Cannabis in the Treatment of Traumatic Brain Injury: A Primer for Clinicians

Ponnambalam, Fallon; Lee, David; Lauwers, Rebecca; Bhalerao, Shree

doi:10.1017/cjn.2019.298

Cited by 14 publications

(11 citation statements)

References 76 publications

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“…However, use of cannabis was found to be associated with lower severity than the other two [153]. Most of the time patients are indulged in cannabis use postinjury, unaware of its proven benefits or multiple effects [151,154]. Moreover, cannabis abuse may cause neurological stress and enhance risk of psychosis in adolescent patients and may outweigh its potential therapeutic benefits [155].…”

Section: Traumatic Brain Injury: Modulation Of Ecs Improves Recovery Post Tbimentioning

confidence: 99%

Targeting the endocannabinoid system: a predictive, preventive, and personalized medicine-directed approach to the management of brain pathologies

et al. 2020

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Cannabis-inspired medical products are garnering increasing attention from the scientific community, general public, and health policy makers. A plethora of scientific literature demonstrates intricate engagement of the endocannabinoid system with human immunology, psychology, developmental processes, neuronal plasticity, signal transduction, and metabolic regulation. Despite the therapeutic potential, the adverse psychoactive effects and historical stigma, cannabinoids have limited widespread clinical application. Therefore, it is plausible to weigh carefully the beneficial effects of cannabinoids against the potential adverse impacts for every individual. This is where the concept of "personalized medicine" as a promising approach for disease prediction and prevention may take into the account. The goal of this review is to provide an outline of the endocannabinoid system, including endocannabinoid metabolizing pathways, and will progress to a more in-depth discussion of the therapeutic interventions by endocannabinoids in various neurological disorders.

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Section: Traumatic Brain Injury: Modulation Of Ecs Improves Recovery Post Tbimentioning

confidence: 99%

Targeting the endocannabinoid system: a predictive, preventive, and personalized medicine-directed approach to the management of brain pathologies

et al. 2020

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“…Though these are a novel class of drugs deserving close study, more data are necessary to prove their efficacy for treatment of brain injury, as historically many compounds have seemed promising in vitro , including likely hundreds of compounds thought to facilitate neuroplasticity and neuroprotection, but have not borne out in clinical trials ( 61 , 62 ). There is already mixed evidence to suggest the use of non-classical psychedelics ketamine ( 63 , 64 ), as well as tetrahydrocannabinol (THC) ( 65 , 66 ) and cannabidiol ( 67 , 68 ), as neuroprotectants after TBI and stroke. Presence of THC on urine drug screen is associated with decreased mortality in adult patients sustaining TBI ( 65 ).…”

Section: Discussionmentioning

confidence: 99%

Psychedelics for Brain Injury: A Mini-Review

Khan

Carter²,

Aggarwal

et al. 2021

Front. Neurol.

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Objective: Stroke and traumatic brain injury (TBI) are among the leading causes of disability. Even after engaging in rehabilitation, nearly half of patients with severe TBI requiring hospitalization are left with major disability. Despite decades of investigation, pharmacologic treatment of brain injury is still a field in its infancy. Recent clinical trials have begun into the use of psychedelic therapeutics for treatment of brain injury. This brief review aims to summarize the current state of the science's relevance to neurorehabilitation, and may act as a resource for those seeking to understand the precedence for these ongoing clinical trials.Methods: Narrative mini-review of studies published related to psychedelic therapeutics and brain injury.Results: Recent in vitro, in vivo, and case report studies suggest psychedelic pharmacotherapies may influence the future of brain injury treatment through modulation of neuroinflammation, hippocampal neurogenesis, neuroplasticity, and brain complexity.Conclusions: Historical data on the safety of some of these substances could serve in effect as phase 0 and phase I studies. Further phase II trials will illuminate how these drugs may treat brain injury, particularly TBI and reperfusion injury from stroke.

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“…There has been conflicting evidence regarding the efficacy of marijuana to treat depression, PTSD, anxiety, and sleep deprivation 44–46. Recently published clinical practice guidelines reviewed literature investigating the use of cannabinoid-based medicines (CBM) for treatment of chronic pain in co-occurring conditions 47.…”

Section: Discussionmentioning

confidence: 99%

The Interaction of Opiate Misuse and Marijuana Use on Behavioral Health Outcomes Using the Traumatic Brain Injury Model Systems Pain Collaborative Dataset

Callender,

Lai,

Driver

et al. 2024

Journal of Head Trauma Rehabilitation

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Objective: To determine if the interaction of opiate misuse and marijuana use frequency is associated with behavioral health outcomes. Setting: Community. Participants: Three thousand seven hundred fifty participants enrolled in the Traumatic Brain Injury Model Systems who completed the Pain Survey and had complete opioid use and marijuana use information. Design: Cross-sectional, secondary analysis from a multisite observational cohort. Main Outcome Measure(s): Clinically significant behavioral health symptoms for posttraumatic stress disorder (PTSD), depression, anxiety, and sleep quality. Results: Three thousand five hundred thirty-five (94.3%) participants did not misuse opiates, 215 (5.7%) did misuse opiates (taking more opioid pain medication than prescribed and/or using nonprescription opioid pain medication); 2683 (70.5%) participants did not use marijuana, 353 (9.3%) occasionally used marijuana (less than once a week), and 714 (18.8%) regularly used marijuana (once a week or more frequently). There was a statistically significant relationship (P < .05) between the interaction of opiate misuse and marijuana use frequency and all behavioral health outcomes and several covariates (age, sex, cause of injury, severity of injury, and pain group category). Pairwise comparisons confirm that statistically significant associations on behavioral health outcomes are driven by endorsing opiate misuse and/or regular marijuana use, but occasional marijuana use was not associated. Conclusions: Higher odds of clinically significant PTSD, depression, anxiety, and poor sleep quality are present in people with traumatic brain injury (TBI) who misuse opiates and/or who use marijuana regularly. In the absence of opiate misuse, regular marijuana use had higher odds of worse behavioral health outcomes than occasional and no use. The interaction of opiate misuse and regular marijuana use yielded the highest odds. Individuals with TBI should be informed of the relationship of substance use and behavioral health outcomes and that current chronic pain may mediate the association.

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Cannabis in the Treatment of Traumatic Brain Injury: A Primer for Clinicians

Cited by 14 publications

References 76 publications

Targeting the endocannabinoid system: a predictive, preventive, and personalized medicine-directed approach to the management of brain pathologies

Targeting the endocannabinoid system: a predictive, preventive, and personalized medicine-directed approach to the management of brain pathologies

Psychedelics for Brain Injury: A Mini-Review

The Interaction of Opiate Misuse and Marijuana Use on Behavioral Health Outcomes Using the Traumatic Brain Injury Model Systems Pain Collaborative Dataset

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