Cannabinoids—Perspectives for Individual Treatment in Selected Patients: Analysis of the Case Series

Abstract

Cannabinoids can be successfully used in the treatment of many symptoms and diseases; however, most often they are not the drugs of first choice. They can be added to the primary therapy, which can improve its effectiveness, or be introduced as the basic treatment when the conventional methods have failed. Small clinical trials and case reports prove the benefits of applying medicinal cannabis in various indications; however, clinical trials in larger groups of patients are scarce and often controversial. Due to limited scientific evidence, it is essential to conduct further experimental trials. Understanding the role of endocannabinoids, as well as the composition of cannabis containing both phytocannabinoids and terpenes plays an important role in their clinical use. The clinical effects of cannabinoids depend, among other things, on the activity of the endocannabinoid system, the proportion of phytocannabinoids, such as Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), and the dosage used. The article discusses the role of phytocannabinoids and the potential of using them in different clinical cases in patients suffering from chronic pain, opioid dependence, depression and migraine, who did not respond to the conventional therapeutic methods. In each of the presented cases, the implementation of cannabinoids altered the course of the disease and resulted in symptom relief. Every decision to introduce cannabinoids to the treatment should be made individually with careful attention paid to details. Additionally, it is worth taking care of good clinical communication and education so that the implemented therapy is safe, effective and properly perceived by the patient.

Screening System of Cannabis sativa Extracts Based on Their Mitochondrial Safety Profile Using Cytochrome c Oxidase Activity as a Biomarker

“…Cannabidiol and tetrahydrocannabinol are cannabinoid compounds that have demonstrated analgesic efficacy in chronic neuropathic pain treatment [ 11 ], and their combinations with other drugs also suggest a promising role as anti-inflammatories [ 12 ] or as drugs for cancer therapy [ 13 , 14 ], migraine [ 15 ], opioid and alcohol dependence [ 16 ]. The psychoactive effects of THC have been a major limitation to the cannabinoids’ medicinal use, but the emergence of new varieties of plants with high-CBD and low-THC content opens a new window of opportunities for their use in many countries.…”

“…All these medicines together with medical cannabis have demonstrated analgesic efficacy in chronic neuropathic pain treatment [ 11 ]. In addition, an increasing number of cannabinoids and their combinations seem promising as anti-inflammatory drugs [ 12 ], in cancer therapy [ 13 , 14 ], migraine [ 15 ], opioid and alcohol dependence treatment [ 16 ]. It has been shown that very low doses of THC + CBD and THCA + CBDA combinations have an anti-emetic effect [ 17 ] which is an example of a combination use advantage when compared to the administration of high doses of a single active component.…”

Use of hemp extracts rich in THC and CBD in the chronic pain management

“…Najczęściej kannabinoidy dodaje się do stosowanych wcześniej analgetyków i koanalgetyków, co daje możliwość ograniczenia ich dawek lub w wybranych przypadkach całkowite odstawienie. Rzadko zatem kanabinoidy stosowane są w monoterapii i nie jest to powszechnie zalecana praktyka [29,[43][44][45][46][47].…”

A new approach to treating sleep disorders? - Medical marijuana review

“…Research suggests that CBD, in particular, may have anxiolytic and antidepressant effects, potentially beneficial for conditions such as anxiety and depression [16,17]. However, the relationship between cannabis use and psychiatric disorders is complex, with some studies indicating that excessive or inappropriate use of cannabis may exacerbate symptoms of these conditions or contribute to the onset of disorders in vulnerable individuals [18,19]. Therefore, careful clinical assessment and monitoring are essential when considering cannabis-based treatments for psychiatric disorders.…”