Epilepsy

Therapeutic use of cannabis and cannabinoids: an evidence mapping and appraisal of systematic reviews

John Bayhi — Mon, 03 Feb 2020 19:39:52 +0000

Date Added:

February 3, 2020

Journal/Publication:

BMC Complementary Medicine and Therapies

Publisher:

Springer Nature

Publication Date:

January 15, 2020

Issue:

Volume:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1186/s12906-019-2803-2

Keywords

Another summary of what we know about the therapeutic effects of cannabinoids. The figures appear to be useful. James W. Mold, MD, MPH

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Background

Although cannabis and cannabinoids are widely used with therapeutic purposes, their claimed efficacy is highly controversial. For this reason, medical cannabis use is a broad field of research that is rapidly expanding. Our objectives are to identify, characterize, appraise, and organize the current available evidence surrounding therapeutic use of cannabis and cannabinoids, using evidence maps.

Methods

We searched PubMed, EMBASE, The Cochrane Library and CINAHL, to identify systematic reviews (SRs) published from their inception up to December 2017. Two authors assessed eligibility and extracted data independently. We assessed methodological quality of the included SRs using the AMSTAR tool. To illustrate the extent of use of medical cannabis, we organized the results according to identified PICO questions using bubble plots corresponding to different clinical scenarios.

Results

A total of 44 SRs published between 2001 and 2017 were included in this evidence mapping with data from 158 individual studies. We extracted 96 PICO questions in the following medical conditions: multiple sclerosis, movement disorders (e.g. Tourette Syndrome, Parkinson Disease), psychiatry conditions, Alzheimer disease, epilepsy, acute and chronic pain, cancer, neuropathic pain, symptoms related to cancer (e.g. emesis and anorexia related with chemotherapy), rheumatic disorders, HIV-related symptoms, glaucoma, and COPD. The evidence about these conditions is heterogeneous regarding the conclusions and the quality of the individual primary studies. The quality of the SRs was moderate to high according to AMSTAR scores.

Conclusions

Evidence on medical uses of cannabis is broad. However, due to methodological limitations, conclusions were weak in most of the assessed comparisons. Evidence mapping methodology is useful to perform an overview of available research, since it is possible to systematically describe the extent and distribution of evidence, and to organize scattered data.

Author/s:

Montero-Oleas, N, Arevalo-Rodriguez, I, Nunez-Gonzalez, S, Viteri-Garcia, A, Simancas-Racines, D

Cannabidiol Products Are Everywhere, but Should People Be Using Them?

Brian Desmarais — Thu, 21 Nov 2019 18:13:38 +0000

Date Added:

November 22, 2019

Journal/Publication:

Journal of the American Medical Association

Publication Date:

November 20, 2019

URL:

Cannabidiol Products Are Everywhere, but Should People Be Using Them?

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1001/jama.2019.17361

Keywords

CBD

MeSH

cannabis

cannabidiol

united states food and drug administration

Here is another concise review on cannabidiol. This one looks like it could be useful to give to patients who have questions about it. James W. Mold, MD, MPH

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Even with pharmaceutical-grade CBD, potentially dangerous adverse events can occur. With unregulated CBD products, the adverse events are unpredictable, in part because their ingredients might not be the same as those listed on the package.

Author/s:

Rubin, R.

Disorders of Arousal in adults: new diagnostic tools for clinical practice

John Bayhi — Fri, 01 Nov 2019 17:52:36 +0000

Date Added:

November 1, 2019

Journal/Publication:

Sleep Science Practice

Publisher:

Springer Nature

Publication Date:

October 2, 2019

Issue:

Volume:

URL:

Disorders of Arousal in adults: new diagnostic tools for clinical practice

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1186/s41606-019-0037-3

Keywords

Video-polysomnography

MeSH

REM Sleep Behavior Disorder

Homicide

Sleep Arousal Disorders

Electroencephalography

Epilepsy

This is a review of the diagnosis and management of patients with various arousal disorders. James W. Mold, MD, MPH

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Disorders of Arousal (DOA) are mental and motor behaviors arising from NREM sleep. They comprise a spectrum of manifestations of increasing intensity from confusional arousals to sleep terrors to sleepwalking.

Although DOA in childhood are usually harmless, in adulthood they are often associated with injurious or violent behaviors to the patient or others. Driving motor vehicles, suspected suicide, and even homicide or attempted homicide have been described during sleepwalking in adults. Furthermore, adult DOA need to be differentiated from other sleep disorders such as Sleep-related Hypermotor Epilepsy or REM Sleep Behavior Disorder.

Although many aspects of DOA have been clarified in the last two decades there is still a lack of objective and quantitative diagnostic criteria for DOA.

Recent advances in EEG analysis and in the semiological characterization of DOA motor patterns have provided a better definition of DOA diagnosis.

Our article focuses on the DOA diagnostic process describing accurately the newest DOA clinical, EEG and video-polysomnographic tools in order to aid clinicians in DOA assessment.

Author/s:

Loddo, G, Lopez, R, Cilea, R, Dauvillers, Y, Provini, F

Clinicians’ Guide to Cannabidiol and Hemp Oils

Brian Desmarais — Wed, 11 Sep 2019 21:41:17 +0000

Date Added:

September 18, 2019

Journal/Publication:

Mayo Clinic Proceedings

Publisher:

Mayo Foundation for Medical Education and Research

Publication Date:

September 1, 2019

Issue:

Volume:

Pages:

1840-1851

URL:

Clinicians’ Guide to Cannabidiol and Hemp Oils

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.mayocp.2019.01.003

Keywords

cannabidoil

cannabis

PMID (1):

31447137

MeSH

This is a review of what is known about cannabidiol and other hemp-related oils from the Mayo Clinic. James W. Mold, MD, MPH

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Cannabidiol (CBD) oils are low tetrahydrocannabinol products derived from Cannabis sativa that have become very popular over the past few years. Patients report relief for a variety of conditions, particularly pain, without the intoxicating adverse effects of medical marijuana. In June 2018, the first CBD-based drug, Epidiolex, was approved by the US Food and Drug Administration for treatment of rare, severe epilepsy, further putting the spotlight on CBD and hemp oils. There is a growing body of preclinical and clinical evidence to support use of CBD oils for many conditions, suggesting its potential role as another option for treating challenging chronic pain or opioid addiction. Care must be taken when directing patients toward CBD products because there is little regulation, and studies have found inaccurate labeling of CBD and tetrahydrocannabinol quantities. This article provides an overview of the scientific work on cannabinoids, CBD, and hemp oil and the distinction between marijuana, hemp, and the different components of CBD and hemp oil products. We summarize the current legal status of CBD and hemp oils in the United States and provide a guide to identifying higher-quality products so that clinicians can advise their patients on the safest and most evidence-based formulations. This review is based on a PubMed search using the terms CBD, cannabidiol, hemp oil, and medical marijuana. Articles were screened for relevance, and those with the most up-to-date information were selected for inclusion.

Author/s:

VanDolah H.J., Bauer, B.A., Mauck, K.F.