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Peter Kwong
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the planet. How China's
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The International Cannabinoid Research
Society held its 16th annual meeting June 24-28 at a hotel on
the shores of Lake Balaton, about 80 miles southwest of Budapest.
Most of the 350 registrants were scientists -chemists, pharmacologists-
employed by universities and/or drug companies. The sponsor given
top billing was Sanofi-Aventis, manufacturer of a synthetic drug,
known variously as "SR-141716A," "Rimonabant,"
and "Acomplia," that blocks cannabinoid receptors in
the brain. Additional support came from Allergan, AstraZeneca,
Bristol-Meyers Squibb, Cayman Chemical, Eli Lilly, Elsohly Laboratories,
Merck, Pfizer, two Hungarian companies -Gedeon Richter Pharmaceutical
and Sigma-Aldrich- and G.W. Pharmaceuticals. Researchers affiliated
with other drug companies presented papers and posters and audited
the proceedings. For most the holy grail is a product that will
exert the beneficial effects of cannabis without that bad side-effect
known as "euphoria."
It so happened that on the
next-to-last day of the ICRS meeting, Sanofi got approval to
start selling its cannabinoid-receptor blocker in England as
an anti-obesity pill. R. Stephen Ellis, MD -one of two California
doctors in attendance- informally asked Sanofi researchers what
happens when a Rimonabant/Acomplia user ingests external THC
-i.e., smokes a joint? Apparently, the company hasn't studied
the interaction. "If this drug becomes the blockbuster they
anticipate," says Ellis, "We are going to be seeing
many, many patients who use cannabis for, say, chronic pain and
take Rimonabant to lose weight. Will the beneficial effects be
negated? Will they require different dosages? Probably -because
there will be two molecules, THC and Rimonabant, competing for
the same receptor sites." According to the pharmacologists,
Rimonabant will outcompete THC, but not shut it out completely.
Sanofi reps said they expect
U.S. approval for Rimonabant/Acomplia by next spring, maybe sooner,
and Bloomberg News quotes stock analysts who foresee $5.5 billion
in annual sales. (Sanofi may use the name "Zimulti"
in the U.S.) Although company spokespersons are careful to say
the cannabinoid-antagonist drug is for obese patients with diabetes
and/or high cholesterol, it will be prescribed to countless millions
of people who want to lose a few pounds. Some 13,000 people have
taken Rimonbant in clinical trials. In the largest trial, subjects
lost 14 pounds the first year and 2.4 pounds the second year.
But they gained the weight back when they stopped taking the
drug, implying that you have to take it as long as you live to
maintain the effect.
As the involvement of so many
corporate labs in the ICRS suggests, many more drugs that exert
effects via the body's endocannabinoid system will be introduced
in the years ahead. T.M. Fong of Merck enthusiastically described
his team's discovery of a new "inverse agonist" that
led to "food intake reduction and weight loss" in mice
and rats. Competition for Rimonabant/Acomplia/Zimulti is already
in the pipeline.
The attitude of ICRS scientists
towards Rimonabant is surprisingly fearless. Esther Fride of
the College of Jedea and Samaria presented a paper that flatly
asserted "cannabinoid CB1 receptor antagonists induce weight
loss without undesirable side effects." The paper was entitled
"Undesirable Weight Gain Caused by Prolonged Use of Anti-Depressant
Medication May be Prevented With Rimonabant Without Loss of Antidepressant
Effectiveness." Fride and co-author Nikolai Gobshtis worked
with mice and rats, using a measure of depression known as the
"forced-swim test" in which swimming and struggling
are supposedly good signs, floating a sign of giving up (depression).
The bottom line to the consumer: if you're gaining weight on
Prozac ("After short term weight loss," Fride noted,
"antidepressant medication, when administered for prolonged
periods, often induces weight gain"), you can take Rimonabant.
We'll provide more news from
the ICRS meeting in future dispatches -including encouraging
findings by Donald Abrams, MD, re vaporization and results from
a Canadian study in which 13 of 14 patients who used G.W.'s Sativex
for severe pain and spasticity reported relief (mild to very
good). It was my sad honor to stand by and answer questions about
a poster by Tod Mikuriya, MD, who canceled his planned trip to
Hungary for health reasons Meanwhile back in California the DEA
has sent an extraordinary letter of complaint to the Medical
Board of California, alleging that four doctors in the San Diego
area have been approving cannabis use for conditions that they
-the DEA agents- don't consider sufficiently grave. The Board
has initiated investigations based on the complaint. The reality
is, doctors who know something about how the cannabinoid system
works are going to be far better suited than their uneducated
counterparts to monitor and treat a population in which millions
are taking Rimonabant/Acomplia and its inevitable imitators.
Fred Gardner is the editor of O'Shaughnessy's
Journal of the California Cannabis Research Medical Group. He
can be reached at: fred@plebesite.com
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