Newsgroup: it.salute.cefalee
Titolo: Marijuana e mal di crapa

Ciao Enneggì...
Prima di tutto, non posso non ringraziare per l'immeritato tributo di
simpatia rivoltomi dagli amici cefali e non.
Immeritato ripeto e per questo ancor più gradito.
Allora... cari amici medici...
io ho quarant'anni e quindi sono passato (quasi indenne) attraverso il post
'68, ho combattuto a volte con e a volte contro le ultime femministe (come
mi piacevano con le loro gonne a fiori, così fiere e così ingenue),
saltellavo disinvoltamente tra Pink Floyd e la disco music (mentre a casa
leggevo "porci con le ali") ed infine... son passato attraverso le droghe
nel senso stretto del termine.
Me le sono viste sfilare attorno tutte sia perchè non era possibile passare
giornata senza che qualcune te le offrisse in una maniera o nell'altra, sia
perchè mi è capitato di stare con gruppi di amici che ne facevano uso.
Grazie a una sorta di individualismo esasperato, sono riuscito a mantenere
la mia identità all'interno di quei gruppi e quindi di decidere in maniera
critica ed autonoma il da farsi.
Lunga premessa per dire che concettualmente sono contrario all'uso di
droghe... però...
Ho letto in giro che un alcaloide (cannabinolo? cannabina? cannadapesca? boh
?) contenuto nelle foglie di marijuana è stato utilizzato con successo
contro le cefalee, sia come sintomatico sia in profilassi a fronte di scarsi
effetti collaterali e conseguenze (tutte esilaranti hihihi). Il loro
migliore impiego sembra sia nelle cefalee da weekend. Leggo inoltre che ci
sono persone che si curano autocoltivandosi le piantine in casa e che si
fanno passare il mal di crapa a suon di cannoni. (Aspide se non altro
divertente..)
Forse sono le classiche bufale da settimanale, ma chiedo lo stesso... esiste
qualche studio serio sull'argomento ? Le pubblicazioni scientifiche hanno
mai affrontato questo argomento ?
Questo fatto taciterebbe la coscienza di molti se si ipotizzasse di farsi un
bello spinello per scopi terapeutici...
Leopondolo ha "riflesso" e senza cistifellea e con le dita loctitate sulla
tastiera ha ripreso a farneticare (Vox popoli...)

 mai affrontato questo argomento ?
Si. Oddio, non so se sulle cefalee nello specifico, relativamente alle
quali ho letto diverse cosucce, ma ad onor del vero per lo più
divulgative perchè l'ho già detto che tendo a non approfondire troppo
questo aspetto della mia misera esistenza triptanizzata ;-). Ma
sull'utilizzo della maria in campo medico esistono studi, per lo più
americani se non vado errando. Qualche cosa dovrei avere anche io sparso
negli archivi di non so bene quale studio (sono disordinatisssimaaaaa
:-)) ) Per quanto posso ricordare ora, a poco meno di due ore
dall'assunzione dello zomig e quindi in pieno obnubilamento del
sensorio, viene adottata ad esempio per rendere più tollerabili gli
effetti collaterali dei chemioterapici (si dovrebbe svomitazzare meno),
per rendere meno atroci alcuni dolori credo più che altro in campo
oncologico (una sorta di innalzamento della soglia del dolore), e anche
per *trattare* alcuni stati depressivi mmme pare. Il tutto avviene in
America, ovviamente :-)
Non ho estremi biblio da darti, così su due piedi. Magari poi salta
anche fuori che non ce ne sono proprio ihihiiiihihihih e che mi sono
inventata tutto...gggiuro che non sono un pusher! ;-))) Dì, magari con
una bella ricerchina su Medline...se ho tempo nei prossimi secoli la
faccio, eh? Io credo sia meglio che mi fermi, perchè mi rendo conto di
non essere più completamente padrona dei miei neuroni! Ciaooooo....
Enjoy
Laurafuori

divertente..)
Io sono una figlia degli anni settanta cresciuta negli ottanta,
sicche' mi e' andata solo bene che ero una brava bimba un po'
ciellina, a quei tempi era di moda la coca che ahime' non e' tra le
leggere :)
Idealmente sono contraria anche io, anche alle canne, ed ebbi gia'
modo di spiegare le mie ragionevolissime ragioni su questo NG.
Ciononostante ho un amico ex-sessantottino che a suon di canne ha
fatto riprendere la mamma (signora molto sportiva) dall'inappetenza
post-chemio, quindi non ho dubbi, qualcosa di buono c'e'.
E ciononostante, nel mese che ho diviso la casa con un cannarolo
convinto, a parte rischiare di andare a fuoco io e la casa, ho avuto
la massima concentrazione di malditesta della mia vita. E badabene,
solo fumo passivo :) E' stato anche il mese con la maggior
concentrazione di attacchi di riso isterico ed immotivato, il che mi
ha di contro fatto un gran bene all'umore in generale...
E tu mi dirai, ma cara questo non e' no studio scientifico. Ecche',
non posso vanolare cinque minuti pure io? :))))
CIAO
Laura chesi fa solo di fondente, meglio se di provenienza belga. Alla
faccia degli effetti collaterali sul cefalo! :)

 effetti collaterali 
Si, indubbiamente ci sono alcuni aspetti farmacologici
interessanti........ma solo da un punto di vista speculativo!
E' ancora molto improbabile pensare ad un uso terapeutico dello "spinello"
......
D'altra parte non è neanche una "scoperta" recente. Per es. in un trattato
di farmacognosia del 1946 c'è il "balsamo tranquillo" a base di giusquiamo,
canapa indiana e rosolaccio, per lenire i "dolori osteocopi del
sifilitico".......
Un saluto
-- 
Dr. Francesco Maria Andreozzi
Anestesia Rianimazione Terapia del Dolore
Ambulatorio Cefalee e Dolore Neuropatico
ASL RMH Osp. Civ. Genzano
fra...@tin.it
 

 faccia degli effetti collaterali sul cefalo! :)
Guarda guarda cosa deve sentire un torinese doc:
Cioccolato belga????
Sara' meglio farti assaggiare cosa riescono a fare
da queste parti!!!!
Ciao,
Massimo

 sifilitico".......
Si .. questa la sapevo.. il rosolaccio (papavero comune), il giusquiamo
(Hyosciamus niger) sono entrambi sedativi...
Credo addirittura che il giusquiamo venisse venduto fino a una 50 ina di
anni fa in sigarette per combattere l'asma...
Grazie per le info.
Leopondolo sotterrerà il mondo in una risata (anche senza narghilè..)

 negli archivi di non so bene quale studio
Okay, allora, nulla sulle cefalee se non questa indicazione biblio un
po' datata:
Migraines: primarily anecdotal reports:
Volfe, Dvilansky, and Nathan, "Cannabinoids Block Release of
 Serotonic from Platelets Induced by Plasma from Migraine
 Patients", Int'l. J. Clin. and Pharm. Res. 5 (1985): 243-246.
 ma mi sono attivata e spero di ottenere risultati a breve, sempre
ammesso e non concesso che interessi ancora
l'argomento. Giusto per inciso, mi stà scoppiando la cefalea, e siamo al
quarto giorno consecutivo!! Ma questi sono squisitamente problemi miei
[;-)) Per ora mi calo il triptano eheheheh, e penso proprio che
difficilmente potrà essere sostituito da una canna :-(
Io ora stò per fare una cosa che non so quanto ti/vi possa interessare,
ma
la farò ugualmente O:-))) Giusto per capire che l'utilizzo della
cannabis in campo medico è effettivamente materia di contendere a
livello di ricerca scientifica e non solo, e si studia, si studia, e si
pubblica
:-))
*************************************
NORML (The National Organization for the Reform of Marijuana
Lows) --------> un po' di parte.... ;-)))
Statement on the Medical Use of Marijuana
Science Supports Amending Federal Law
by Paul Armentano
NORML Publications Director
   "Federal authorities should rescind their prohibition of the medical
use of marijuana for seriously ill patients and allow physicians to
decide which patients to treat. The government should change marijuana's
status from that of a Schedule I [prohibited] drug ... to that of a
Schedule II drug ... and regulate accordingly."
-- Dr. Jerome Kassirer, editor, New England Journal of Medicine, January
30, 1997
   Marijuana prohibition applies to everyone, including the sick and
dying. Of all the negative consequences of prohibition, none is as
tragic as the denial of medical marijuana to the tens of thousands of
seriously ill patients who could benefit from its therapeutic use.
    It is clear from available studies and rapidly accumulating
anecdotal evidence that marijuana is therapeutic in the treatment of a
number of serious ailments and is less toxic and costly than many
conventional medicines for which it may be substituted.1 Most recently,
a federally commissioned report by the National Academy of Sciences
(NAS) determined that, "Marijuana's active components are potentially
effective in treating pain, nausea, the anorexia of AIDS wasting, and
other symptoms" including multiple sclerosis.2 In some cases, marijuana
appears more effective than the commercially available drugs it
replaces.3
    The best established medical use of smoked marijuana is as an
anti-nauseant for cancer chemotherapy. During the 1980s, researchers in
six different state-sponsored clinical studies involving nearly 1,000
patients determined smoked marijuana to be an effective anti-emetic.4
For many of these patients, smoked marijuana proved more effective than
both conventional prescription anti-nauseants and oral THC (marketed
today as the synthetic pill, Marinol).5 Dr. John Benson, Jr.,
co-principle investigator for the latest NAS report, concluded in March
1997 that "short term marijuana use appears to be suitable in treating
conditions like chemotherapy-induced nausea" for patients who do not
respond well to other medications.6 Currently, many oncologists are
recommending marijuana to their patients despite its prohibition.7
    Scientific and anecdotal evidence also suggests that marijuana is a
valuable aid in reducing pain and suffering for patients with a variety
of other serious ailments. For example, marijuana alleviates the nausea,
vomiting, and the loss of appetite experienced by many AIDS patients
without accelerating the rate at which HIV positive individuals develop
clinical AIDS or other illnesses.8 According to the National Institutes
of Health (NIH), marijuana "increase[s] food enjoyment and the number of
times individuals eat per day."9 The most recent NAS report found
cannabinoid drugs "promising for treating wasting syndrome in AIDS
patients,"10 and recommended those patients unresponsive to conventional
AIDS medications smoke marijuana to combat the wasting syndrome.11
    An earlier 1982 report by the National Academy of Sciences (NAS)
suggested that marijuana reduces intraocular pressure (IOP) in patients
suffering from glaucoma, the leading cause of blindness in the United
States.12 A follow up 1994 report by the Australian federal government
determined that, "There is reasonable evidence for the potential
efficacy of THC in the treatment of glaucoma, especially in cases which
have proved resistant to existing anti-glaucoma agents," and recommended
the drug's use under medically supervised conditions.13
    Clinical and anecdotal evidence also points to the effectiveness of
marijuana as a therapeutic agent in the treatment of a variety of
spastic conditions such as multiple sclerosis, paraplegia, epilepsy, and
quadriplegia. Animal studies and carefully controlled human studies
support marijuana's ability to suppress convulsions. In November 1998,
England's House of Lords Science and Technology Committee said they were
"convince[d] ... that cannabis ... certainly does have genuine medical
applications ... in treating the painful muscle spasms and other
symptoms of MS," and recommended legalizing medical use of the drug.14
The latest NAS report also noted marijuana seems to alleviate muscle
spasms associated with MS.15
    Many patients and older Americans use marijuana therapeutically to
control chronic pain. NAS researchers found that, "The available
evidence from both animal and human studies indicates that cannabinoids
can produce a significant analgesic effect."16 Several recent scientific
studies performed by researchers at the University of San Francisco and
elsewhere demonstrate that compounds in marijuana modulate pain signals
in much the same way as morphine and other opiates.17 This new research
led the Society of Neuroscience to pronounce that, "Substances similar
to or derived from marijuana, known as cannabinoids, could benefit the
more than 97 million Americans who experience some form of pain each
year."18
    New research indicates that marijuana constituents appear to protect
brain cells during a stroke. Researchers at the National Institute for
Mental Health called compounds in marijuana potent antioxidants.19
Doctors rely on antioxidants to protect stroke victims from toxic levels
of a brain chemical called glutamate. Head trauma and strokes cause the
release of excessive glutamate, often resulting in irreversible damage
to brain cells. In laboratory studies, marijuana compounds performed
better than traditional antioxidants like vitamins C and E.20
References
1. House of Lords Select Committee on Science and Technology, "Ninth
Report," London: United Kingdom (1998); American Public Health
Association, Resolution 9513: Access to Therapeutic Marijuana/Cannabis,
Washington, DC: APHA Public Policy Statements (1995); Commonwealth
Department of Human Services and Health, The health and psychological
consequences of cannabis use, Canberra, Australia: Australian Government
Publishing Service (1994): 185-199; Federation of American Scientists,
Medical Use of Whole Cannabis, Washington, DC: Statement of the FAS
(1994); Lester Grinspoon, M.D. et al., Marihuana, The Forbidden Medicine
(second edition), New Haven, Connecticut: Yale University Press (1997);
John Morgan, M.D. et al., Marijuana Myths, Marijuana Facts: A Review of
the Scientific Evidence, New York City: Lindesmith Center (1997): 17-25.
