Cannabis could help manage symptoms of some neurological conditions

The data on cannabis and its components for treatment of neurological disorders are plentiful, according to Michele Faulkner, PharmD, FASHP. “Cannabis is a huge topic,” said Faulkner during an APhA2021 Virtual session products treat disorders.Most pharmacists probably familiar with as epilepsy. In 2018, FDA approved Epidiolex (Greenwich Biosciences) the first-ever product containing cannabidiol. drug indicated two rare severe forms epilepsy in patients ages 2 years older. “The overwhelming majority concerning potential therapy neurology has been derived from surveys users [and] open-label studies, there quite high bias lot this information,” Faulkner.Faulkner, professor pharmacy practice at Creighton University Schools Pharmacy Medicine Nebraska, no evidence that can cure any disease or it slows down progressive diseases, such Parkinson's.What cannabis?The plant contains 554 compounds. These compounds, active chemicals, include 113 cannabinoids, which tetrahydrocannabinol (THC) cannabidiol (CBD).“As we look pharmacological actions expected therapeutic responses, name label not going help us, but instead knowing whether it's THC type, CBD hybrid type,” Kari Franson, PhD, BCPP, associate dean Southern California.Although still area evolving research, cannabinoids known have different effects body. binds cannabinoid receptors body, while may interact indirectly receptors. chemical responsible psychoactive quality cannabis, also antinausea analgesic effects. CBD, properties, inflammation. Other compounds plant, terpenes flavonoids, play synergistic role cannabis—what's “entourage effect.”Fiona Oxsher, cofounder general manager LKN Extractions, learning about body's endocannabinoid system—which was only discovered 2002—helps us understand how work.The system controls person's response stress, well one's mood, appetite, energy balance, more. April 21, 2021, APhA webinar, Oxsher explained our bodies increasingly void because environment, food eat, other factors. Plants way saturate system—the CB1 CB2 receptors, specifically—she said.Cannabinoids present rosemary, echinacea, kava, plants. “But highest percentage cannabinoids,” Oxsher.Inconclusive dataFor most symptom management. During her presentation, discussed research few conditions outside epilepsy: multiple sclerosis, Parkinson's disease, headache disorders.Full- vs. broad-spectrum productsFull spectrum full complement major minor cannabinoids—these both phytochemicals. On hand, alternative full-spectrum products; they everything them THC.Hemp marijuana fall under federal designations. Hemp variety grown specifically fiber used industrial purposes. 2018 Farm Bill legalized production sale hemp extracts. less than 0.3% THC. Marijuana greater considered Schedule I by DEA federally illegal.View Large Image Figure ViewerDownload Hi-res image Download (PPT)“We need be honest efficacy inconclusive,” Faulkner. “Changes legal status outpaced scientific development really unprecedented indications without strong clinical being included acceptable receipt medical cannabis.”For example, accepted 17 states, despite statements organizations like American Academy Neurology say does work motor symptoms levodopa-induced dyskinesia disease.Drug interactionsMost inquiring products.“Patients already using [CBD] will come saying want explore it,” Michael Deme, pharmacist RxClinic Charlotte, NC, 21 webinar.Even though lacking specific interactions, Deme where pharmacist's expertise needed.“We do know metabolized liver enzymes CYP2C19 CYP3A4,” Deme. “Most those players all metabolism.”To cite just one if patient carbamazepine, inducer, CDB dose might effective them. “Maybe getting benefits after while. Maybe their too low inducer medication.” opposite hold true when inhibitor, could causing adverse effect.According some interactions “In particular, interacts several antiepileptic medications use these same disorders,” she said.Faulkner medication doses diazepam, clobazam, stiripentol, likely reduced prevent toxicity patients.She worth noting elevations seem occur more readily coadministration valproic acids. “This important you family member who seeking out child seizures conventional therapies oversight practitioner,” said. disorders. Most Parkinson's. What Oxsher. (CBD). “As California. Although effect.” Fiona work. Cannabinoids Inconclusive illegal.“We disease. For Full- illegal. Full “We cannabis.” Drug products. “Patients webinar. Even needed. metabolism.” To effect. According patients. She