- Endocannabinoids vs. Phytocannabinoids
What is the endocannabinoid system?
The endocannabinoid system (ECS) is a complex nerve cell signaling system that modulates the central nervous system’s function and helps maintain homeostasis. Homeostasis is the state of equilibrium in the body in which all the organs function optimally, maintaining physiological, cognitive and emotional balance.
The endocannabinoid system is made up of three key components:
- Endocannabinoids: Chemical compounds that carry signals between nerve cells (neurotransmitters). The two main identified endocannabinoids are:
- Anandamide (AEA)
- 2-Arachidonoylglycerol (2-AG)
- Endocannabinoid receptors: Proteins embedded on the cell membrane which bind to the endocannabinoids and react, initiating neural activity. The two main identified endocannabinoid receptors are:
- Endocannabinoid recycling: Enzymes in the nerve cells break down the endocannabinoids back into their components for reuse when the next neurotransmission is required. The two principle enzymes found in the endocannabinoid system are:
- Fatty acid amide hydrolase (FAAH) that breaks down AEA
- Monoacylglycerol lipase (MAGL) that breaks down 2-AG
What are endocannabinoids?
“Endocannabinoid” derives its name from phytocannabinoids -- “phyto” meaning “plant-based” -- a class of psychoactive substances first discovered in Cannabis sativa (marijuana) plants. Endocannabinoids are cannabis-like compounds naturally produced by the body in the nerve cells.
Two endocannabinoids, AEA and 2-AG and their functions have been studied to a great extent. Several more endocannabinoids have been discovered, though their functions and roles in the endocannabinoid system are yet to be determined.
How are endocannabinoids released?
Unlike other neurotransmitters, endocannabinoids are not stored in the nerve cells. Endocannabinoid precursors are present in the fat molecules in the cell membrane and are released upon demand, when the endocannabinoid receptors are activated.
What is the function of endocannabinoids?
Endocannabinoid receptors are concentrated in the brain, but are also present in nerve tissues all over the body. When a condition such as injury, fever or infection disrupts the body’s homeostasis, the endocannabinoid system helps restore the body’s homeostasis.
The endocannabinoid system plays a significant role in the normal functioning of the body’s systems that include:
- Central nervous system
- Cardiovascular system
- Gastrointestinal system
- Reproductive system
- Skeletal system
- Immune system
- Metabolic processes
The endocannabinoid system is an important mediator in regulating:
The functions of the endocannabinoid system are not fully understood. Some studies suggest endocannabinoid deficiency and a disturbed homeostasis may be the cause for certain diseases such as migraine, fibromyalgia and irritable bowel syndrome. Research continues on the gamut of roles endocannabinoids play, and their potential therapeutic uses.
What are the therapeutic uses of cannabinoids?
The Cannabis sativa plant contains hundreds of compounds. Two of them, tetrahydrocannabinol (THC) and cannabidiol (CBD), bind to the human endocannabinoid receptors CB1-R and CB2-R. Both THC and CBD have medical benefits, but only THC produces euphoric effects.
The cannabis plant contains other minor cannabinoids that interact with the human endocannabinoid system, but their effects are far weaker and they are present in lower concentrations.
Medications can target the ECS therapeutically in two ways:
- Cannabinoid receptor agonists: These drugs bind to the CB1-R and CB2-R and stimulate their activity (for example, CBD).
- Cannabinoid receptor antagonists: These drugs are used to suppress cannabinoid receptor activity (for example, rimonabant).
The potential therapeutic uses for cannabinoids include:
- Pain management
- Neurologic diseases such as:
- Psychiatric disorders such as:
- Anxiety disorders
- Bipolar disorder
- Personality disorders
- Attention deficit and hyperactivity disorder
- Substance abuse and addictions
- Anorexia nervosa
- Atherosclerosis (plaque buildup in the artery walls)
- Gastrointestinal conditions such as:
- Alcoholic and chronic liver diseases
- Gut motility disorder
- Inflammatory bowel syndrome
- Diabetic nephropathy (diabetes-related kidney disease)
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What are the FDA-approved cannabinoid drugs?
Currently, medical use of cannabis is legal in 29 states. Three cannabinoid receptor agonist drugs are approved by FDA.
Approved for use as
- Antiemetic (anti-nausea and vomiting) for chemotherapy
- Appetite stimulant for people with acquired immunodeficiency syndrome (AIDS)
Side effects include:
- Feeling high
- Nausea and vomiting
- Abdominal pain
- Central nervous system toxicity
Antiemetic for chemotherapy when other therapies are unsuccessful
Side effects include:
The FDA in 2018 approved this first-ever CBD-based drug for childhood seizure disorders like Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) in patients 2 years of age and older.
Side effects include:
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Symptoms unique to migraine and migraine auras are water retention, problems sleeping, appetite changes, and talkativeness. Symptoms unique to seizure and seizures auras are depression, a feeling of heaviness, a feeling that a seizure is approaching, and depression.
Many of the symptoms of migraine and seizures are the same, however, seizures do not cause migraines; however, people who have seizures are twice as likely to have migraines and vice-versa. People who have migraines are twice as likely to have seizures, and people with seizures are twice as likely to have migraines; however, one condition does not cause the other.
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Seizure vs. Seizure Disorders (Differences and Similarities)
The differences between a seizure, epilepsy, and seizure disorders are confusing to many people. What makes it more confusing, is that they are not the same thing. A seizure begins suddenly, and is a symptom of another disease. When a seizure occurs there is uncontrolled activity in the brain that usually only lasts for a short period. While a seizure disorder is a medical condition, in which the person has episodes of uncontrolled activity in the brain producing symptoms that include one or more seizures. Epilepsy is considered a seizure disorder.
There are two types of major seizures, generalized and partial seizure type and the symptoms depend upon the part of the brain affected, and may include:
- Loss of consciousness
- Thought disturbances
- Eye rolling
- Stiff limbs
- Twitching on only one side or a portion of the body like an arm or leg.
- Involuntary urination or bowel movement
- Repetitive shaking or jerking of the body
- Staring into space, sometimes with eye blinking
- No loss of consciousness, but the person becomes confused for a few minutes
A third type of seizure is called unclassified seizure.
Seizure disorders are classified under two types of major seizures (generalized and partial), and a third type called unclassified seizures. There are about 40 types of named seizure disorders. The symptoms and signs are different depending on the part of the brain affected by the seizure. Examples of seizure disorders are:
- Febrile seizures
- Benign Rolandic epilepsy
- Catamenial epilepsy
- Absence seizures
- Frontal lobe epilepsy
Sometimes there is a known cause for a seizure like alcohol, cocaine or other illegal drug abuse, drug reactions, a severe chemical imbalance in the blood, or medical problems like low blood pressure. Treatment, management, and prevention of seizures include medication and avoiding any known causes or common triggers.
CDC. "Types of Seizures." Updated: Apr 10, 2017.
Harvard Health Publications; Harvard Medical School. "Generalized Seizures (Grand Mal Seizures)."
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