2. Institute of Medicine News, March 17, 1999; National Academy of
Sciences Institute of Medicine, Marijuana and Medicine: Assessing the
Science Base, Washington, DC: National Academy Press (1999);
3. Lester Grinspoon, M.D., et al., Marihuana, The Forbidden Medicine.
4. R.C. Randall, Cancer Treatment & Marijuana Therapy, Washington, DC:
Galen Press (1990): 217-243; Kevin Zeese, Marijuana: Medical
Effectiveness Is Proven By Research, Falls Church, Virginia: Common
Sense for Drug Policy (1997); "Annual Report: Evaluation of Marijuana
and Tetrahydrocannabinol in Treatment of Nausea and/or Vomiting
Associated with Cancer Therapy Unresponsive to Conventional Anti-Emetic
Therapy: Efficacy and Toxicity," Board of Pharmacy, State of Tennessee,
(1983); McNeil, Robert P., "The Lynn Pierson Therapeutic Research
Program: A Report on Progress to Date," Behavioral Health Services
Division, Health and Environment Department, State of New Mexico,
(1983); "Seventeenth Annual Report of the Research Advisory Panel,"
prepared for the Governor and Legislature by the California Research
Advisory Panel, San Francisco, California, (1986); "Michigan Department
of Public Health Marijuana Therapeutic Research Project, Trial A
1980-81," Department of Social Oncology, Evaluation Unit. Michigan
Cancer Foundation, (1982), Kunter, Michael H., "Evaluation of the Use of
Both Marijuana and THC in Cancer Patients for the Relief of Nausea and
Vomiting Associated with Cancer Chemotherapy After Failure of
Conventional Anti-Emetic Therapy: Efficacy and Toxicity," as prepared
for the Composite State Board of Medical Examiners, Georgia Department
of Health, Emory University, Atlanta, Georgia (1983); "Annual Report to
the Governor and Legislature on the Antonio G. Olivieri Controlled
Substances Therapeutic Research Program," New York State Department of
Health, (1986) as it appeared in Cancer Treatment and Marijuana Therapy,
(1990).
5. "Annual Report: Evaluation of Marijuana and Tetrahydrocannabinol in
Treatment of Nausea and/or Vomiting Associated with Cancer Therapy
Unresponsive to Conventional Anti-Emetic Therapy: Efficacy and
 Toxicity," Board of Pharmacy, State of Tennessee; "The Lynn Pierson
Therapeutic Research Program: A Report on Progress to Date," Behavioral
Health Services Division, Health and Environment Department, State of
New Mexico; "Seventeenth Annual Report of the Research Advisory Panel,"
prepared for the Governor and Legislature by the California Research
Advisory Panel; Vincent Vinciguerra, et al., "Inhalation marijuana as an
antiemetic for cancer chemotherapy," New York State Journal of Medicine,
(1988): 525-527.
6. Institute of Medicine News, March 17, 1999.
7. Rick Doblin, et al., "Marihuana as Anti-emetic Medicine: A Survey of
Oncologists' Attitudes and Experiences," Journal of Clinical Oncology,
(1991): 1275-80; John Morgan, M.D. et al., Marijuana Myths, Marijuana
Facts: A Review of the Scientific Evidence, 20.
8. Commonwealth Department of Human Services and Health, The health and
psychological consequences of cannabis use, 195; Richard Kaslow, M.D.,
et al., "No Evidence for a Role of Alcohol or Other Psychoactive Drugs
in Accelerating Immunodeficiency in HIV-1 Positive Individuals," Journal
of The American Medical Association, (1989): 3424-29.
9. National Institues of Health, "Workshop on the Medical Utility of
Marijuana, Report to the Director," Washington, D.C. (1997): 4.
10. National Academy of Sciences Institute of Medicine, Marijuana as
Medicine: Assessing the Science Base, 4.22.
11. Institute of Medicine News, March 17, 1999. National Academy of
Sciences Institute of Medicine, Marijuana and Health, Washington, DC:
National Academy Press (1982): 140-151.
12. National Academy of Sciences Institute of Medicine, Marijuana and
Health, Washington, DC: National Academy Press (1982): 140-151.
13. Commonwealth Department of Human Services and Health, The health and
psychological consequences of cannabis use, 199.
14. House of Lords Select Committee on Science and Technology, "Ninth
Report;" Associated Press, November 12, 1998.
15. Institute of Medicine News, March 17, 1999.
16. National Academy of Sciences Institute of Medicine, Marijuana and
Medicine: Assessing the Science Base, 4.9.
17. "Synthetic marijuana-like drug eases pain - study," Reuters News
Service, September 23, 1998; "Study Explains How Marijuana Kills Pain,"
San Francisco Chronicle, September 24, 1998; "Easing the Agony:
Marijuana does more than merely make you stoned," The New Scientist
(United Kingdom), September 26, 1998; "Cannabinoid Anagesia Explained,"
The Lancet, September 26, 1998; "How Does Marijuana Kill Pain,"
Associated Press, October 4, 1998.
18. Society for Neuroscience, Press Conference: Marijuana & Analgesia,
October 26, 1997.
19. A. Hampson, et al., "Cannabidiol and delta-9-tetrahydrocannabinol
are neuroprotective antioxidants," Proceedings of the National Academy
of Sciences 95 (1998): 8268-8273; "Cannabis is stroke hope," The
Guardian (United Kingdom), July 4, 1998; "MarijuanaÕs Healing
Properties," Associated Press, July 5, 1998.
*****************************************
Un po' di estremi biblio, in ordine sparso e assolutamente non
esaustivi:
Merritt JC, Crawford WJ, Alexander PC, Anduze AL, Gelbart SS: Effect of
marihuana on intraocular and blood pressure in glaucoma. Ophthalmology
1980; 87:222-28
Chang AE, Schilling DJ, Stillman RC, Et Al: Delta-9-tetrahydrocannabinol
as an antiemetic in cancer patients receiving high dose methotrexate.
Ann Intern Med 1979; 91:819-24
Ungerleider JT; Andrysiak T: Therapeutic issues of marijuana and THC
(tetrahydrocannabinol). Int J Addict 1985 May; 20(5):691-9
Vinciguerra, Moore and Brennan, "Inhalation Marijuana as an
 Anti-emetic for Cancer Chemotherapy", NY State J. Med. 88
 (Oct 1988): 525-527.
 [78 percent of 56 patients with nausea resistant to standard
   drugs became symptom-free]
Chang et al., "Delta-9-THC as an Antiemetic in Cancer Patients
 Receiving High-dose Methotrexate", Ann. Internal Med. 91
 (1979): 819-824.
 [smoked THC more effective than oral, among other findings]
Doblin and Kleiman, "Marihuana as Anti-emetic Medicine: A Survey of
 Oncologists' Attitudes and Experiences", J. Clin. Oncology 9
 (191): 1275-1280.
 [44% had recommended illegal use of marijuana; half would
  prescribe it if it were legal]
Glaucoma:
Hepler and Frank, "Marihuana Smoking and Intraocular Pressure", JAMA
 217 (1971): 1392.
 [reduces IOP in patients with glaucoma]
Hepler, Frank, and Petrus, "Ocular Effects of Marijuana Smoking", in
 _The Pharmacology of Marijuana_, ed. Braude and Szara.  (NY:
 Raven, 1976), vol.2: 815-824.
 [no tolerance to IOP effect apparent over 94-day study]
Multiple sclerosis: (mostly case studies)
Clifford, "THC for Tremor in Multiple Sclerosis", Ann. Neurology 13
 (1983): 669-671.
 [case study of treatment of resistant and disabling tremor]
Meinck et al., "Effects of Cannabinoids on Spasticity and Ataxia in
 Multiple Sclerosis", J. Neurology 236 (1989): 120-122.
 [case study of marijuana for "motor and sexual handicaps"]
Lyman et al., "Delta-9-THC: A Novel Treatment for Experimental
 Autoimmune Encephalitis", J. Neuroimmunology 23 (1989): 73-81.
 [THC increased survival of this MS model from 2% (placebo)
  to 95%.  May *prevent* progression of MS!]
"spasms": (also speculative)
Malec, Harvey, and Cayner, "Cannabis Effect on Spasticity in Spinal
 Cord Injury", Arch. Physical and Med. Rehab. 63 (March
 1982): 116-118.
 [half of the patients surveyed used marijuana for muscle
  spasms]
Maurer et al., "Delta-9-THC Shows Antispastic and Analgesic Effects
 in a Single Case Double-Blind Trial", Eur. Arch. Psychiatry
 and Clin. Neurosci. 240 (1990): 1-4.
 [oral THC comparable in efficacy to codeine, but more
  effective at reducing muscle spasms]
labor pains: anecdotal, unless you consider nineteenth-century use.
But as to analgesia in general:
Noyes, Brunk, Avery, and Canter, "The Analgesic Properties of
 Delta-9-THC and Codeine", Clin. Pharm. and Therapeutics 18
 (1975): 84-89.
 [20 mg THC approximately as effective as 120 mg codeine in
  patients with advanced cancer]
Milstein, MacCannel, Karr, and Clark: "Marijuana-produced Changes in
 Pain Tolerance: Experienced and Non-experience Subjects",
 Int'l. Pharmacopsychiatry 10 (1975): 177-182.
 [analgesic effect greater in more experienced users]
Smoked THC vs. inhaled isoproterenol: Tashkin et al., "Effects of
 Smoked Marijuana in Experimentally Induced Asthma", Amer.
 Rvw. of Respiratory Disease 112 (1975): 377-386.
 [smoked THC had slower, longer effect]
Inhaled THC vs. isoproterenol: Vachon et al., "Airways response to
 Aerosolized Delta-9-THC: Preliminary Report", in _The
 Therapeutic Potential of Marijuana_, ed. Cohen and Stillman.
 [inhaled THC had faster, shorter effect]
Davis and Ramsey, "Antiepileptic Action of Marijuana-Active
 Substances", Federation Proceedings 8 (1949): 284-285.
 [2 of 5 cases of severe anticonvulsant-resistant grand mal
  epilepsy controlled]
Consroe, Wood, and Buchsbaum, "Anticonvulsant Nature of Marijuana
 Smoking", JAMA 234 (1975): 306-307.
 [case study: marijuana effective as adjunct to phenytoin and
  phenobarbital]
Cunha, Carlini, Periera, et al., "Chronic Administration of
 Cannabidiol to Healthy Volunteers and Epileptic Patients",
 Pharmacology 21 (1980): 175-185.
 [cannabidiol effective as adjunct to antiepileptic drugs]
**********************************
Poi su Repubblica del 15 marzo 1999 Claudia Moriglione scriveva:
*Fino a qualche tempo fa, si trattava solo di sperimentazioni isolate,
punte avanzate di un processo ancora tutto da costruire. E invece in un
paese considerato severo sul tema droga, e cioé gli Stati Uniti, la
distribuzione controllata di marijuana, per fini terapeutici, si sta
diffondendo a macchia d'olio: finora, una legge che istituisce "oasi" in
cui è concesso questo tipo di consumo è in vigore in ben cinque
territori, la "pioniera" California, l'Arizona, l'Oregon, Washington e
l'Alaska; ma, come rivela un'inchiesta del quotidiano nazionale "Usa
today", anche altrove l'attenzione è più che mai desta. Ecco allora che
iniziative del genere sono in cantiere in Nevada e nel Maine, dove
l'esito del dibattito è previsto per il prossimo novembre; in Colorado,
dove forse il provvedimento sarà varato entro il 2000; mentre la
discussione è stata appena avviata in Florida, Massachusetts, Michigan e
Ohio.
