Abstract

Cannabis has been used for centuries for therapeutic purposes. In the last century, the plant was demonized due to its high abuse liability and supposedly insufficient health benefits. However, recent decriminalization policies and new scientific evidence have increased the interest in cannabis therapeutic potential of cannabis and paved the way for the release of marketing authorizations for cannabis-based products. Although several synthetic and standardized products are currently available on the market, patients’ preferences lean towards herbal preparations, because they are easy to handle and self-administer. A literature search was conducted on multidisciplinary research databases and international agencies or institutional websites. Despite the growing popularity of medical cannabis, little data is available on the chemical composition and preparation methods of medical cannabis extracts. The authors hereby report the most common cannabis preparations, presenting their medical indications, routes of administration and recommended dosages. A practical and helpful guide for prescribing doctors is provided, including suggested posology, titration strategies and cannabinoid amounts in herbal preparations obtained from different sources of medical cannabis.

Highlights

  • The medical use of preparations derived from Cannabis sativa L. has a long history [1,2]

  • We aim to describe and detail the different herbal cannabis preparations currently available to treat neuropathic pain associated with different pathologies and movement disorders, such as Tourette syndrome and Parkinson’s disease

  • The term “herbal cannabis” refers to dried harvested female flowering tops, which contain the highest concentrations of cannabinoids, mainly THC, CBD, cannabigerol (CBG), cannabichromene (CBC), cannabidivarin (CBDV) and tetrahydrocannabivarin (THCV), together with their non-psychoactive carboxylated forms [31,32]

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Summary

Introduction

The medical use of preparations derived from Cannabis sativa L. has a long history [1,2]. In Asia, mainly in China and India, cannabis has been used for centuries for religious and medical purposes to treat neuralgias, convulsions, migraines [3,4], rheumatic pain, intestinal constipation, sexual disorders [4], asthma, malaria [5] and gout [3,4,5]. From the 19th century onwards, cannabis use became very popular in Europe and America [3], and the plant entered Western pharmacopoeias as a medical remedy [6]. Tinctures and other preparations were used to treat various disorders including convulsions in infants, tetanus, migraine, enteralgia, neuralgia, insomnia and hysteria [3,7].

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