By Ariana Eunjung Cha January 24
A new class of epilepsy medications based on an ingredient derived from marijuana could be available as soon as the second half of 2018 in the United States, pending Food and Drug Administration approval.
Officials from GW Pharmaceuticals, the company that developed the drug, on Wednesday announced promising results from a study on 171 patients randomized into treatment and placebo groups. Members of the group, ages 2 to 55, have a condition called Lennox-Gastaut syndrome and were suffering from seizures that were not being controlled by existing drugs. On average they had tried and discontinued six anti-seizure treatments and were experiencing 74 “drop” seizures per month. Drop seizures involve the entire body, trunk or head and often result in a fall or other type of injury.
The results, published in the Lancet, show that over a 14-week treatment period, 44 percent of patients taking the drug, called Epidiolex, saw a significant reduction in seizures, compared with 22 percent of the placebo group. Moreover, more of the patients who got the drug experienced a 50 percent or greater reduction in drop seizures.
Cryptococcal meningitis is a life-threatening condition most commonly observed in immunocompromised individuals. We describe a daily cannabis smoker without evidence of immunodeficiency presenting with confirmed Cryptococcus neoformans meningitis. An investigation of cannabis samples from the patient's preferred dispensary demonstrated contamination with several varieties of Cryptococcus, including C. neoformans, and other opportunistic fungi. These findings raise concern regarding the safety of dispensary-grade cannabis, even in immunocompetent users.
disease and health outcomes; drugs misuse (including addiction); exposures; healthcare improvement and patient safety; infectious diseases
BMJ Case Rep. 2018 Jan 26;2018. pii: bcr-2017-221435. doi: 10.1136/bcr-2017-221435.
This review provides an overview of the changing US epidemiology of cannabis use and associated problems. Adults and adolescents increasingly view cannabis as harmless, and some can use cannabis without harm. However, potential problems include harms from prenatal exposure and unintentional childhood exposure; decline in educational or occupational functioning after early adolescent use, and in adulthood, impaired driving and vehicle crashes; cannabis use disorders (CUD), cannabis withdrawal, and psychiatric comorbidity. Evidence suggests national increases in cannabis potency, prenatal and unintentional childhood exposure; and in adults, increased use, CUD, cannabis-related emergency room visits, and fatal vehicle crashes…more limited literature suggests that Medical Marijuana Laws (MMLs) have led to increased cannabis potency, unintentional childhood exposures, adult cannabis use, and adult CUD. Ecological-level studies suggest that MMLs have led to substitution of cannabis for opioids, and also possibly for psychiatric medications. Much remains to be determined about cannabis trends and the role of MMLs and RMLs in these trends. The public, health professionals, and policy makers would benefit from.
Conclusion: Medical marijuana laws appear to have contributed to increased prevalence of illicit cannabis use and cannabis use disorders. State-specific policy changes may also have played a role. While medical marijuana may help some, cannabis-related health consequences associated with changes in state marijuana laws should receive consideration by health care professionals and the public.
The World Health Organisation has announced its findings after a months-long study into cannabidiol, or CBD, declaring the medicinal cannabis component to be well tolerated and an effective treatment for some forms of epilepsy. The WHO also recommended CBD not be a scheduled drug.
According to the report, the non-psychoactive component of cannabis does not exhibit any effects indicative of abuse or dependence. Adverse side effects were put down to drug-drug interactions between CBD and a patient's existing medications.
"In general, clinical studies have reported that even high doses of oral CBD do not cause those effects that are characteristic for THC and for cannabis rich in THC," said the report.
"CBD has been found to have relatively low toxicity, although not all potential effects have been explored."