Un fenomeno sempre più esteso, dunque. E abbastanza "trasversale",
rispetto alla vocazione più o meno "liberal" delle varie popolazioni
coinvolte. Sembra insomma che, oltreoceano, sempre più si cerca di
guardare al problema in termini puramente scientifici, e non ideologici:
in quest'ottica, i fautori della cannabis, almeno per uso medico,
sottolineano le sue virtù calmanti e antidolorifiche, nei casi di cancro
e di altre malattie terminali. Un interesse che, dalla società civile, è
salito fino alle massime istituzioni: entro pochi giorni sono attesi i
risultati di uno studio sul tema, commissionato dalla Casa Bianca.
*******
Invece il 13 luglio 1998, sempre su Repubblica,  Claudia Di Giorgio
scriveva:
*Tra le foglie della marijuana
la speranza per l'Alzheimer
Il "cannabidiolo" riesce a prevenire i danni ai tessuti cerebrali, senza
provocare effetti allucinogeni
 E' tra le foglie seghettate della marijuana che si nasconde una
speranza di cura per chi è colpito da ictus cerebrale o soffre di
patologie neurodegenerative come l'Alzheimer o il Parkinson. La notizia
arriva dagli Stati Uniti, dove un gruppo di ricercatori guidato
dall'inglese Aidan Hampson e composto dal farmacologo italiano Maurizio
Grimaldi, da David Wink e dal premio Nobel Julius Axelrod, ha scoperto
che il cannabidiolo, una delle componenti attive della cannabis, riesce
a prevenire i danni ai tessuti cerebrali senza però provocare gli
effetti allucinogeni tipici della marijuana. Lo studio, i cui risultati
sono stati pubblicati nei Proceedings of the National Academy of
Sciences, riguarda per adesso solo cellule animali coltivate in vitro,
ma è destinato a rinfocolare le polemiche intorno all'uso medicinale
della cannabis.
Utilizzata a scopo terapeutico migliaia di anni prima di Cristo, oggi la
marijuana è illegale quasi in tutti i paesi occidentali, ma da anni
esiste un forte movimento, attivo soprattutto negli Stati Uniti, a
favore della sua reintroduzione come analgesico ed antiemetico,
specialmente per i malati di cancro e di Aids.
Lo studio di Hampson e Grimaldi è il primo a individuare le capacità
neuroprotettive di un componente della cannabis, per di più privo di
effetti psicoattivi. Da esso, in prospettiva, potrebbe arrivare un
farmaco capace di contrastare la terza causa di morte a livello
mondiale.
********
Dall'intervista con Grimaldi:
****
"I cannabinoidi sono dei forti antiossidanti, vale a dire che sono in
grado di neutralizzare le molecole ossidanti potenzialmente pericolose
specialmente a livello cerebrale. Quando si è colpiti da un ictus, una
parte consistente del danno non si verifica subito, in conseguenza della
mancanza di ossigeno al cervello, ma per colpa di una serie di reazioni
chimiche che scatenano la produzione agenti ossidanti fortemente
distruttivi, i quali disgregano le cellule un po' come se le
bruciassero. Uno di essi, ad esempio, è il perossido, che altro non è
che la comune acqua ossigenata. Come può constatare chiunque lo applichi
ad una ferita aperta per disinfettarla, si tratta di una sostanza molto
aggressiva, in grado di uccidere velocemente le cellule nervose. Per
intenderci, il perossido appartiene alla categoria dei radicali liberi,
di cui si parla molto per il ruolo che giocano nei processi di
invecchiamento dell'organismo in generale. I componenti attivi della
cannabis, la cui azione antiossidante sembra superiore persino a quella
della vitamine E e C, riescono a bloccare il perossido e gli altri
agenti lesivi che si basano sullo stesso meccanismo ossidante. In più,
data la grande diffusibilità cerebrale dei cannabinoidi, è facile farli
arrivare direttamente dove ce n'è più bisogno".
La vostra ricerca enfatizza in modo particolare il fatto che una delle
componenti della cannabis da voi studiata non ha effetti psicoattivi,
cioè non provoca le alterazioni mentali tipiche della marijuana. Di che
sostanza si tratta?
"E' il cannabidiolo, o CBD, il quale, a differenza di altri
cannabinoidi, non stimola il cervello a produrre le attività a cui si
devono gli effetti a cui allude, ad esempio gli effetti piacevoli
ricercati dai fumatori di marijuana. Tuttavia, mantiene intatto il suo
potere antiossidante e quindi permette di intervenire terapeuticamente
senza effetti collaterali e con una bassissima tossicità. Si tratta,
insomma, di un farmaco antiossidante e non psicoattivo in alternativa
alle sostanze psicoattive, provviste in questo caso dell'effetto
euforizzante indesiderato".
Il cannabidiolo può riparare i danni dell'ictus cerebrale?
"Purtroppo no. Ciò che è stato irrimediabilmente danneggiato non può,
almeno oggi, essere recuperato nel cervello. Riesce però, almeno secondo
le indicazioni che vengono dalla nostra ricerca, a salvare ciò che non è
ancora irreparabilmente distrutto. Tutto dipende, insomma, da quanto
rapidamente si riesce ad intervenire, e quindi a minimizzare il danno e
a favorire il massimo del recupero della funzione cerebrale".
A quali altre patologie potrebbe essere applicato?
"Devo precisare, anzitutto, che le nostre ricerche si sono svolte
esclusivamente in vitro, su cellule di ratto, e che prima di arrivare ad
eventuali applicazioni terapeutiche sull'uomo c'è ancora una lunghissima
strada da percorrere. Tuttavia, almeno teoricamente, il cannabidiolo
potrebbe essere impiegato in tutte le patologie neurodegenerative, tra
cui il morbo di Alzheimer, quello di Parkinson, oppure la corea di
Huntington ed anche nei traumi cranici gravi con sofferenza contusiva
del parenchima cerebrale. Lo spettro di possibili applicazioni è dunque
molto ampio e riguarda campi della patologia medica molto rilevanti sia
sul piano sanitario che su quello sociale".
Esistono studi in questo settore in Italia?
"Sì, anche in Italia ci sono gruppi che lavorano sui cannabinoidi ma
questo e' il primo studio che ne ha evidenziato l'effetto
neuroprotettivo e ne ha caratterizzato i meccanismi.******
okay, vi ho tediati abbastanza, vado nell'angolino ad aspettare che la
pillolozza sortisca gli effetti sperati :-)
Enjoy
Lauradolorante

Mah, anche questo non so quanto possa essere di interesse. A me
interessň, ma io sono curiosa di natura ;-)) Semmai vi fermate alle
prime dieci righe e non ci pensate piů ;-)))
Enjoy
Lauratrip
***********************************************************
History of the Medical Use of Marijuana
from the National Commission of Marijuana and Drug Abuse
The term "marihuana" is a word with indistinct origins. Some believe it
is derived from the Mexican words for "Mary Jane"; others hold that
"marihuana" comes from. the Portuguese word marigu-ano which means
"intoxicant" (Geller and Boas, 1969: 14). This chapter outlines the many
and varied uses of marihuana through history, and deals with its use in
medicine and its use as an intoxicant.
The experience of the 1960's might lead one to surmise that marihuana
use spreads explosively. The chronicle of its 3,000 year history,
however, shows that this "explosion" has been characteristic only of the
contemporary scene. The plant has been grown for fiber and as a source
of medicine for several thousand years, but until 500 A.D. its use as a
mind-altering drug was almost solely confined in India. The drug and its
uses reached the Middle and Near East during the next several centuries,
and then moved across North Africa, appeared in Latin America and the
Caribbean, and finally entered the United States in the early decades of
this century (Snyder, 1970: 129).
Meanwhile it had been introduced into European medicine shortly after
the invasion of Egypt by Napoleon and had a minor vogue as an intoxicant
for a time in France.
Regardless of which parts of the world are discussed, many of the same
problems and concerns about cannabis are common to all, including the
United States. Understanding its various uses during many centuries in
diverse countries and continents can perhaps lead to a better
understanding of marihuana in general.
History of the Medical Use
The history of cannabis products and their use has been long, colorful
and varied. "To the agriculturist, cannabis is a fiber crop; to the
physician, it is an enigma; to the user, a euphoriant; to the police, a
menace; to the trafficker, a source of profitable danger; to the convict
or parolee and his family, a source of sorrow" (Mikuriya, 1969: 34). The
fact is that cannabis has been held simultaneously in high and low
esteem at various times throughout recorded history, particularly in our
own times.
The volume of information available on the medical application of
cannabis is considerable. Occasionally certain references have been
condensed or deleted, but this should not detract from the completeness
of the report.
This historical survey of the medical uses of marihuana is introduced by
abroad overview of its use, including brief notes on current and
projected research, and then considers specific historical settings and
circumstances in ancient China, moving on to Egypt, India, Greece,
Africa, and the Western World.
Cannabis sativa has been used therapeutically from the earliest records,
nearly 5,000 years ago, to the present day (Mikuriya, 1969: 34) and its
products have been widely noted for their effects, both physiological
and psychological, throughout the world. Although the Chinese and Indian
cultures knew about the properties of this drug from very early times,
this information did not become general in the Near and Middle East
until after the fifth century A.D., when travelers, traders and
adventurers began to carry knowledge of the drug westward to Persia and
Arabia.
Historians claim that cannabis was first employed in these countries as
an antiseptic and analgesic. Other medical uses were later developed and
spread throughout the Middle East, Africa, and Eastern Europe.
Several years after the return of Napoleon's army from Egypt, cannabis
became widely accepted by Western medical practitioners. Previously, it
had had limited use for such purposes as the treatment of burns. The
scientific members of Napoleon's forces were interested in the drug's
pain relieving and sedative effects. It was used during, and to a
greater extent, following his rule in France, especially after 1840 when
the work of such physicians as O'Shaughnessy, Aubert-Roche, and Moreau
de Tours drew wide attention to this drug.
With the rise of the literary movement of the 1840-1860 period in France
(Gautier, Baudelaire, Dumas, etc.), cannabis became somewhat popular as
an intoxicant of the intellectual classes.
In the United States, medical interest in cannabis use was evidenced in
1860 by the convening of a Committee on Cannabis Indica of the Ohio
State Medical Society, which reported on its therapeutic applications
(McMeens, 1860: 1). Between the period 1840-1890, Walton states that
more than 100 articles were published recommending cannabis for one
disorder or another.
Concern about cannabis as an intoxicant led the government of India to
establish the India Hemp Commission of 1893-94 to examine the entire
question of cannabis use in India.
Paralleling the question over cannabis use in the latter half of the
19th century was the growing medical use of other medications superior
to cannabis in their effects and more easily controlled as to dose.
Consequently, medical use of cannabis declined and cannabis began to
lose support of the medical profession.
During the years between 1856-1937, cannabis lost its image as a
medicine and was left with a disreputable image as an intoxicant. Strong
public reaction coupled with a campaign in the public press led to a
federal anti-marihuana law in 1937. (The drug was illegal in many states
before 1937.) The issue of medical use remained active, however, and Dr.
William C. Woodward, Legislative Counsel to the AMA, an opponent of
cannabis use and the only physician to be a witness at the Taxation of
Marihuana hearings, stated:
There are exceptions in treatment in which cannabis cannot apparently be
successfully subsituted for. The work of Pascal seems to show that
Indian Hemp has remarkable properties in revealing the subconscious;
hence, it can be used for psychological, psychoanalytic and
psychotherapeutic research (Hearings, House of Representatives, 1937:
91).
Although cannabis drugs are generally regarded as obsolete and rarely
used in "western" medicine today, cannabis is "still used extensively in
the Ayruvedic, Unani and Tibbi systems of medicine of the
Indian-Pakastani subcontinent" ("The Cannabis Problem, 1962: 27). The
Pharmacopoeias of India mention cannabis use in the recent past. Two
preparations of cannabis, a liquid extract and a tincture, are listed in
the 1954 and 1966 Pharmacopoeias of India which contain descriptions of
cannabis and its extract and how it is made (Chopra & Chopra, 1957: 9).
A more recent source makes reference to the fact that "in contemporary
India and Pakistan, there continues to be widespread indigenous medical,
'quasi-medical,' and illicit use of both opium and cannabis" (Chopra &
Chopra, 1957: 12-13). Bouquet notes that hemp resin is occasionally used
in the native medicines of the countries where it is collected. He
points especially to India where, "the medical systems . . . make much
use of cannabis as a sedative, hypnotic, analgesic, anti-spasmodic and
anti-hemorrhoidal" (Bulletin on Narcotics, 1962:27).
