medicating restless leg patient with selected terpenes

[docesq]

a patient flies frequently for business, experiencing restless leg syndrome at high altitudes. he asks if I can formulate a cannabis medication for him and i'd appreciate any suggestions. he is on metoprolol selective b blocker for high blood pressure, Flecainide for irregular heartbeat, Eliquis for anticoagulant.  Understanding that CBD generally inactivate cytochrome P450 and thereby increases efficacy of his meds, plus relaxes arterial walls and may decrease blood pressure, I am hesitant to just formulate a sublingual tablet with CBD.  I can selectively add any terpenes to the tablets to modulate the effects and wonder if anyone has thoughts on which terpenes might be most useful?

thanks for any thoughts.

[Restorium2]

I would ask his cardiologist. You have some very serious conditions there and you have went way past where the science is. My experience with RLS is hit and miss with cannabis oil depending on the patient. I really don't think that selectively adding imitation terpenes does anything for RLS. Rule of thumb is to give the patient a tiny amount of cannabis oil in a controlled setting to see what works (not on an airplane). 

[t-pain]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480566/

Marijuana

There are no studies on marijuana for treating RLS, but there is considerable anecdotal evidence from patients as to its effectiveness. Typically, only 1 or 2 puffs of a marijuana cigarette or vaporizer is sufficient to relieve RLS symptoms. It is not clear how long the relief lasts, as most patients use this at bedtime, but they do report the very rapid disappearance of their symptoms, which then helps them fall asleep.

 

sorry thats all i got.

unfortunately there is very little research on the terps for any given condition. at best there are a few rat studies saying if a specific terp is anti-spasmodic. there are no studies on combination terpene therapies.

so my advice would be to check all of the folk/chinese medicine books about which herbs help with spasticity / RLS and then find out which terpenes are in those herbs, and then formulate something based on all of that, possibly only

in my personal opinion , i do not like all of this terpene play that people are doing now. people say they add terpenes to hash oil ? i dont get it, and i do not like it..

of course, this is not medical advice and , like resto says, any number of these herbs and terpenes could cause serious adverse reactions in heart patients. while cannabis is safe and non toxic, the same cannot be said about other herbs, especially when you start mixing your own concoctions. be safe and do no harm, not a snake oil salesman.

 

and heres what the internet says:

https://popnaturals.com/know-your-medicine/

THCA, THC, CBD, Mycrene are anti spasmodic

 

https://www.ncbi.nlm.nih.gov/books/NBK224382/

 

7MARIJUANA AND MUSCLE SPASTICITY

Coping with stiff, aching, cramping muscles is a way of life for most of the 2.5 million people in the world who have multiple sclerosis. Many of the 15 million people with spinal cord injuries also suffer from the same symptoms, which cause pain, limit movement, and rob people of needed sleep. Although several conventional medications can reduce these patients' discomfort, taking them rarely provides complete relief. Often the drugs cause weakness, drowsiness, and other side effects that some patients find intolerable.

Given this outlook, it is not hard to understand why some people with multiple sclerosis and spinal cord injuries have sought relief through marijuana. Several such patients told the IOM team that their muscle spasms decreased after smoking marijuana (see Chapter 2). Some also said they valued the drug because it relieved nausea or helped them sleep. Likewise, in a 1982 survey of people with spinal cord injuries, 21 of 43 respondents reported that marijuana reduced muscle spasticity¹ (a condition in which muscles tense reflexively and resist stretching), while nearly every participant in a 1997 survey of 112 regular marijuana users with multiple sclerosis replied that the drug lessened both pain and spasticity.² This is not to say that most people with multiple sclerosis find relief with marijuana but only that the marijuana users among them do.

Animal research, too, suggests that marijuana calms muscle spasticity. Spasms are thought to originate in areas of the brain that control movement, including several sites with abundant cannabinoid receptors. In one experiment, researchers found that rodents became more animated under the influence of small amounts of cannabinoids but less active when they received larger doses. Many marijuana users also note that the drug affects movement, making their bodies sway and their hands unsteady. The exact mechanism(s) by which cannabinoids exert these effects remains unknown.

Despite these suggestive findings and the depth of anecdotal evidence, marijuana's antispasmodic properties remain largely untested in the clinic. The few existing reports are extremely limited in scope; for example, none of the studies discussed in this chapter included more than 13 patients, and some were conducted on a single patient. Also, in several cases the patients' subjective evaluations of improvement contrasted with objective measures of their physical performance. Still, the lack of good universally effective medicine for muscle spasticity is a compelling reason to continue exploring cannabinoid drugs in the clinic.

 

 

there are some expensive terpene books on the subject, i do not have a list.

Terpenes—Advances in Research and Application

 

[Sharoniousphunk]

I have RLS. I work in a medical marijuana dispensary and thank god I do!!  I’ve smoked everything we have on the wall and the Terpenes that help me the most are terpinoline, limonene,  and linalool. Some indicas heavy in caryophellene make it worse, even though it can be found in strains that do help. There are two strains that I smoke that help the best! The 3 main Terpenes in both of these strains are limonene, caryophellene and linalool in both strains and one is a sativa and the other is an indica dominate. Terpinoline, found in strains like Jack Herer, help when I have an RLS attack during the day and I don’t want to be too spaced out or tired. But the limonene, which I have in both sativa and indica strains help me tremendously, and I smoke those at night. Linalool isn’t normally a main terpene (Ocimene is another good one that helps), but I know it helps people with epilepsy and seizures, so I wonder if that is a nice component that is helping me keep still! Having a head high and RLS seems to be the key for me and help way better than strains that just offer the body high. I also believe I have ADHD, as well, and limonene cuts the chatter off in my brain and just gives me overall frontal lobe relief. 

[Wild Bill]

18 hours ago, Sharoniousphunk said:

... the Terpenes that help me the most are terpinoline, limonene,  and linalool.

I've also found that strains with a citrus flavor seem to help the most with pain. Indicas are normally what is recommended but I've generally found that sativas help me the most.