For more than twenty years, international research on the endocannabinoid system of the human body has sought to understand the mode of action of cannabis and its constituents. There is ample evidence for the therapeutic success of using cannabinoids for indications such as epilepsy or the treatment of pain, not only as an adjunct but as a first-line treatment. However, there is still insufficient data to develop safe cannabinoid drugs in Austria, which is why a research group led by neurobiologist Tibor Harkany from the Molecular Neuroscience Division of MedUni Vienna summed up the enormous therapeutic potential of the medicinal use of cannabis in a recently published article. review article in the leading journal “Science”.
It is the difficult socio-political discourse that is holding back progress in the development of drugs containing constituents of the medicinal plant Cannabis sativa. On the one hand, there is the ever-present danger of abuse of cannabis as a drug, and on the other hand, there is the current trend of increasing demand for products containing cannabinoids that are freely available. on the market.
Tibor Harkany, neurobiologist and head of the molecular neuroscience division at the MedUni Brain Research Center in Vienna, notes a contradictory phenomenon: âWe know that cannabis could be used for many diseases and, to some extent, we also know how it works. But the fact that there are so many products on the market also makes it seem like it helps with everything and nothing. But, in fact, cannabis is not a miracle plant, it has very specific uses. and we urgently need a number of scientific, evidence-based clinical trials on this topic.
The clinical effects of cannabis-based medicines are mainly due to the activation of the endogenous cannabinoid receptors CB1 and CB2. The most abundant substances in the cannabis plant are delta-9-tetrahydrydrocannabiol (THC) and cannabidiol (CBD), the latter having no psychoactive effects. From anecdotal observations to even international clinical trials, analgesic, anxiolytic, antiepileptic, antipsychotic, sedative and neuroprotective effects have been attributed to CBD. Currently, CBD is approved in some countries for the treatment of intractable epilepsy and spastic paralysis. In Austria, the CBD-containing drug Sativex is approved for the treatment of multiple sclerosis and spasms and Epidiolex is approved for the treatment of certain genetic forms of epilepsy. Dronabinol is also used as an adjunct for chronic pain and in the treatment of cancer.
Harkany even insists on the potential use of cannabinoids as a first-line treatment for epilepsy, as they are said to have a rapid and favorable influence on the progression of the disease.
Psychiatrist Siegfried Kasper, Head Emeritus of the Department of Psychiatry and Psychotherapy at MedUni Vienna, who has extensive experience in clinical studies of this type and collaborates with Harkany on several projects in the interest of translational research, summarizes: âIt is very important for both academia and pharmaceutical companies to initiate fundamental and translational studies to better understand the specific effects of cannabinoids. There would be a great future if we could standardize the forms of application of the constituents of cannabis and then conduct research with standardized extracts in designed clinical trials. The two scientists are united in their belief that “cannabis must be introduced into evidence-based medicine”.
Vienna Medical University
Keimpema, E., et al. (2021) Biological basis of cannabinoid drugs. Mechanistic information on cannabinoid signaling could improve therapeutic applications. Science. doi.org/10.1126/science.abf6099.