Dr Frankel talks about Trigeminal Neuralgia and the positive effect he has seen cannabis have on patients dealing with it. Some feedback received by three recent patients is also included.
The beginning of neuroscience is considered to have started around 1700BC when the first writings making reference to the brain occurred. This early reference has developed into the 17 branches of modern neuroscience studies.
The first cannabinoid was isolated in 1964, followed by the identification of the first cannabinoid receptor in the brain of a rat in 1988, and the first endocannabinoid in 1992.
Needless to say, neurosciences related to the study of cannabinoids and the endocannabinoid system has a ways to go to catch up.
Studies of the effects, actions and interactions of cannabinoids and the endocannabinoid system are progressing across multiple scientific disciplines around the world. The endocannabinoid system’s exchanges with every other system and condition of the human body affect so many of us therefore understanding is key.
As long as cannabis is classified as a Schedule I drug there will be limitations on the progress of studies. But the potential payoffs for the effective treatment of disease will spur innovation and the further quest for knowledge of the true therapeutic uses of cannabis medicines.
The information gained from clinical trials as well as research on the application of various combinations and dosages of cannabinoids is showing the promise as well as the shortcomings of cannabis therapies.
While I have extensive clinical experience in the use of cannabis medicines for the treatment of a wide variety of diseases, disorders, syndromes and conditions, I still find it can be an ongoing process to determine the most effective cannabis therapy for each individual patient.
Of particular interest and activity in my practice are neurological conditions brought on or unresolved by traditional pharmaceuticals.
Most recently we are seeing significant progress in cannabis therapies for neuropathic pain, neuroprotection, seizure conditions and acetylcholine deficiencies.
The majority of neuropathic pain patient patients I am treating are female patients who have been given Paclitaxel or Taxol for breast cancer. They are generally experiencing unbearable neuropathic pain along with several co-conditions brought on by the pain and stress. In many cases their cancer is managed or in remission, but their pain and related issues remained unresolved. Most have been prescribed Gabapentin or Neurontin at the onset of pain. CBD has been shown to prevent and reduce or relieve Taxol induced neuropathic pain and many patients respond positively to CBD therapy. We certainly need additional research on chemotherapy induced neuropathic pain and CBD, but in the meantime it has been proven that CBD is extremely safe and offers many other benefits to these patients, including calming effects, and relief of anxiety and insomnia.
As a neuroprotectant, CBD is being used to by the Israeli Defense Forces to limit neurological damage following head trauma. It is also effective in limiting damage following vascular events, such as stroke and myocardial infarction and in the treatment of neurodegenerative diseases, including Parkinson’s, Alzheimer’s and Dementia. Since CBD is essentially non-psychoactive, therapies can be administered at higher dosages without motor impairment or toxicity that may be associated with higher doses of THC.
One of the most publicized benefits of cannabis therapies has been in the relief of seizures. I have come to expect seizures in children and young adults to vastly improve with moderate doses of CBD.
My young patients have primary seizure disorders, Dravet’s, other genetic related disorders or are on the Autistic Spectrum. Initially all of these patients were coming in for seizure related disorders, but now it has spread and there are some very interesting initial findings.
In over 80% of the patients, seizures either cease or greatly diminish. In some cases, there is only pre-seizure behavior with are no actual seizures. When these kids are back in school, they are highly improved, even though they still have some “aborted seizures”, as a result to CBD use.
For Autistic children with violent outbursts, we are finding that additional THC is required to suppress the outbursts.
The most satisfying and amazing findings, however, are not related to the control of seizures or other behaviors; the most amazing findings have been vast improvements over their first year in neck tone, increased alertness, occasionally some speech improvement and over-all increase muscle tone, again with decreased spasticity. In many cases at initial consultation the child would have poor neck tone and poor neck control, and at one-year post visit their head is well controlled and they are responsive.
I have worked with several children who develop more normal and “connected” emotional behavior after taking cannabis medicine. For example, a year prior, the child was never jealous or much aware of their sibling and now they act out with jealousy. You might say that is a nuisance for the parents, but I can assure you that the parents are overjoyed to see new and “normal” feelings in their child.
So, what is happening? For sure something is happening in these children that is way, way beyond seizure or outburst control. I think we might be witnessing neurological improvement.
Possibly they are getting improvement neurologically and some new neurological circuits are forming. This leads me to wonder what would happen if we gave these children CBD from initial diagnosis?
In my 37 years of practice as an internal medical doctor, I have dealt with many patients suffering from myasthenia gravis and various other neuromuscular disorders. Prior to discovering medical cannabis, I was limited by traditional therapies. However, with several options for dosed medical cannabis therapies we are seeing some exciting and promising results.
It has become clear that many, but not all, of the mitochondrial diseases often have neuromuscular, cerebral and other issues. Each disease is different, but they share some common characteristics. They often have acetylcholine deficiency states, centrally, peripherally or both. Additionally, they frequently have circulating antibodies against acetylcholine receptors or acetylcholinesterase, the enzyme that breaks down acetylcholine. We have found THC, THC-Acid and CBD can all lead to increasing acetylcholine activity and/or function in the central and peripheral nervous system. It is well worth continued therapy using this multi-cannabinoid triad of therapy.
There is increasing evidence that cannabinoids, particularly CBD, possess antioxidant, anti-inflammatory and neuroprotective properties. This makes cannabis therapies effective in the treatment of a wide variety of oxidative stress associated diseases including: atherosclerosis, cancer, diabetes, rheumatoid arthritis, myocardial infarction, cardiovascular diseases, chronic inflammation, stroke and many other inflammatory, autoimmune and age related diseases. The use of various cannabis therapies in these patients has resulted in generally improved conditions and I am hopeful further research will provide viable alternatives for patients whose conditions are not able to be managed through traditional pharmaceutical therapies.
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