Thursday, August 9, 2018

Marijuana In Neurological disorders M.A.Aleem Trichy

Marijuana In Neurological disorders.

Dr.M.A.Aleem  M.D.D.M (Neuro)

Emeritus Professor
The Tamilnadu Dr.M.G.R. Medical University

Former President
Tamilnadu Pondycherry Association of Neurologists

Former Vice-Principal
KAPV Govt. Medical College and MGM Govt. Hospital.

Consultant Neurologist
ABC Hospital

Trichy 620018
Tamilnadu
India

drmaaleem@hotmail.com
Phone 9443159940

The use of Marijuana ( cannabis) for neurologic disease can be traced at least as far back as 1500–3000 BC, in the writings of Chinese Emperor Shen-Nuang. Much of the early use of this was for treatment of headaches, with first documentation of its use for this purpose was noted in 600 AD. 

Medicinal Marijuana was introduced to the West in the mid-1800s and usef for spasms in rabies and tetanus, infantile convulsions and it was also advocated in migraines in the early 1900s. 

Action site at Neuronal Axis

In Neuronal axis  cannabis acts presynaptically on endocannabinoid receptors, namely, CB1 and it modulate its functions.

The medical use of cannabis for the treatment of neurologic diseases is in raise in recent days.

Multiple Sclerosis

In neurological disorders  Multiple sclerosis has showed the most robust evidence for the efficacy of cannabis, primarily in subjective, and possibly objective, improvement in spasticity and spasms and pain.

Seizure Disorders

 Oral liquid formulation of plant-derived Cannabis can be  effective in seizure control in Dravet syndrome, Lennox-Gastaut syndrome, and neonatal hypoxic-ischemic encephalopathy. A recent presentation found that the liquid formulation in doses up to 25 mg/kg can reduce the seizure frequencies in multiple drug-resistant epilepsy syndromes and in some  seizure types.

Parkinson Disease

Clinical trials showed that the effect of cannabis on Parkinson disease is conflicting and poorly understood.It is ineffective in dyskinesias in parkinson disease. 

Headache

Cannabis can be useful to control migraine and other headaches but needs more clinical studies. 

Pain

Oral cannabis extract may be useful to reduce central neurogenic pain.

Bladder Disorders

Cannabinoids ( Nabiximols) is probably effective in certain urinary bladder disorders.

Until  recently cannabis is not showing promising results  in tremors Huntingdon disease Tourette syndrome and in cervical dystonia.

Side effects

 Acute use of cannabis has been shown to cause anxiety and panic, impaired attention/memory/psychomotor performance, increased chance of psychosis in those already predisposed, and tachycardia. 

Long-term effects are less well studied, but there is evidence of cannabis dependence, bronchitis, increased risk of  accidents, and the potential for mild withdrawal symptoms.here is no evidence cannabis use increases risk of cancer, leads to permanent psychiatric cognitive deficits, or can result in overdose.

Marijuana in India

It has a long history in India. The earliest mention of cannabis has been found in The Vedas the sacred Hindu texts. These writings may have been compiled as early as 2000 to 1400 B.C. 

In Indian society, common terms for Marijuana preparations include charas (resin), ganja (flower), and bhang (seeds and leaves).

The prevalence of abuse" of Marijuana in India is at or more than 3.2%.

According to the World Drug report 2016, the retail price of cannabis in India was US$0.10 per gram, the lowest of any country in the world. 

The medicinal uses of cannabis is also available in Sharngadhara Samhita (13th century) ancient Indian medical scripts.  

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