According to the Canadian Commission of Inquiry into the Non-Medical Use
of Drugs:
There is no currently accepted medical use of cannabis in North America
outside of an experimental context. Although cannabis has been reported
to produce an array of possibly useful medical effects, these have
either not been adequately investigated, or can be replaced by using
other more readily available and convenient drugs. The natural product's
variability in potency and instability over time are among the factors
which have led to its disfavor in Western 20th century medicine....
cannabis has often been employed in the past, and is currently used
illicitly in North America, to reduce the secondary symptoms and
suffering caused by the flue and the common cold. These . . . alleged
therapeutic properties of cannabis have not been adequately studied in a
scientific context, and their general medical potential remains a matter
of conjecture (1970: 74).
Similar statements regarding cannabis are to be found in Marijuana,
edited by Erich Goode, and in the textbook Pharmacological Basis of
Therapeutics by Goodman and Gilman (1970: 300). Concerning therapeutic
uses, the latter states:
Although cannabis was once used for a wide variety of clinical disorders
and has even been demonstrated to have antibacterial activity, there are
at present no well substantiated indications for its use. It is no
longer an official drug. Preparations are rarely available (cannabis
preparation and synthetic THC are obtainable only for research
purposes), and prescriptions are regulated by special tax laws.
Hollister (1971: 27) lists a few difficulties of the therapeutic use of
cannabis:
The onset of the action of oral doses of THC is often rather slow,
contrary to that of conventional sedative-hypnotics.
Doses high enough to produce a marked hypnotic effect are almost always
accompanied by some degree of psychotomimetic-like perceptual disorders,
which many patients might find disagreeable.
The fine titration of dose required to provide sedative effects is
likely to be difficult.
The drug does not have novel effects compared with other
sedative-hypnotics.
The Department of Health, Education, and We] fare report to Congress in
1971, Marihuana and Health, repeats the statement of the Canadian
Interim Report of Inquiry into the Non-Medical Use of Drugs, and states:
"There is no currently accepted medical use of cannabis in the United
States outside of an experimental context" (DHEW: 1971: 27). Allen
Geller and Maxwell Boas (1969: 4) think that cannabis' "unsavory
reputation has largely stymied further research."
Despite the many statements discounting cannabis' therapeutic
usefulness, some authorities maintain that its medical value might be
reborn through further research and/or use. David Solomon, in his
foreword to The Marihuana Papers (1968: xxi) argues that:
Marihuana should be accorded the medical status it once had in this
country as a legitimate prescription item. After 1937, with the passage
of the Marihuana Tax Act and subsequent federal and state legislation,
it became virtually impossible for physicians to obtain or prescribe
marihuana preparations for their patients. Thus, the medical profession
was denied access to a versatile pharmaceutical tool with a history of
therapeutic utility going back thousands of years.
In a 1970 article, "Pot Facing Stringent Scientific Examination ,"
reference is made to Dr. Par who states that there are three areas in
which "chemical and animal experiments are under way:"
(1) Analgesia-mood elevation plus analgesic power may make useful drug.
(2) Blood pressure reduction-hypertension may be helped by new drugs
which lower the blood pressure by what seems to be action on the central
nervous system.
(3) Psychotherapeutic-new compounds are antidepressants and antianxiety
drugs (Culliton: 1970).
Mikuriya cites it studies concerning cannabis funded by the National
Institute of Mental Health in 1961. The studies were "either specialized
animal experiments, part of an observational sociologic study of a
number of drugs, or explorations of chemical detection methods"
(Mikuriya, 1969: 38).
Feinglass has pointed to four general categories into which the clinical
studies of marihuana could be divided (1968: 206-208). They are:
Anticonvulsant effects-treatment of tetanus, convulsions of rabies,
epilepsy, and infant convulsions.
Psychotherapeutic actions - appetite-stimulation, treatment of
depression, and as a sedative and hypnotic in reducing anxiety;
treatment of addiction.
Antibiotic properties.
Pain-affecting power.
Grinspoon suggests:
Very little research attention has been given to the possibility that
marihuana might protect some people from psychosis. Among users of the
drug, the proportion of people with neuroses or personality disorders is
usually higher than in the general population; one might therefore
expect the incidence of psychoses also to be higher in this group. The
fact that it is not suggests that for some mentally disturbed people,
the escape provided by the drug may serve to prevent a psychotic
breakdown (1969: 24).
Mikuriya lists many possible therapeutic uses of THC and similar
products in his paper "Marihuana in Medicine: Past, Present and Future."
He includes:
Analgesic-hypnotic, appetite stimulant, antiepileptic, antispasmodic,
prophylactic and treatment of the neuralgias, including migraine and tic
douloureaux, antidepressant-tranquillizer, anti-asthmatic, oxytocic,
anti-tussive, topical anesthetic, withdrawal agent for opiate and
alcohol addiction, child birth analgesic, and antibiotic (1968: 39).
China
The oldest known therapeutic description Of cannabis was by the Emperor
Shen-Nung in the 28th century B.C. in China, where the plant had long
been grown for fiber. He prescribed cannabis for beri-beri,
constipation, "female weakness," gout, malaria, rheumatism and
absentmindedness (Bloomquist, 1968: 19).
Egypt
In Egypt, in the 20th century B.C., cannabis was used to treat sore
eyes. Additional medical usage was not reported until much later.
India
Prior to the 10th century B.C., bhang, a cannabis preparation, was used
as an anesthetic and antiphlegmatic in India. In the second century
A.D., a Chinese physician, Hoa-Tho, prescribed it as an analgesic in
surgical procedures (Mikuriya, 1969: 34).
From the 10th century B.C. up to 1945 (and even to the present time),
cannabis has been used in India to treat a wide variety of human
maladies. The drug is highly regarded by some medical practitioners in
that country.
The religious use of cannabis in India is thought to have preceded its
medical use (Blum and Associates, II, 1969: 73; Snyder, 1970: 125). The
religious use of cannabis is to help "the user to free his mind from
worldly distractions and to concentrate on the Supreme Being" (Barber,
1970: 80).
Cannabis is used in Hindu and Sikh temples and at Mohammedan shrines.
Besides using the drug as an aid to meditation, it is also used to
overcome hunger and thirst by the religious mendicants. In Nepal, it is
distributed on certain feast days at the temples of all Shiva followers
(Blum & Associates, 1969, 11: 63).
The Hindus spoke of the drug as the "heavenly guide," "the soother of
grief." Considered holy, it was described as a sacred grass during the
Vedic period (Fort, 1969: 15). A reference to cannabis in Hindu
scriptures is the following:
To the Hindu the hemp plant is holy. A guardian lives in bhang ... Bhang
is the joy giver, the sky filer, the heavenly guide, the poor man's
heaven, the soother of grief ... No god or man is as good as the
religious drinker of Mang. The students of the scriptures of Benares are
given bhang before they sit to study. At Benares, Ujjain and other holy
places, yogis take deep draughts of Mang that they may center their
thoughts on the Eternal . . . By the help of Mang ascetics pass days
without food or drink. The supporting power of Mang has brought many a
Hindu family safe through the miseries of famine (Snyder, 1970: 125).
Greece
In ancient Greece, cannabis was used as a remedy for earache, edema, and
inflammation (Robinson, 1946: 382-383).
Africa
Cannabis was used in Africa to restore appetite and to relieve pain of
hemorrhoids, its antiseptic uses were also known to certain African
native tribes (O'Shaughnessy, 1842: 431). Various other uses, in a
number of countries, included the treatment of tetanus, hydrophobia,
delirium tremens, infantile convulsions, neuralgia and other nervous
disorders, cholera, menorrhagia, rheumatism, hay fever, asthma, skin
diseases, and protracted labor during childbirth.
The 19th Century
Documents of the 19th century report on the use of cannabis to control
diarrhea in cholera and to stimulate appetite. In his reports of the
late 1830's and early 1840's, O'Shaughnessy (1842: 431) stated that
tetanus could be arrested and cured when treated with extra large doses
of cannabis.
John Bell, M.D., Boston, reported enthusiastically in 1857, about the
effects of cannabis in the control of mental and emotional disorders as
opposed to the use of "moral discipline" to restrain the mentally ill.
Similarly, in 1858, Moureau. de Tours reported several case histories of
manic and depressive disorders treated with hashish (Walton, 1938: 3).
The Ohio State Medical Society's Committee on Cannabis Indica, convened
in 1860, reported that their respondents claimed cannabis successfully
treated neuralgic pain, dysmenorhea, uterine hemorrhage, hysteria,
delirium tremens, mania, palsy, whooping cough, infantile convulsions,
asthma, gonorrhea, nervous rheumatism, chronic bronchitis, muscular
spasms, tetanus, epilepsy and appetite stimulation (McMeens, 1860: 1).
The India Hemp Commission (1894: 174) likewise was informed of similar
medicinal uses for cannabis. Specific reports included the use of
cannabis as an analgesic, a restorer of energy, a hemostat, an ecbolic,
and an antidiaretic. Cannabis was also mentioned as an aid in treating
hay fever, cholera, dysentery, gonorrhea, diabetes, impotence, urinary
incontinence, swelling of the testicles, granulation of open sores, and
chronic ulcers. Other beneficial effects attributed to cannabis were
prevention of insomnia, relief of anxiety, protection against cholera,
alleviation of hunger and as an aid to concentration of attention.
MEDICAL USES IN THE 20TH CENTURY
Despite the fact that marihuana was made illegal in the United States in
1937, research has continued on the medical uses of marihuana. The
findings include various possible medical applications of cannabis and
its chemical derivatives.
One of the most recent and interesting findings (Frank, 1972) concerns
the effect of cannabis in reducing intraocular pressure. It was found
that as the dose of marihuana increased, the pressure within the eye
decreased by up to 30%. This occurred in normal persons as well as in
those with glaucoma, a disease of the eye in which increased intraocular
pressure may cause blindness. Much more research is necessary in
connection with this experimental clinical finding before final judgment
can be passed on such a possible therapeutic value.
During the past 20 years in western medicine, marihuana has been
assigned antibiotic activity; as a result, several studies relating to
this possibility have been undertaken. H. B. M. Murphy (1963: 20)
reported investigations in Eastern Europe. He stated that "it is alleged
to be active against gram positive organisms at 1/100,000 dilution, but
to be largely inactivated by plasma, so that prospects for its use
appear to be, confined to E. N. T. (ear, nose and throat) and skin
infections."
Dr. J. Kabelikovi (1952: 500-503) and his coworkers carried out tests on
rats, which were similar to tests carried out with penicillin in vitro.
The alcohol extract of cannabis was bacterially effective against many
gram-positive and one gram-negative microorganisms. It was also found
that a paste form of external application was successful. According to
Kabelikovi, "from a study of 2,000 herbs by Czechoslovakian scientists
it was found that cannabis indica (the Indian Hemp) was the most
promising in the realm of antibiotics."
In a 1959 publication of Pharmacie, Krejci stated: "From the flowering
tips and leaves of hemp, cannabis sativa var indica bred in Middle
Europe, were extracted a phenol and an acid fraction. From the acid
fraction, two acids were obtained, of which one preserved its antibiotic
properties" (p. 349). In another Czechoslovakian publication, Krejci
(1961: 1351-1353) referred to two additional samples with antibiotic
activity.
Sample I in Fig. 1 has been sufficiently identified as cannabidiolic
acid and sample 9 as cannabidiol. Both fractions show antibiotic
activity. The results of tests lead us to conclude that the
antibacterial action of cannabis sativa is not identical to the hashish
effect found, for example, in tetrahydrocannabinol. However, it was
established that cannabis sativa is effective as an antibiotic for local
infections.
Kabelik, Krejci, and Santavy (1960: 13) include in "Cannabis as a
Medicant" the various microorganisms against which cannabis is
effective.
Proof could be furnished that the cannabis extracts produce a very
satisfactory antibacterial effect upon the following microbes:
staphylococcus pyogenes aureus, steptococcus alpha haemolyticus,
streptococcus beta haemolyticus, enterococcus, diplococcus pneumonia, B.
anthracis, and corynebacterium diptheriae i.e., all of them
gram-positive microorganisms. Noteworthy is the effect upon
staphylococcus aureaus strains, which are resistant to penicillin and to
other antibiotics.
These authors also mentioned that E. coli (gramnegative bacteria) were
tested and found to be resistant to the cannabis extract. One of the
conclusions was "the possibility of utilizing the antibiotics locally
without any danger of producing resistant strains to other antibiotics
administered at the same time throughout treatment" (Kabelik, et al.,
1960: 13).
Veliky and Genest in "Suspension Culture of Cannabis Sativa," (1970)
reported that "the ethanol extract of cultured cells exhibited
antibiotic activity against Bacillus megatherium, staphlococcus aureaus
and escherichia coli" (p. 493).
