Appetite cannabinoids

Standardised preparations of cannabinoid agonists are available for therapeutic use in some countries [238]. Dronabinol (Marinol ), an oral preparation of A -THC (67), is used clinically as an appetite stimulant in AIDS patients and an antiemetic in cancer chemotherapy. A synthetic analogue of (67), nabilone (Cesamet ), (381), is also used to suppress nausea and vomiting in cancer chemotherapy. 

Much debate has been waged over medicinal uses of cannabis. Several therapeutic uses have been proposed, including antiemetic, analgesic, appetite stimulant, and muscle relaxant. A synthetic cannabinoid, dronabinol (Marinol) has been marketed for clinical treatment of appetite loss, nausea, and vomiting. Although synthetic, it is identical to the main psychoactive chemical constituent of cannabis (A9-THC). 

Cannabinoids produced positive results for treatment of AIDS-related anorexia. Positive results of open trials were later confirmed with methodologically controlled studies. Dronabinol (2.5 mg PO twice daily) produced consistent and substantial improvement in appetite in patients with AIDS (Beal et al. 1995, 1997). Patients also reported improved... 

Colombo G, Agabio R, Diaz G, Lobina C, Reali R, Gessa GL. (1998). Appetite suppression and weight loss after the cannabinoid antagonist SR 141716. Life Sci. 63(8) PL113-17. 

Mattes RD, Engelman K, Shaw LM, Elsohly MA. (1994). Cannabinoids and appetite stimulation. Pharmacol Biochem Behav. 49(1) 187-95. 

THC-Delta 9-tetrahydro-cannabinol (cannabis) Cannabinoid receptor Relaxation, euphoria, and enhancement of senses, increase in appetite, sense of time... 

Increased appetite is frequently attributed to smoking marijuana. Cannabinoids are effective antiemetics, particularly in treating emesis arising during chemotherapy. A -THC has been reported to be as effective as codeine as an analgesic, although pronounced behavioral effects occur with analgesic doses. 

THC was first isolated from hashish in 1964 by Raphael Mechoulam (1930-) and Yehiel Gaoni at the Weizmann Institute. Mechoulam had obtained 5 kg hashish from Israeli police officials and the earliest scientific work on THC and cannabinoids used this source. In the early 1990s, the specific brain receptors affected by THC were identified. These receptors are activated by a cannabinoid neurotransmitter called arachidonylethanolamide, known as anandamide. Anandamide was named by Mechoulam using ananda, which is the Sanskrit word for ecstasy. Anandamide is thought to be associated with memory, pain, depression, and appetite. THC is able to attach to and activate anandamide receptors. These receptors are actually called THC receptors rather than anandamide receptors because researchers discovered that THC attaches to these receptors before anandamide was discovered. The areas of the brain with the most THC receptors are the cerebellum, the cerebral cortex, and the limbic system. This is why marijuana affects thinking, memory, sensory perception, and coordination. 

However A9-tetrahydrocannabinol anatagonizes the peripheral CB2 receptor while acting as an agonist for the CNS CB1 receptor [133]. Cannabinoid receptors mediate the appetite stimulant and psychoactive effects of cannabinoids which have therapeutic potential for relief from nausea and pain [132]. 

Similar to opioids, the cannabinoid system appears to be intricately involved in normal physiology, specifically in the control of movement, formation of memories, and appetite control. Basic research has discovered that members of this family of compounds have the capacity to protect threatened neurons, thereby slowing neurodegenerative processes that ultimately lead to physical disability. As the function of the physiological role of endocannabinoids becomes clearer, it appears the system may be involved in the pathology of several neurological diseases, specifically multiple sclerosis, spasticity, and pain. In 1999 the German journal, Forschende Komplementar-medizin und Klassische Naturheilkunde (Research in Complementary and Classical Natural Medicine) commented ... 

Institute of Medicine (IOM), a branch of the National Academy of Sciences, publishes the report Marijuana Assessing the Science Base, which concluded that cannabinoids showed significant promise as analgesics, appetite stimulants, and anti-emetics, and that further research into producing these medicines was warranted. 

Cannabinoid receptors include the CB1 receptors (which have a high incidence in the CNS and inhibit adenylyl cyclase, close Ca2+ channels and open K+ channels via Gai) and CB2 receptors (which are present in immune cells and act via Gai proteins to inhibit adenylyl cyclase). CB1 and CB2 receptors bind the endogenous ligand anandamide (arachi-donylethanolamide) as well as A9-tetrahydroc.annabinol from marijuana (Cannabis saliva). A9-Tetrahydroc,annabinol antagonizes the peripheral CB2 receptor but acts as an agonist for the CNS CB1 receptor. Cannabinoid receptor agonists have appetite stimulant and psychoactive effects and have therapeutic potential for relief from nausea and pain. 

Rimonabant inhibits the CB1 cannabinoid receptor. It reduces appetite. It has a high risk of precipitating depression and, at the time of writing, NICE (the UK s regulatory authority) is considering advising its withdrawal from the market. 

Nabilone is a synthetic cannabinoid and has properties similar to tetrahydrocannabinol (the active constituent of marijuana) which has an antiemetic action. It is used to relieve nausea or vomiting caused by cytotoxic drugs. Adverse effects include somnolence, dry mouth, decreased appetite, dizziness, euphoria, dysphoria, postural hypotension, confusion and psychosis. These may be reduced if prochlorperazine is given concomitantly. 

Delta-9-THC and some synthetic analogs are used therapeutically, for example, for nausea and vomiting produced by antineoplastic chemotherapy, analgesic, anticonvulsant for epilepsy, anti-inflammatory agent, appetite stimulant for patients with AIDS, as well as treatment for conditions such as asthma and glaucoma. Synthetic cannabinoids used therapeutically include dronabinol, nabilone, and levonamtradol. 

It is of note that in some embodiments, the specific cannabinoids isolated are those cannabinoids with suspected health benefits or suspected medicinal uses. For example, the cannabinoids and cannflavins may be used as anti-emetics, antinauseants, appetite stimulants, antiinflammatories, antioxidants, neuroprotectives, analgesics, suppressants for primary immune response, glaucoma remedies, antineoplastics, migraine headache remedies, menstrual pain remedies, anticonvulsants, anti-epileptics, or movement disorder remedies. The essential oils may be used for aromatherapy or as flavoring/scenting adjuvants. 

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