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  • ∆9-tetrahydrocannabinol (THC), Cannabidiol (CBD), Cannabinoid/s, Cannabis
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Pharmacovigilance in the Age of Legalized Cannabis: Using Social Media to Monitor Drug–Drug Interactions Between Immunosuppressants and Cannabis-Derived Products

Please use this link to access this publication. Abstract Introduction A clinical trial of Epidiolex®, the only US FDA-approved cannabis-derived consumer product (CDP), discovered an interaction with an immunosuppressant (tacrolimus) that led to drug toxicity, highlighting the unique intersection of prescription and commonly unregulated consumer products. Objective We aimed to identify if similar drug–drug interactions (DDIs) are occurring among the consumer CDP market, even though they cannot be identified through trials. Methods We searched Reddit for subreddits related to CDPs or health, resulting in 63,561,233 posts. From these, we identified 190 posts discussing both immunosuppressants and CDPs. Two blinded investigators evaluated the following. (1)...
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CBD for pets: navigating quality assurance, safety standards, and marketing strategies

Abstract As the human cannabinoid (CBD) market grows, there is an inevitable transfer of the same or similar products into the veterinary sector. Advances in veterinary medicine and care of companion animals has led to extended life expectancy and consequently, there is an increased incidence of age-related chronic conditions that compromise quality of life. CBD products may alleviate these conditions. Research into CBD for companion animal species is on the rise, however, we found that there are no licensed veterinary CBD products available in the market due to a lack of appropriate testing and/or data. Here we outline the data that is available and...
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Efficacy and Safety of Transdermal Medical Cannabis (THC:CBD:CBN formula) to Treat Painful Diabetic Peripheral Neuropathy of Lower Extremities

Abstract Introduction: Diabetic peripheral neuropathy (DPN) represents a prevalent neurological complication affecting millions of patients globally. This clinical investigation evaluated the therapeutic efficacy and safety profile of a novel transdermal medical cannabis formulation (THC:CBD:CBN) in treating painful DPN of the lower extremities. Methods: This phase III, double-blind, placebo-controlled, randomized clinical trial was conducted at Don Chan Hospital, Thailand, enrolling 100 participants over a 12-week intervention period. Using a computer-generated randomization sequence, participants were allocated to receive either the standardized cannabis formulation or a matched placebo. The primary outcome measure comprised pain intensity assessment using the validated Thai version of the Neuropathic Pain Symptom Inventory (NPSI-T). Secondary outcomes...
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Medicinal Cannabis and the Intestinal Microbiome

Abstract Historically, the multiple uses of cannabis as a medicine, food, and for recreational purposes as a psychoactive drug span several centuries. The various components of the plant (i.e., seeds, roots, leaves and flowers) have been utilized to alleviate symptoms of inflammation and pain (e.g., osteoarthritis, rheumatoid arthritis), mood disorders such as anxiety, and intestinal problems such as nausea, vomiting, abdominal pain and diarrhea. It has been established that the intestinal microbiota progresses neurological, endocrine, and immunological network effects through the gut–microbiota–brain axis, serving as a bilateral communication pathway between the central and enteric nervous systems. An expanding body of clinical evidence emphasizes that...
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The Therapeutic Potential of Cannabidiol in the Management of Temporomandibular Disorders and Orofacial Pain

Abstract Background: Temporomandibular disorders (TMDs) are a group of conditions affecting the temporomandibular joint (TMJ) and associated muscles, leading to pain, restricted jaw movement, and impaired quality of life. Conventional treatments, including physical therapy, medications, and surgical interventions, have varying degrees of success and potential side effects. Cannabidiol (CBD), a non-psychoactive component of cannabis, has gained attention for its anti-inflammatory, analgesic, and anxiolytic properties. This study explores the potential role of CBD in TMD management. Methods: A review of existing literature was conducted (2007–2024), focusing on preclinical and clinical studies assessing the efficacy of CBD in pain modulation, inflammation reduction, and muscle relaxation. Relevant studies...
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Efficacy and Safety of Transdermal Medical Cannabis (THC:CBD:CBN formula) to Treat Painful Diabetic Peripheral Neuropathy of Lower Extremities

