Cannabinoids for clinicians: the rise and fall of the cannabinoid antagonists.

Full Abstract

The endocannabinoid system has emerged as a significant player in the control of energy balance and metabolism, through its direct central and peripheral effects, as well as via its interaction with other appetite-regulating pathways. There is mounting evidence that the endocannabinoid system is overactive in obesity and were it possible to safely dampen-down the elevated endocannabinoid tone, lipid and carbohydrate profiles could be improved and weight loss induced. The series of randomised clinical trials showed reproducible beneficial effects on weight, HbA1c and lipid parameters, in addition to other cardiovascular risk factors. However, to date, clinical developments have been halted because of psychiatric side effects. Although recent evidence has highlighted the importance of an appetite-independent, peripheral mode of action, it is still unclear whether selectively blocking the peripheral system could potentially solve the problem of the central side effects, which thus far has led to the demise of the cannabinoid antagonists as useful pharmaceuticals. In this concise review, we summarise the data on the metabolic effects of the cannabinoid pathway and its antagonists.

Author information

Author/s: Butler, Helen (H); Korbonits, Márta (M);

Affiliation: Department of Endocrinology, Barts and the London School of Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.

Grants: 081922/Z/07/Z (Agency:Wellcome Trust)

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review

Journal: European journal of endocrinology / European Federation of Endocrine Societies (Eur J Endocrinol), published in England. (Language: eng)

Reference: 2009-Nov; vol 161 (issue 5) : pp 655-62

Dates: Created 2009/10/16; Completed 2009/11/13;

PMID: 19729432, status: MEDLINE (last retrieved date: 11/15/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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