Other reports said that "a pronounced antibiotic effect has been
observed in South America, where fresh leaves, after being ground, are
used as a poultice for furuncles, and in folk medicine in Europe for
treatment of erysipelas" (Kabelik, et al., 1960: 8).
This section on the -antibiotic uses of cannabis concludes with a
summary of several reports from various countries. In Pharmacopee Arabe:
"The ground-up seeds are mixed with bread for people with tuberculosis"
(Andrews and Vinkenoog, 1967: 145). In Czechoslovakia: "A preparation
from seed pulp was . . . introduced by Sirek to act as a roborant diet
in treatment of tuberculosis" (Kabelik, 1960: 8). "In Southern Rhodesia
the plant is used as an African remedy for malaria, anthrax, sepsis,
black water fever, dysentery, blood-poisoning, tropical quinine-malarial
haemoglobinuria, and a wart medicine" (Watt, 1961: 13). In Argentina:
Cannabis is considered a real panacea for tetanus, colic, gastralgia,
swelling of the liver, gonorrhoea, sterility, impotency, abortion,
tuberculosis of the lungs and asthma ... even the root-bark has been
collected in spring, and employed as a febrifuge, tonic, for treatment
of dysentery and gastralgia, either pulverized or in form of decoctions.
The root when ground and applied to burns is said to relieve pain. Oil
from the seeds has been frequently used even in treatment of cancer . .
. (Kabelik, 1960: 8).
In 1949, Davis and Ramsey reported a study of the effect of THC on
epileptic children. "The demonstration of anticonvulsant activity of the
tetrahydrocannabinol (THC) congeners by laboratory tests (Loewe and
Goodman, Federation Proc., 6: 3521 1947) prompted clinical trial in five
institutionalized epileptic children" (David and Ramsey, 1949: 284-285).
Of these five children, all had severe symptomatic grand mal epilepsy
with mental retardation; three also had cerebral palsy; and three had
focal seizure activity. The EEG tracings were reported to be grossly
abnormal in all five children. The results after treatment with
homologues of THC, were reported as follows:
Three children-responded at least as well as to previous therapy.
Fourth child-almost completely seizure free. Fifth child-entirely
seizure free.
As a result of their study, David and Ramsey (1949: 284-285) felt that
"the cannabinols herein reported deserve further trial in
non-institutionalized epileptics."
Dr. Vansim of Edgewood Arsenal has written in a recently published book
"Psychotomimetic Drugs," that the synthetic preparations of cannabis are
of interest. There are three areas where they may be of definite use in
medicine (Efron, 1969: 333-334). One concerns the use of a cannabis
analogue which Dr. Walter S. Loewe reported very effective in preventing
grand mal seizures if given in small doses.
The second use refers to cannabis as an antidepressant. Straub (Walton,
1938: 3), Adams (1942: 726-727), and Stockings (1947, 920-922) point to
the possible use of cannabis and cannabis analogues in relieving
dysphoria in depressed patients. Other authors (Parker and Wrigley,
1950: 278-279) had lesser success but recommended further research in
this field.
A report from London in 1968 suggests that cannabis treats the symptoms
and not the cause by focusing the user's attention on his anxieties and
pains without helping him to resolve them (Report by the Advisory
Committee, 1968: 11).
The third use is described by Douthwaite, who used hashish in 1947 "for
reducing of anxiety and tension in patients with duodenal ulcer" (Pond,
1948: 279).
A report in a 1965 issue of Medical News ("Cardiac Glycocides," p. 6)
suggests cannabis as treatment for a specific form of malignancy.
Cannabis is recognized as an appetite stimulant, which suggests that the
drug might be useful in the treatment of pathological loss of appetite
known as anorexia nervosa (Grinspoon, 1969: 21). Similar symptoms exist
in terminal cancer patients who, when treated with cannabis over a short
period of time, demonstrated stimulation of appetite, euphoria,
increased sense of well-being, mild analgesia and an indifference to
pain which reduced the need for opiates (DHEW, 1971: 11).
Cannabis has been recently proposed as an adjunct in the treatment of
alcoholics and drug addicts. Roger Adams (1942: 726-727) and Todd
Mikuriya (1970a: 187-191) noted that the substitution of smoked cannabis
for alcohol may have rehabilitative value for certain alcoholics.
Regarding the use of cannabis analogue in the treatment of drug, alcohol
and depressive state withdrawal, Thompson and Proctor (1953: 520523)
report the following:
Depressive States:
20 cases of neurotic depression-4 improved (20%)
6 cases of psychotic depression-none improved (00%)
Post-Alcoholic Cases:
70 cases--59 reported clinical alleviation of symptoms (84%)
Drug Cases:
6 cases of barbiturate addiction-4 reported amelioration of symptoms
(66%)
4 cases of dilaudid addiction-3 reported alleviation (75%)
2 cases of pantopan and one paregoric addiction-all reported smooth
withdrawal (100%)
12 cases of Demerol addiction-10 withdrawals in one week (83%)
6 cases of morphine addiction-2 withdrawals without unpleasant symptoms
(33%)
The doctors concluded that "Pyrahexyl (a synthetic cannabis-like drug)
and related compounds are beneficial in the treatment of withdrawal
symptoms from the use of alcohol to a marked degree, and in the
treatment of withdrawal symptoms from the use of opiates to a less
marked, but still significant degree" (Thompson & Proctor,
1953:520-523).
Drs. Allentuck and Bowman (1942) undertook a study of the use of
marihuana in the morphine abstinence syndrome. They stated:
A series of cases were selected from among drug addicts undergoing
treatment. . . . Comparative results were chartered for the gradual
withdrawal, total withdrawal, and marihuana derivative substitution, as
methods of treatment. . . . 49 subjects were studied. The results in
general, although still inconclusive, suggest that the marihuana
substitution method ameliorated or eliminated (the symptoms) sooner, the
patient was in a better frame of mind, his spirits elevated, his
physical condition was more rapidly rehabilitated, and he expressed a
wish to resume his occupation sooner (p. 250).
In his study of the medical application of cannabis for Mayor
LaGuardia's committee, Dr. Samuel Allentuck reported "favorable results
in treating withdrawal of opiate addicts with tetrahydrocannabinol
(THC), a powerful purified product of the hemp plants" (Mikuriya, 1969:
38).
Roger Adams' detailed studies, as reported by Dr. C. K. Himmelsbach in
his 1944 article "Treatment of the Morphine Abstinence Syndrome with a
Synthetic Cannabis-Like Compound" (1944:26), indicated that "withdrawal
manifestations were considered to be mild. The reported therapeutic
value of marihuana was attributed to improved appetite, greater sleep,
euphoria, and a reduction of the intensity or elimination of abstinence
phenomena." Himmelsbach, however, had lesser success when he studied the
effect of a "pyrahexyl" compound on the morphine abstinence syndrome, as
noted by his conclusions that:
(1) Pyrahexyl compound appears to possess considerable cannabis-like
effect when administered orally, but little or none when given
intramuscularly.
(2) When given by mouth In definitely effective amounts pyrahexyl
compound had no appreciable ameliorative effect on the opiate abstinence
syndrome (P. 29).
The New York City Mayor LaGuardia's Committee on Marihuana (1944:
147-148) reported two possible therapeutic applications of marihuana:
The first is the typical euphoria-producing action which might be
applicable in the treatment of various types of mental depression; the
second is the rather unique property which results in the stimulation of
appetite. In the light of this evidence and in view of the fact that
there is a lack of any substantial Indication of dependence on the drug,
It was reasoned that marihuana might be useful in alleviating the
withdrawal symptoms in drug addicts. However, the studies here described
were not sufficiently complete to establish the value of such treatment
. . . .
A study was then undertaken at Riker's Island (N.Y.) Penitentiary
involving 56 morphine or heroin addicted inmates. Two groups were
equally matched according to age, physical condition, length and
intensity of habit, etc. One group received no treatment or Magendie's
solution, and the other received 15 mg. of THC and/or placebo.
"The impression was gained that those who received tetrahydrocannabinol
had less severe withdrawal symptoms than those who received no treatment
or who were treated with Magendie's solution" the report stated.
However, the report further said that this alleged therapeutic use of
marihuana should be "investigated under completely controlled
conditions" before meaningful conclusions can be developed (New York
City Mayor, AU: 147-148).
Some reports indicate that cannabis helps relieve labor pains. Such uses
are reported among native tribes in South Africa and Southern Rhodesia:
"The Suto tribe fumigates the parturient woman to relieve pain;"the
Sotho women of Basutoland "are reported as smoking cannabis to stupefy
themselves during childbirth," and have also been known to "administer
the ground-up achene with bread or mealiepap to a child during weaning"
(Watt, 1962:13).
The use of cannabis in the treatment of leprosy has been described in a
1939 dictionary of Malayan medicine: "Seeds of Hydnocarpus anthelmintim
... form the basis of the Tai Foon Chee treatment of leprosy. After
crushing and sieving, they are mixed with cannabis indica in the
proportion of two parts of the seeds to one of Indian hemp" (Andrews and
Vinkenoog, 1967: 146). Likewise, Watt and Breyer-Brandwijk quote Pappe
that "the early colonist employed a decoction in the treatment of
chronic cutaneous eruptions, possibly in leprosy (Andrews and Vinkenoog,
1967: 146).
Kabelik, Krejci, and Santavy have reported favorable results "in
stornatitis aphtosa, gingivitis, and in paradentoses with a mouthwash of
the following composition: Tinct. Cannabis 20.0, Tinct. Chamomillae,
Tinct. jernmarum populi (or another tan for example, Tinct. Gallarum) aa
10.0 to be applied in the form of sprays or linaments to the inside of
the mouth" (Kabelik et al., 1960: 13).
In reference to the use of cannabis, Chopra and Chopra (1957: 12-13)
listed some preparations used in the practice of indigenous medicine in
India in 1957. They summarize their article "The Use of the Cannabis
Drugs in India" (1957: 12-13) by saying:
. . . with regard to the use of cannabis in Indian indigenous medicine
at the present time, it may be said that It was and still is fairly
extensively used in both the Ayurvedle (Hindu) and Tibbi (Mohammedan)
systems of medicine as an anodyne, hypnotic, analgesic and
antispasmodic, and as a remedy for external application to piles. It is
also used in the treatment of dysmennorhoea, rheumatism, chronic
diarrhoea of the sprue type, gonorrhoea, malaria and mental diseases on
the advice of itinerant practitioners of Indigenous medicine as well as
quacks who roam about the country. For medicinal purposes the drug is
administered by mouth and hardly ever by smoking.
The use of cannabis drugs in indigenous medicine has greatly declined
during recent years for two reasons-firstly, because of the rapid
deterioration of the potency of cannabis drugs in storage, the specimens
available on the market being often Inert and quite useless; secondly,
because a number of potent and effective drugs of the type used In
western medicine are now available on the market and are used quite
extensively by the practitioners of indigenous medicine in place of
cannabis, for the anodyne, sedative and hypnotic effects. In the rural
areas of India, however, the practitioners of indigenous medicine still
use cannabis quite extensively In their practice.
The same article lists a variety of uses in which cannabis is employed
therapeutically in veterinary medicine.
Dr. R. N. Chopra (1940: 361) reports the following medicinal household
uses of Indian Hemp:
The hemp drugs are popularly used as household remedies in the
amelioration of many minor ailments. A mild beverage made from bhang
leaves is believed to sharpen appetite and to help digestion. Indian
hemp Is commonly used as a smoke and as a drink for its supposed
prophylactic value against marihuana in malarious tracts. Bhang
beverages form one of the popular household remedies for gonorrhoea and
dysuria. On account of their mild diuretic and sedative properties these
drinks probably give a certain amount of symptomatic relief. Likewise,
the use of bhang for dysmenorrhea, asthma, and other spasmodic
conditions is not uncommon. A poultice made from fresh leaves is a
common household remedy for painful affections of the eyes,
conjunctivitis, swollen joints, orchitis, and other acute inflammatory
conditions.
Tuberculosis, anthrax, tetanus, and menstrual cramps are among the
miscellaneous medical uses of cannabis reported. Reports from Mexico
indicate the use of marihuana smoking "to relax and to endure heat and
fatigue" (Mikuriya, 1969: 37).
Kabelik et al. (1960: 13) also discuss other varied uses of cannabis.