Abstract Introduction: Diabetic peripheral neuropathy (DPN) represents a prevalent neurological complication affecting millions of patients globally. This clinical investigation evaluated the therapeutic efficacy and safety profile of a novel transdermal medical cannabis formulation (THC:CBD:CBN) in treating painful DPN of the lower extremities. Methods: This phase III, double-blind, placebo-controlled, randomized clinical trial was conducted at Don Chan Hospital, Thailand, enrolling 100 participants over a 12-week intervention period. Using a computer-generated randomization sequence, participants were allocated to receive either the standardized cannabis formulation or a matched placebo. The primary outcome measure comprised pain intensity assessment using the validated Thai version of the Neuropathic Pain Symptom Inventory (NPSI-T). Secondary outcomes...
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A cohort study comparing the effects of medical cannabis for anxiety patients with and without comorbid sleep disturbance

Abstract Background Research on cannabis-based medicinal products (CBMPs) in anxiety remains inconclusive due to a paucity of high-quality evidence. Studies indicate a bidirectional relationship between generalized anxiety disorder (GAD) and sleep disruption, but it is unclear how this affects CBMP treatment outcomes. This study aims to compare the patient-reported outcome measures (PROMs) of patients prescribed CBMPs for GAD, with and without impaired sleep. Methods Changes in PROMs were recorded from baseline to 1, 3, 6, and 12 months between those with impaired or unimpaired sleep. Multivariate logistic regression was applied to compare factors associated with a clinically significant improvement in GAD-7 at 12 months. Secondary outcomes...
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Medicinal cannabis extracts are neuroprotective against Aβ1–42-mediated toxicity in vitro

Abstract Background Phytocannabinoids inhibit the aggregation and neurotoxicity of the neurotoxic Alzheimer's disease protein β amyloid (Aβ). We characterised the capacity of five proprietary medical cannabis extracts, heated and non-heated, with varying ratios of cannabidiol and Δ9-tetrahydrocannabinol and their parent carboxylated compounds to protect against lipid peroxidation and Aβ-evoked neurotoxicity in PC12 cells. Methods Neuroprotection against lipid peroxidation and Aβ1–42-induced cytotoxicity was assessed using the thiazolyl blue tetrazolium bromide (MTT) assay. Transmission electron microscopy was used to visualise phytocannabinoid effects on Aβ1–42 aggregation and fluorescence microscopy. Results Tetrahydrocannabinol (THC)/tetrahydrocannabinolic acid (THCA)-predominant cannabis extracts demonstrated the most significant overall neuroprotection against Aβ1–42-induced loss of PC12 cell...
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Cannabinoids Used for Medical Purposes in Children and Adolescents A Systematic Review and Meta-Analysis

Please use this link to access this publication. Key Points Question  What is the adverse event profile of cannabinoids used for medical purposes in children and adolescents? Findings  In this systematic review and meta-analysis of 23 randomized clinical trials including 3612 participants, cannabinoids used for medical purposes in children and adolescents were associated with increased risk of adverse events, serious adverse events, and withdrawals due to adverse events compared with the control group. Meaning  The findings suggest that physicians considering cannabinoids for medical purposes in children and adolescents should weigh the risk and benefit profile of cannabinoids and available therapeutic options as well as the individual’s underlying...
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Characteristics for Medical Cannabis Treatment Adherence among Autistic Children and Their Families: A Mixed-Methods Analysis

Abstract Introduction: Medical cannabis treatment for autistic children has recently become popular, and studies have focused on examining the treatment’s effects on children’s symptom presentation, reported side effects, and dropout rates. However, no previous study has investigated the factors influencing adherence and dropout rates in cannabis treatment. Method: This explanatory sequential mixed-methods study explored these factors by examining the characteristics of 87 autistic children and their families and deepening parents’ perspectives and experiences of the 6-month CBD-rich cannabis treatment’s benefits and barriers. Results: We found this treatment to have a high (75%) adherence rate, relatively mild side effects, and substantial reported benefits for the children and families. However, this...
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