in refractory psychosis
with dronabinol: four case reports. J Clin Psychiatry

2. Science: In an observational study nabilone was as effective as
gabapentin in the treatment of patients with peripheral neuropathy

In a non-randomized observational study at the University of Calgary,
Canada, patients diagnosed with peripheral neuropathy where permitted
to initiate monotherapy with nabilone or gabapentin or add one of
these two medications to their existing treatment. Reassessment and
modulation of dosing and/or medications occurred at 3- and 6-month
intervals. Medication adverse effects and drug efficacy, as well as
questionnaires, were assessed at 6 months.

101 patients initiated monotherapy, 49 with nabilone and 52 with
gabapentin. 119 patients used one of the medications in addition to
their current treatment, of whom 55 used nabilone and 64 gabapentin.
After six months 35 patients still used nabilone and 32 patients
still used gabapentin as monotherapy, and 38 patients used nabilone
and 46 patients gabapentin as adjuvant therapy. The mean daily dose
of nabilone after three and six months in the monotherapy group was
about 3 mg. Significant improvements in pain were seen in all
treatment groups at 6 months. Numerous sleep parameters improved in
patients receiving nabilone or gabapentin either as monotherapy or
adjuvant treatment. Anxiety and depression scores were significantly
improved in all treatment groups. Authors concluded that “the
benefits of monotherapy or adjuvant therapy with nabilone appear
comparable to gabapentin for management of NeP [neuropathy].”

(Source: Bestard JA, Toth CC. An Open-Label Comparison of Nabilone
and Gabapentin as Adjuvant Therapy or Monotherapy in the Management
of Neuropathic Pain in Patients with Peripheral Neuropathy. Pain
Pract. 2010 Nov 18. [in press])

News in brief

***Canada: Poll on legalization
According to a poll by Angus Reid released on 29 November 50 per cent
of Canadians support legalizing cannabis while 44 per cent are
opposed and 6 per cent were undecided. From 23 to 24 November 2010,
Angus Reid Public Opinion conducted an online survey among 1,000
randomly selected Canadian adults. (Source: Angus Reid poll of 29
November 2010)

***Science: Stroke
According to animal research at the Complutense University in Madrid,
Spain, activation of the endocannabinoid system by a synthetic
cannabinoid (WIN55,212-2) promoted the recovery of white and grey
matter of the brain after ischemia (reduced blood suply) in new-born
rats. (Source: Fernández-López D, et al. Stroke 2010;41(12):2956-64.)

***Science: Posttraumatic stress diorder
According to research from Australia with 80 clients of a methadone
maintenance program of whom 52.7 per cent suffered from post
traumatic stress disorder (PTSD) cannabis “may be used to self-treat
certain PTSD symptoms, supporting the self-medication hypothesis.”
(Source: Villagonzalo KA, et al. Compr Psychiatry. 2010 Nov 24. [in

***Science: Multiple sclerosis
According to research at the University of Bologna, Italy, a cannabis
extract containing THC and CBD (cannabidiol) given to mice with CREAE
significantly reduced neurological deficits. CREAE is the
abbreviation of chronic relapsing experimental autoimmune
encephalomyelitis, an animal model of multiple sclerosis. (Source:
Buccellato E, et al. J Ethnopharmacol. 2010 Nov 19. [in press])

***Science: Oral cancer
Scientists at the University of California in San Francisco, USA,
investigated the effects of cannabinoids on oral cancer pain and
tumor growth in a mouse cancer model. A CB1 receptor selective
cannabinoid (ACEA), a CB2 receptor selective cannabinoid (AM1241) as
well as a non-selective cannabinoid (WIN55,212-2) all reduced cancer
cell proliferation in a dose-dependent manner in cell experiments.
All reduced cancer pain (mechanical allodynia). Tumor growth was
reduced with the CB2 receptor selective cannabinoid in mice. (Source:
Saghafi N, et al. Neurosci Lett. 2010 Nov 18. [in press]).

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