In human therapy the best results have been obtained with the following
medicaments combined with substances derived from cannabis: dusting
powder together with boric acid (otitis), ointment (staphylococcus
infected wounds, staphylodermia and so on), ear drops (otitis chron.),
alcohol solutions with glycerine (treatment of rhagades on the nipples
of nursing women-prevention of staphylococcic mastitis,) aqueous
emulsions (sinusitis), dentin powder with the IRC (Isolated Resin from
Cannabis) (caries). The preparations mentioned above have been already
tested clinically, and will eventually be made available for production.
. . . the experiments made in clinical practice, particularly in
stomatology, otorhinolaryngology, gynecology, dermatology, phisiology,
with some pharmaceutical preparations containing antibacterial
substances from cannabis have been reported. Attention has been drawn to
the advantageous utilization of the active substances from cannabis in
veterinary medicine, and particularly in preventive medicine for
anthropozoonoses.
Murphy (1963: 20) refers to an article by Lang, "Treatment of Acute
Appendicitis with a Mixture of Ma Jen," which says "the drug has
apparently been used in China for the treatment of appendicitis." The
Xosa tribe in South Africa "employs it for treatment of inflammation of
the feet" (Kabelik et al., 1960: 7), while the Mfengu and Hottentot use
the plant as a snake-bite remedy (Watt, 1962: 13).
Other therapeutic uses attributed to marihuana are for the treatment of
migraine headaches, as an analgesic, and as a hypnotic. Hollister (1971:
28) stated that "other uses which have been proposed for marihuana
include the treatment of epilepsy, as prophylaxis for attacks of
migraine or facial neuralgia, or as a sexual stimulant."

:-))
Ho trovato questo....mmmmmmh, secondo me dovremo continuare a farci
*legalmente* coi triptani e amenità similari per un bel pezzo ancora!
;-))) Mi sembra che, al di là di quanto si strombazzi, sia tutto ancora
abbastanza aneddotico, o basato su evidenze significative ma ancora
preliminari e tutte da dimostrare e confermare, se non altro per quel
che riguarda l'utilizzo dei cannabinoidi nel trattamento delle cefalee.
In altri campi di applicazione la validità terapeutica della Cannabis e
dei suoi derivati è stata invece convalidata da studi clinici in doppio
cieco (antinausea in chemioterapizzati e stimolazione dell'appetito in
soggetti con "wasting syndrome" da AIDS). Esistono poi anche tutta una
serie di studi *minori*, con soggetti campione troppo ridotti e non
condotti secondo i trials medici canonici, che non consentono di andare
oltre alle supposizioni e che devono essere verificati ed approfonditi.
C'è poi il non irrilevante problema della via di somministrazione,
perchè non è che ci si accende un cannone e via :-)))
Oh, se vi stò scassando las pelotas ditelo pure, che mica mi offendo io
:-) Però prima che mi fermiate vi appiccico, in un altro post, un
interessante studio italiano. Interessante per chi?? Direte voi :-))) De
gustibus... ;-))))
Enjoy
Lauracefalalgicaperilquintogiornoconsecutivo
**********************************************************
Cannabis for Migraine Treatment The Once and Future Prescription?
An Historical and Scientific Review
Abstract:
Cannabis, or marijuana, has been used for centuries for both symptomatic
and prophylactic treatment of migraine. It was highly esteemed as a
headache remedy by the most prominent physicians of the age between 1874
and 1942, remaining part of the Western pharmacopoeia for this
indication even into the mid twentieth century. Current ethnobotanical
and anecdotal references continue to refer to its efficacy for this
malady, while biochemical studies of THC and anandamide have provided a
scientific basis for such treatment.
Keywords:
migraine, headache, Cannabis, marijuana, dronabinol, ethnobotany
Ethan Russo, M.D.
Clinical Child and Adult Neurologist
Clinical Assistant Professor of Medicine, University of Washington
Adjunct Associate Professor of Pharmacy, University of Montana
Address:
Department of Neurology
Western Montana Clinic
515 West Front Street
Missoula, MT 58907-7609
Introduction:
One of the basic tenets of medical history is that remedies fall in and
out of favor. Once supplanted, most pharmaceuticals fail to re-attain a
position of prominence. Very few are popular for many decades. Not many
physicians today are aware of the prominence that Cannabis drugs once
held in medical practice. Problems with quality control and an
association with perceived dangerous effects sounded the death knell for
Cannabis as a recognized Western therapy. Other medicines that are far
more potentially damaging than Cannabis remain in our pharmocopeias
because of recognized medical indications: opiates for pain control,
amphetamines for narcolepsy and attention deficit hyperactivity
disorder, etc. Thalidomide, which was banned due to its role in birth
defects, may be effecting a therapeutic revival. Even the lowly leech is
once again the object of serious medical investigation. This study will
examine the history of Cannabis use for one indication, that of headache
treatment, its scientific rationale, and possible future as an
alternative therapeutic agent.
Historical and Ethnobotanical Usage of Cannabis in Migraine Treatment:
Headaches have likely afflicted man throughout history. Archeological
records substantiate an ancient association between man and the plant
genus Cannabis, plant family, Cannabaceae. Its botanical origin has been
debated to be as far east as China, but most experts suspect it to be in
Central Asia, possibly in the Pamir Plains (Camp, 1936). Some botanists
have maintained Cannabis as monotypic genus, while others (Schultes et
al., 1974) have provided convincing documentation of three Cannabis
species: sativa, indica, and ruderalis. All contain the psychoactive
chemical delta-9-tetrahydrocannabinol (THC) in varying degree.
Use of Cannabis fibers to make hemp has been documented as early as 4000
BC by Carbon-14 dating (Li, 1974), and that use has been maintained
continuously up to the present day. Its seed grain was an ancient human
foodstuff, which may have lead to an early recognition of its medicinal
use. The first records of the latter seem to be in the Pên-tsao Ching, a
traditional herbal written down in the first two centuries AD, but said
to be based on the oral traditions passed down from the Emperor
Shên-nung in the third millenium BC. The text noted that the plant
fruits "if taken in excess will produce hallucinations (literally
"seeing devils")(Li, 1974). The Zend-Avesta, the holy book of
Zoroastrianism, which survives only in fragments, dating from around 600
BC in Persia, alludes to the use of Banga in a medical context, and it
is identified as hemp by the translator (Darmesteter, 1895).
The classical Greek literature also documents knowledge of the
inebriating actions of Cannabis. Herodotus, circa 450 BC, described how
the Scythians set up tents, heated stones and threw Cannabis seeds or
flowering tops upon them to create a vapor, and "the Scythians,
delighted, shout for joy." The Greek physicians Dioscorides and Galen
expounded on medical indications, mainly gastrointestinal (Brunner,
1977).
The Atharva Veda of India, dated to between 1400 and 2000 BC referred to
a sacred grass, bhang, and medicinal references to Cannabis were cited
by Susrata in the sixth to seventh centuries AD (Chopra and Chopra,
1957) and included indication for its use for headache (Dwarakanath,
1965). O'Shaughnessy introduced the medical use of Cannabis indica, or
"Indian hemp," to the West in 1839 (Walton, 1938; Mikuriya, 1969). His
treatise on the subject supported the utility of an extract in patients
suffering from rabies, cholera, tetanus, and infantile convulsions.
Throughout the latter half of the nineteenth century, many prominent
physicians in Europe and North America advocated the use of extracts of
Cannabis indica for the symptomatic and preventive treatment of
headache.
Proponents included Weir Mitchell in 1874, E.J. Waring in 1874, Hobart
Hare in 1887, Sir William Gowers in 1888, J.R. Reynolds in 1890, J.B.
Mattison in 1891, et al., (Walton, 1938; Mikuriya, 1969). Cannabis was
included in the mainstream pharmacopeias in Britain and America for this
indication. As late as 1915, Sir William Osler, the acknowledged father
of modern medicine, stated of migraine treatment (Osler, 1915),
"Cannabis indica is probably the most satisfactory remedy. Seguin
recommends a prolonged course." This statement supports its use for both
acute and prophylactic treatment of migraine.
In 1916, in a quotation attributed to Dr. Dixon, Professor of
Pharmacology, Kings' College, and the University of Cambridge (Ratnam,
1916), reference is specifically made to the therapeutic effects of
smoked Cannabis for headache treatment. He stated, "In cases where
immediate effect is desired, the drug should be smoked, the fumes being
drawn through water. In fits of depression, mental fatigue, nervous
headache, feelings of fatigue disappear and the subject is able to
continue his work refreshed and soothed."
In the years that followed, Cannabis came to be perceived as a drug of
abuse, smoked by certain classes of people as "marijuana" or
"marihuana." Nevertheless, it retained adherents for a variety of
medical indications, throughout the early decades of the twentieth
century. In 1938 Robert Walton published a comprehensive review of
Cannabis, with botanical, historical, chemical and political discussions
(Walton, 1938). After discussing the abuse issue, he stated his belief
that the political action that had rendered marijuana illegal in the
U.S.A. in 1937 (and which the American Medical Association vigorously
opposed), should not serve to prohibit further medical use and
scientific
investigation of Cannabis' possible applications. Walton referred to
twelve major authorities on its efficacy for migraine, and only one
detractor.
In 1941, Cannabis preparations were dropped from the United States
Pharmacopeia (U.S.P.), but the following year, the editor of the Journal
of the American Medical Association still advocated oral preparations of
Cannabis in treatment of menstrual (catamenial) migraine (Fishbein,
1942). This practitioner seemed to prefer Cannabis to ergotamine
tartrate, which remains in the migraine armamentarium, some fifty-five
years later. Thus, Cannabis was touted in eight consecutive decades in
the mainstream Western medical literature as a, or the, primary
treatment for migraine. As late as 1957, despite governmental controls
in that country, Cannabis drugs retained a role in the indigenous
medicine of India (Chopra and Chopra, 1957), and other countries.
In the 1960's marijuana moved to center stage of Western consciousness,
and attained a degree of notoriety sufficient to render medical usage
inconceivable to most. Medical research has resumed only recently,
spurred on by anecdotal reports of patients who serendipitously
discovered its benefits on their maladies.
Modern Research Developments on Cannabis:
In 1974, the first of several studies appeared examining issues of pain
relief with Cannabis (Noyes and Baram, 1974). This article examined five
case studies of patients who volitionally experimented with the
substance to treat painful conditions. Three had chronic headaches, and
found relief by smoking Cannabis that was comparable, or superior to
ergotamine tartrate and aspirin.
One subsequent study of Cannabis pertained to pain tolerance in an
experimental protocol (Milstein et al., 1975). A statistically
significant increase in pain threshold was observed after smoking
Cannabis in both naïve (8% increase) and experienced subjects (16%
increase). Another trial involved oral THC in cancer patients (Noyes et
al., 1975a). They observed a trend toward pain relief with escalating
doses significant to the P<0.001 level. The peak effect occurred at
three hours with doses of 10 and 15 mg., but not until five hours after
ingestion of 20 mg. Subsequently, the analgesic effect of THC was
compared to codeine (Noyes et al., 1975b). In essence, 10 mg. of oral
THC vs. 60 mg. of codeine, and 20 mg. of THC vs. 120 mg. of codeine
relieved the subjective pain burden of patients by similar
decrements. The effects of 10 mg. of THC were well tolerated, but at 20
mg., sedation, and psychic disturbances bothered many of the elderly
Cannabis-naïve subjects.
In the 1980's more comprehensive data on pharmacological effects of
Cannabis and its derivative, THC became available. In 1983, research
with varying potencies of smoked Cannabis demonstrated some correlation
between serum THC levels and subjective "high" (Chiang and Barnett,
1983). Additionally, experimental subjects were able to distinguish the
potency of the various samples with accuracy.
In a forensic review (Mason et al., 1985), the issue of marijuana's
effect on driving was addressed, and it was indicated that isolated
reports of adverse outcomes secondary to impairment by Cannabis as a
sole inebriant were rare. The authors concluded that there was no
suitable correlation between plasma or blood levels of THC and the
degree of apparent impairment a human might exhibit.
In 1986 the journal Pharmacological Reviews devoted an entire issue to
Cannabis and cannabinoids. In "Cellular Effects of Cannabinoids"
(Martin, 1986), the author noted their analgesic properties, but
reported that the mode of action was not blocked by naloxone, and seemed
to work independently of opioid mechanisms.
Another article examined pharmacokinetics (Agurell et al., 1986). Many
facets were presented, including their findings that smoking a standard
marijuana cigarette destroyed 30% of available THC.
The final article of the issue was entitled "Health Aspects of Cannabis"
(Hollister, 1986). Pertinent points made included dose delivery
efficiency of THC by inhalation of 10% in marijuana-naïve vs. 23% in
experience smokers. Oral bioavailability for THC was only about 6%, and
onset of effects was not seen
for 30-120 minutes.
