What is Sativex?
Sativex (Delta-9 tetrahydrocannabinol and cannabidiol) is a combination drug that contains a roughly one-to-one ratio of Delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD), the two most active cannabinoids in marijuana.
“Cannabinoid” is the family of chemicals the two drugs belongs to. Cannabinoids are named after the cannabis plant from which manufacturers distil Sativex, and also the body’s endocannabinoid system, which is the neurochemical signaling system THC, CBD and other less potent cannabinoids in marijuana affect.
Sativex is approved for prescription in the United Kingdom, but not in the U.S.
Sativex appears to be cleverly named after the Cannabis Sativa plant variety.
What is Sativex used for?
The UK’s Medicines and Healthcare Products Regulatory Agency — similar to the U.S. Food and Drug Administration — approved Sativex to treat spastic symptoms of multiple sclerosis (MS).
The drug has been tested on a number of other conditions in various clinical studies, however. Researchers have explored its use as a sleep aid for people suffering post-traumatic stress disorder (PTSD), chronic cancer pain that opioids can’t control, and to control nausea and vomiting in chemotherapy recipients to varying degrees of success.
How does Sativex work?
THC and CBD are the main psychoactive ingredients in cannabis. Both interact with the body’s endocannabinoid system to produce changes in mood, perception, and appetite as well as a therapeutic reduction in spastic symptoms of MS.
The endocannabinoid system is a series of cannabinoid receptors, called CB1 and CB2, that sit on the terminal ends of neurons throughout the brain and body. The system also includes the specific cannabinoid chemicals the body makes to fit into the cannabinoid receptors like keys in locks.
The endocannabinoid system helps regulate the propagation of all sorts of different impulses, aside from the MS symptoms Sativex is approved to treat.
The THC and CBD chemicals in whole marijuana mimic anandamide (AEA) and 2-Arachidonoylglycerol (2-AG), which are two endocannabinoid chemicals your body produces naturally. These two neurotransmitter chemicals fit into CB1 and CB2 receptors in the brain and immune system, kicking off a cascade of physiological processes that keep your nervous and immune systems running smoothly.
THC and CBD also fit into CB1 and CB2 receptors, but not as “tightly” as AEA and 2-AG, leading to the shift in perception and mood described as a marijuana high. This means the two chemicals in Sativex are “partial agonists” for the endocannabinoid receptors: they activate the receptors, but not as fully as naturally-occurring cannabinoids, which leads to different effects on the nervous system.
What are the side effects of Sativex?
WARNING: Patients taking Sativex should not drive a vehicle or operate heavy machinery, drink alcohol, smoke marijuana or use recreational drugs while taking the drug.
Patients with a history of substance abuse problems, serious cardiovascular disease, seizures, a history of schizophrenia or bipolar disorder, or who are already taking muscle relaxers should not receive the drug.
Dizziness and fatigue are the two most common side effects of the drug.
Some other side effects include:
- mood changes,
- paranoid ideas
- disorientation (or confusion),
- delusional beliefs,
- transient psychotic reactions,
- suicidal ideation, in rare cases.
In any of these circumstances stop taking Sativex immediately and monitor until the symptoms go away.
This is not a full list of potential side effects; you should consult your doctor if you are prescribed the drug to find out all the potential adverse reactions and potentially harmful drug interactions.
What is the Sativex dosage?
Each 100 microlitre spray contains 2.7mg THC and 2.5mg CBD. The patient will have to spend up to two weeks adjusting the number of sprays to figure out the optimal dose. Patients should limit themselves to 12 sprays per day with a minimum of 15 minutes between sprays.
Can I get addicted to Sativex?
Dependence is unlikely, but people with a history of substance abuse may be more likely to abuse it. Withdrawal symptoms tend to be mild and include sleep problems and reduced appetite, among other issues. These tend to resolve within a couple days.
What else should I know about Sativex?
Sativex is researched and developed by GW Pharmaceuticals, a surprisingly pro-cannabis-legislation company.
The drug was no more effective than a placebo at treating severe cancer pain in a late-phase clinical trial in 2015, but researchers hope they can still use it for this purpose in certain responsive populations.
PREGNANCY SAFETY: Sativex hasn’t been studied in pregnant or nursing mothers, so you should probably avoid it in those situations.
Sativex is excreted in breast milk and passed along to breastfeeding babies, so either don’t take the drug or switch to infant formula if you are nursing.