Smoking of massive Cannabis doses daily for a prolonged period produced
lower intraocular pressure, serum testosterone levels, and airway
narrowing, but no chromosomal aberrations, or impairment of immune
responses were noted (Cohen, 1976). Other "marijuana myths" were
unsupported by careful review of the literature. While aggravation of
pre-existing psychotic conditions by marijuana use was documented, no
cause and effect relationship was noted.
Similarly, chronic use studies in Jamaica (Comitas et al., 1976),
revealed no deficits in worker motivation or production. Two studies of
brain computerized tomography (CT scan) refuted prior claims of heavy
use producing cerebral atrophy (Co et al, 1977; Kuehnle et al., 1977).
With respect to behavior, Hollister refuted the tenet that depicted
Cannabis as a contributor to violent and aggressive behavior. Concerning
addiction, he noted minimal withdrawal symptoms of nausea, vomiting,
diarrhea, and tremors in some experimental subjects after very heavy
chronic usage. Such effects were brief and self-limited.
The next year, an article entitled "Marijuana and Migraine" (El-Mallakh,
1987), presented three cases in which abrupt cessation of frequent,
prolonged, daily marijuana smoking were followed by migraine attacks.
One patient noted subsequent remission of headaches with episodic
marijuana use, while conventional drugs successfully treated the others.
The author hypothesized that THC's peripheral vasoconstrictive actions
in rats, or its action to minimize serotonin release from the platelets
of human migraineurs (Volfe et al., 1985), might explain its actions.
In 1988 action was initiated through the DEA to reclassify marijuana to
Schedule 2, potentially making it available for prescription to
patients. The DEA administrative law judge, Francis Young, reviewed a
tremendous amount of testimony from patients, scientists, and
politicians in rendering his ruling. Although a medical indication of
marijuana for migraine was not considered, its use was approved as an
anti-emetic, an anti-spasticity drug in multiple sclerosis and
paraplegia, while its utilization in glaucoma was considered reasonable.
He stated, "By any measure of rational analysis marijuana can be safely
used within a supervised routine of medical care."
In 1992, a study examined subjective preferences of experimental
subjects smoking Cannabis, or ingesting oral THC (Chait and Zacny,
1992). Ten subjects in two trials preferred smoking active Cannabis over
placebo, while ten of eleven preferred oral THC to placebo. These
results call into serious question the plausibility of true blinding
with placebo preparations in prospective therapeutic drug studies of
marijuana, especially when smoked.
A more profound understanding of Cannabis, THC, and their actions in the
brain has occurred with the discovery of an endogenous cannabinoid in
the human brain, arachidonylethanolamide, named anandamide, from the
Sanskrit word ananda, or "bliss" (Devane et al., 1992). This ligand
inhibits cyclic AMP in its target cells, which are widespread throughout
the brain, but demonstrate a predilection for areas involved with
nociception (Herkenham, 1993). The exact physiological role of
anandamide is unclear, but preliminary tests of its behavioral effects
reveal actions similar to those of THC (Fride and Mechoulam, 1993).
Additional research sheds light on possible mechanisms of therapeutic
action of the cannabinoids on migraine. An inhibitory effect of
anandamide and other cannabinoid agonists on rat serotonin type 3
(5-HT3) receptors was demonstrated (Fan, 1995). This receptor has been
implicated as a mediator of emetic and pain responses. In 1996, a study
in rats demonstrated antinociceptive effects of delta-9-THC and other
cannabinoids in the periaqueductal gray matter (Lichtman et al., 1996).
The PAG has been frequently cited as a likely anatomic area for migraine
generation (Goadsby and Gundlach, 1991).
The understanding that Cannabis and THC effect their actions through
natural cerebral biochemical processes has intensified the public debate
on medical benefits of marijuana. In 1993, a book entitled Marihuana:
The Forbidden Medicine (Grinspoon and Bakalar, 1993) examined a variety
of claims for ailments treated by marijuana, and included an entire
section on migraine. One clinical vignette discussed at length the
medical odyssey of a migraineur through failures with standard
pharmaceuticals, and ultimate preference for small doses of smoked
marijuana for symptom control.
The editor of the British Medical Journal (Smith, 1995) recently wrote
an editorial espousing moderation in the drug war. The Journal of the
American Medical Association published a supportive commentary in 1995
(Grinspoon, 1995). The author rated the respiratory risks potent medical
marijuana as low, and pointed out the contradiction of the Schedule 2
status of synthetic THC, dronabinol, while its natural source, marijuana
remained a Schedule 1 product, and thus unavailable for legal use to
patients who might prefer its easier dose titration. Grinspoon raised as
a theoretical possibility the synergistic effects of the whole plant and
its components as compared to pure THC.
The American Journal of Public Health issued its plea (AJPH, 1996), to
allow access to medical marijuana as an Investigational New Drug (IND).
The Australian government (Hall et al., 1995) recently compiled a recent
exhaustive review of sequelae of Cannabis use. In the summary, it
states:
Acute Effects:
anxiety, dysphoria, panic and paranoia, especially in naïve users;
cognitive impairment, especially of attention and memory, for the
duration of intoxication; psychomotor impairment, and probably an
increased risk of accident if an intoxicated person attempts to drive a
motor vehicle, or operate machinery; an increased risk of experiencing
psychotic symptoms among those who are vulnerable because of personal or
family history of psychosis; an increased risk of low birth weight
babies if cannabis is used during pregnancy. In a current review of over
65,000 patient records in an HMO (Sidney et al., 1997), little effect of
smoked Cannabis was seen on morbidity and mortality of non-AIDS
patients.
Surely, not all in the medical establishment are convinced of the
relative safety or benefit of Cannabis for medical usage. In a recent
review (Voth and Schwartz, 1997) the authors concluded, "The evidence
does not support the reclassification of crude marijuana as a
prescribable medicine." However, their study was far from comprehensive,
confining itself to the clinical issues of nausea, appetite stimulation,
glaucoma, and spasticity.
Methodologically, it was flawed in that only the medical literature from
1975-1996 was screened, an era during which it was quite difficult to
initiate research seeking to support medical indications for Cannabis.
These authors did not examine migraine as an indication for Cannabis
usage, nor did they review the extensive literature of the past. The
debate on the subject of "medical marijuana" has extended to the World
Wide Web, and includes myriad postings with anecdotal attestations of
efficacy for a variety of indications.
Various investigators have examined the roles of different smoke
delivery systems (Gieringer, 1996). From these studies, it is clear that
vaporization of marijuana makes it possible to deliver even high doses
of THC to the lungs of a prospective patient far below the flash point
of the Cannabis leaf, eliminating a fair amount of smoke, containing tar
and other possible carcinogens. However, the marijuana joint was about
as effective as any examined smoking device, including waterpipes, in
providing a favorable ratio of THC to tar and other by-products of
smoking. A standardized smoking procedure for use of Cannabis in medical
research has been developed (Foltin et al., 1988). Suppository
preparations of Cannabis have been used to advantage in the past, and
may be an acceptable form of administration for the migraineur, although
dose titration would be less available.
Discussion:
Despite the development of serotonin 1D-agonist medications, migraine
remains a serious public health issue. An estimated 23 million Americans
suffer severe migraine. Of these, 25% have four or more episodes per
month, and 35% have one to three severe headaches each month (Stewart et
al., 1992). In economic terms, the impact of migraine is enormous: an
estimated 14% of females, and 8% of males missed a portion of, or an
entire day of work or school in one month (Linet et al., 1989). Migraine
has been estimated to account for an economic impact of $1.2 to $17.2
billion annually in the U.S.A. in terms of lost productivity (Lipton et
al., 1993). In 1990 studies were published outlining the biochemical
basis of migraine treatment in serotonin receptor pharmacology
(Peroutka, 1990). It was this research that led to the development of
the first drugs active on serotonin receptor subtypes, sumatriptan, and
ondansetron.
However, despite the justifiable success of sumatriptan in treating
acute migraine, problems remain. Although rapidly active subcutaneously,
its oral absorption is relatively slow, and often unreliable in the
migraineur. Sumatriptan and its analogues are ineffective when
administered in the "aura phase" of classic migraine (Ferrari and
Saxena, 1995). Additionally, headache recurrence after "triptan" 5-HT1D
agonist agents is a not infrequent occurrence. Unfortunately, repetitive
dosing, and development of agents with longer half-lives does not seem
to avert the issue (Ferrari and Saxena, 1995).
Another curiosity in the development of sumatriptan is its relative
inability to pass the blood-brain barrier. Once more, the development of
newer agents with improved central nervous system penetration has not
necessarily improved efficacy, but does increase the likelihood of side
effects, such as chest and throat tightness, numbness, tingling,
anxiety, etc. (Ferrari and Saxena, 1995; Mathew, 1997). Ultimately
disappointing, none of the triptan drugs seems to exert any benefit on
the frequency of migraine incidence, unlike dihydroergotamine, which has
degree of prophylactic benefit. Thus, it is the author's contention that
this group of agents, though impressive, may represent somewhat of a
"therapeutic dead end." Especially considering the large percentages of
migraineurs who either fail to respond to the triptans, or can not
tolerate them, there seems to be definite need for alternative treatment
agents. The author believes that the issue of medical marijuana, and its
possible role in migraine treatment deserves proper scientific
examination, both biochemically and clinically.
Results of controlled clinical trials may be valuable for migraineurs
and professionals who treat them because there is a strong need for
additional medications that will effectively this condition in its acute
state. At this time, the best available medication, injected sumatriptan
(Imitrex) has been ineffective in up to 30% of patients, or has produced
undesirable side effects for up to 66% when administered subcutaneously
(Mathew, 1997). The available evidence seems to suggest that smoked
Cannabis would be a far safer alternative than butorphanol nasal spray
(Stadol-NS), which, heretofore, has been an unscheduled drug approved in
the U.S.A. for migraine treatment despite its addictive potential and
unfavorable side effect profile (Fisher and Glass, 1997).
Conclusions:
1. Cannabis, whether ingested, or smoked, has a long history of
reportedly safe and effective use in the treatment and prophylaxis of
migraine.
2. Cannabis has a mild but definite analgesic effect in its own right.
3. Cannabis seems to affect nociceptive processes in the brain, and may
interact with serotonergic and other pathways implicated in migraine.
4. Cannabis is reportedly an effective anti-emetic, a useful property in
migraine treatment.
5. Cannabis, even when abused, has mild addiction potential, and seems
to be safe in moderate doses, particularly under the supervision of a
physician.
6. Cannabis' primary problem as a medicine lies in its possible
pulmonary effects, which seem to be minimal in occasional, intermittent
use.
7. Cannabis when inhaled, is rapidly active, obviates the need for
gastrointestinal absorption (impaired markedly in migraine), and may be
titrated to the medical requirement of the patient for symptomatic
relief.
8. Cannabis delivered by pyrolysis in the form a marijuana cigarette, or
"joint," presents the hypothetical potential for quick, effective
parenteral treatment of acute migraine.
In closing, a quotation seems pertinent (Schultes, 1973):
There can be no doubt that a plant that has been in partnership with man
since the beginnings of agricultural efforts, that has served man in so
many ways, and that, under the searchlight of modern chemical study, has
yielded many new and interesting compounds will continue to be a part of
man's economy. It would be a luxury that we could ill afford if we
allowed prejudices, resulting from the abuse of Cannabis, to deter
scientists from learning as much as possible about this ancient and
mysterious plant.
Acknowledgements:
The author would like to thank the following individuals:
Rick Doblin and Sylvia Thiessen of the Multidisciplinary Association for
Psychedelic Studies (MAPS), for financial support, and continued advice
and suggestions. Paulette Cote of Western Montana Clinic Library, and
the Inter-Library Loan Department at the Mansfield Library of the
University of Montana for wonderful service in locating obscure
references. Drs. Tod Mikuriya and Lester Grinspoon for provision of
books, suggestions and encouragement. Drs. Keith Parker and Vernon Grund
of the Department of Pharmacy, University of Montana for their guidance
and good sense. Drs. Varro Tyler and Dennis McKenna for their
inspiration and the confidence they engendered. Dr. Donald Abrams for
his continuing efforts in pursuit of medical indications for Cannabis.
The Herbal Research Foundation and NAPRALERT for assistance on
ethnobotanical information. Dr. Samir Ross for his initial guidance on
my inquiries about experimental research on Cannabis. Marie-Josée
Thibault, Deborah Somerville, and Penny King for their faithfulness and
"morale support." Ultimately, to Dr. Mark Russo, for reasons he alone
will understand.
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Io me la meno e me la canto....sarà grave tutto ciò??? Aiut :-X
8-))))))))
Ecco l'articolo italiano di cui al msg precedente (se qualcuno l'ha
letto! ;-)))) )
Enjoy
Laurachemòlasmette
***************************************************
Gli endocannabinoidi:
molecole endogene con attività cannabimimetica Vincenzo Di Marzo1 e
Luciano De Petrocellis 2
1Istituto per la Chimica di Molecole di Interesse Biologico e 2Istituto
di Cibernetica
Consiglio Nazionale delle Ricerche
Via Toiano 6, 80072 Arco Felice (NA), Italia
Cenni storici
Gli studi sul possibile meccanismo d'azione dei derivati della Cannabis
e, di conseguenza, sulle potenziali applicazioni terapeutiche di questi
ultimi, hanno subito un'improvvisa accelerazione con la scoperta di
specifici recettori per il THC nonchè di ligandi endogeni per tali
proteine. Sono stati caratterizzati finora due tipi di recettori per il
THC e i suoi derivati sintetici: il recettore CB1, prevalentemente
espresso nel sistema nervoso ed in alcuni tessuti periferici, scoperto
nel 1990 (1), e il recettore CB2, identificato finora solo in cellule
del sistema immunitario dei mammiferi, individuato per la prima volta
solo nel 1993 (2). Alla scoperta del recettore CB1 ha fatto immediato
seguito, nel 1992, l'isolamento, dal cervello di maiale, del primo
metabolita endogeno in grado di legarsi selettivamente a tale proteina.
Si trattava dell'amide tra l'acido arachidonico e l'etanolammina, due
componenti ubiquitari delle membrane cellulari animali, che venne
chiamata anandamide dalla parola Sanscrita ananda per 'stato di grazia'
(3). Successivamente furono isolati, ancora dal cervello di maiale,
altri due analoghi strutturali dell'anandamide (4), mentre un'altro tipo
di molecola, appartenente alla classe degli intermedi metabolici noti
come monoacilgliceroli, fu identificata in tessuti periferici e proposta
come ligando del recettore CB2: il 2-arachidonoilglicerolo (2-AG). In
seguito venne scoperto che mentre l'anandamide e i suoi analoghi
attivano preferenzialmente il recettore CB1 (5), il 2-AG, che è presente
anche nel cervello dei mammiferi (6), può attivare indifferentemente
entrambi i tipi di recettori per il THC (7).
La scoperta di recettori per il THC e di molecole endogene in grado di
attivare tali proteine, simulando così in gran parte i tipici effetti
psicotropici (e non) della Cannabis, dimostrava l'esistenza di un
sistema cannabinoide endogeno il cui ruolo fisiologico è ancora materia
di dibattito, ed il cui studio futuro potrà portare a comprendere i
meccanismi molecolari che sono alla base dell'abuso di preparati della
canapa indiana, e a sviluppare, sulla base delle ben note proprietà
terapeutiche di tale pianta, nuovi farmaci ad alto potenziale
terapeutico per la cura di malattie del sistema nervoso, immunitario e
cardiovascolare.
Biosintesi ed inattivazione degli endocannabinoidi.
Se molecole endogene svolgono un ruolo quale mediatori di risposte
fisiologiche, devono esistere nelle cellule vie biosintetiche
regolabili, cioè meccanismi molecolari in grado di sintetizzare tali
sostanze al momento e nel luogo opportuno. Inoltre, il segnale chimico
portato da tali molecole deve poter essere terminato, qualora la sua
funzione biologica si esaurisca, attraverso vie cataboliche anch'esse
regolabili. Il coinvolgimento degli endocannabinoidi nella modulazione
di funzioni fisiologiche sia a livello del sistema nervoso che in
tessuti periferici è oggi confermato dalla scoperta di specifici
meccanismi biosintetici e degradativi (8, 9). Sia l'anandamide che il
2-AG vengono prodotti a partire da precursori biosintetici fosfolipidici
e inattivati mediante ricaptazione da parte delle cellule e successive
reazioni di idrolisi e/o esterificazione. In particolare, l'anandamide
viene prodotta dall'idrolisi dell'N-arachidonil-fosfatidiletanolammina
(NArPE), processo catalizzato da una fosfolipasi di tipo D (10). Il
NArPE, a sua volta, viene prodotto dalla N-trans-acilazione della
fosfatidiletanolammina ottenuta prelevando una funzione di acido
arachidonico dalla posizione sn-1 di altri fosfolipidi (11).
Quest'ultima reazione è attivata dagli ioni calcio. Il 2-AG viene invece
prodotto dall'idrolisi enzimatica ed enantioselettiva di diacilgliceroli
attraverso l'enzima sn-1 diacilglicerolo lipasi (11-13). I
diacilgliceroli utilizzati come precursori biosintetici del 2-AG possono
essere ottenuti, a loro volta, dall'idrolisi sia del fosfatidilinositolo
(13), catalizzata dalla fosfolipasi di tipo C, sia dell'acido
fosfatidico (14), catalizzata da una specifica fosfoidrolasi. Questi
meccanismi biosintetici differenziano gli endocannabinoidi da altri
neuromodulatori quali l'acetilcolina, il glutammato, la noradrenalina,
che vengono pre-sintetizzati e conservati in vescicole secretorie. Tali
vescicole, quando la cellula viene stimolata, rilasciano all'esterno il
loro contenuto. L'anandamide e il 2-AG, invece, vengono sintetizzati a
partire dai loro precursori fosfolipidici, contenuti presumibilmente
nella membrana cellulare, solo quando la cellula è stimolata, ad es.
dall'ingresso di ioni calcio, e solo allora vengono rilasciati
all'esterno della cellula. Tale meccanismo rende gli endocannabinoidi
simili ad altri derivati bioattivi dell'acido arachidonico, quali le
prostaglandine. Una volta sintetizzati, gli endocannabinoidi si legano
ai recettori del THC presenti su cellule limitrofe o sulla stessa
cellula che li ha prodotti, comportandosi così come mediatori autocrini
o paracrini. Infatti, la loro natura chimica estremamente poco
idrosolubile ne impedisce la facile diffusione nella matrice
extracellulare o nel sangue. Il legame con i recettori CB1 o CB2, e il
successivo inizio di eventi di trasduzione del segnale cannabimimetico,
quali, ad es., l'inibizione della formazione di AMP ciclico o
dell'ingresso di ioni calcio nella cellula, è alla base dell'azione
biologica degli endocannabinoidi, la terminazione della quale viene
effettuata mediante i seguenti meccanismi: a) ricaptazione da parte
delle cellule, che nel caso dell'anandamide viene facilitata da
trasportatori di membrana, b) idrolisi enzimatica, c) riesterificazione
dei prodotti dell'idrolisi in fosfolipidi di membrana (10, 11, 15). Il
2-AG, inoltre, viene anche riesterificato prima della sua idrolisi
enzimatica (15). L'enzima che catalizza l'idrolisi dell'anandamide è
stato caratterizzato e denominato 'fatty acid amide hydrolase' (16). In
alcune condizioni tale enzima catalizza anche l'idrolisi del 2-AG (15,
17), per il quale, comunque, esistono anche altre 'idrolasi' più o meno
selettive. Sono stati individuati inibitori specifici dell'inattivazione
degli endocannabinoidi, sia al livello dei sistemi di ricaptazione
(18-20), che per quanto riguarda gli enzimi idrolitici (21-23). Tali
molecole possono servire da base per lo sviluppo di nuovi agenti
terapeutici da utilizzare per il trattamento di quelle patologie causate
o peggiorate da un'eccessiva espressione dei meccanismi di inattivazione
o un difettoso funzionamento dei meccanismi biosintetici degli
endocannabinoidi.
Possibile ruolo fisiopatologico degli endocannabinoidi
Benchè l'attività farmacologica in vivo ed in vitro degli
endocannabinoidi, e in particolare dell'anandamide, sia stata oggetto,
negli ultimi 6 anni, di numerosissimi studi (8, 9, 24), solo in pochi
casi si è potuto mettere in relazione la sintesi di tali composti nei
tessuti con l'intervento di particolari situazioni fisiopatologiche.
Sembra ormai chiaro, comunque, che l'anandamide viene prodotta quando la
cellula subisce danni più o meno gravi, prodotti ad es., da un eccessiva
concentrazione intracellulare di calcio (25). Anandamide e 2-AG vengono
prodotte, rispettivamente da macrofagi e piastrine, durante stati
ipotensivi seguenti a shock emorragico e endotossinico (26, 27). I
livelli di anandamide nell'utero di topo aumentano notevolmente durante
la gestazione quando l'organo è meno recettivo all'attecchimento
dell'embrione (28). L'attivazione immunologica di mastociti porta ad una
stimolazione della sintesi di anandamide (29). Questi dati, assieme alle
osservazioni farmacologiche che hanno rilevato per tali metaboliti un
comportamento analogo a quello dei preparati della Cannabis, sembrano
suggerire che gli endocannabinoidi vengono prodotti per proteggere
l'organismo da danni causati da varie situazioni patologiche,
esercitando azione anti-ossidativa, ipotensiva, immunosoppressiva,
antiinfiammatoria e, in particolare, antidolorifica (30). Inoltre, la
distribuzione dei recettori dei cannabinoidi nel cervello (31)
suggerisce per gli endocannabinoidi anche un ruolo fisiologico nel
controllo del movimento e della percezione, nell'inibizione dei processi
di apprendimento e memoria, nel rafforzamento dell'azione degli
oppioidi, nonchè nella regolazione di stati emotivi quali il piacere e
l'aggressività. E' possibile ipotizzare per tali molecole una funzione
'anti-stress' simile e complementare a quella esercitata dalle endorfine
sia a livello 'centrale' che periferico (8). Infine, studi più recenti
stanno approfondendo un possibile coinvolgimento del sistema
endocannabinoide nel controllo della proliferazione di cellule tumorali
(32). Indubbiamente, ancora numerosi sforzi saranno necessari per
individuare il ruolo fisiopatologico degli endocannabinoidi. Dal
successo di tali sforzi dipenderà anche il possibile sviluppo di nuovi
farmaci utili nel trattamento di alcuni disturbi del sistema nervoso,
immunitario e cardiovascolare per i quali esistono ancora rimedi poco
efficaci. Il disegno di nuove molecole con attività selettiva per il
recettore CB2, o di sostanze che non siano in grado di oltrepassare la
barriera emato-encefalica, potrebbe consentire l'ottenimento di farmaci
privi degli indesiderati effetti psicotropici della Cannabis.
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Rispondo con un pň di ritardo alla questione "maria".
Non ci crederete ma la marijuana č addirittura considerata all'interno della
classificazione delle cefalee della International Headache Society e
precisamente all'interno delle Sostanze Illecite.
In pratica, dalle pubblicazioni effettuate (delle quali, se vorrette potrň
darvi indicazione), emergerebbe, in forma piů o meno indiretta, il possibile
effetto profilattico della "maria" sia sull'emicrania che sulla cefalea
muscolo-tensiva.
Purtroppo (ebbene sě, purtroppo), il dato č stato evinto dai casi di mal di
testa insorti in seguito all'interruzione dell'assunzione di marijuana.
In parole povere: una canna al giorno leva il mal di testa di torno (forse),
ma poi se bene vuoi stare tutta la vita te la devi fare (concedetemi questa
licenza poco poetica e molto stupida).
Alessandro De Monte
Neurologo
PS: nella classificazione sono considerati anche la cocaina e il crack

 PS: nella classificazione sono considerati anche la cocaina e il crack
Mi sembra conveniente. Come amputarsi un piede per curare una frattura
al dito. Che poi possa funzionare (la maria intendo) non lo metto in
dubbio. Anche e specialmente nelle muscolotensive, vista l'azione
ansiolitica! ;-)
Saluti
Lella

 ma poi se bene vuoi stare tutta la vita te la devi fare
Bè, oh, in fondo...siamo nati per soffrire! O;-)))))
Daiii, scherzo, io appartengo a quella generazione di passaggio che
*Guarda il '68 cosa ha partorito!! Solo drogati e femmine similuomo mal
vestite. AAAAAARRRRGGGGGH un ex sessantottino! Al rogo al rogo*...più o
meno :-))))
Se poi ti devi far venire il cancro al polmone per curarti la cefalea in
maniera alternativa...bè...mi si consenta!
Enjoy
Lauranew(old?)generation