nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2020-4-125-130nnp-1422Research ArticleREVIEWSОБЗОРЫThe use of cannabinoids in epilepsy as an example: medical, social, and legal aspectsПрименение каннабиноидов на примере эпилепсии: медицинские, социальные и юридические аспектыАкжигитовР. Г.AkzhigitovR. G.

Ренат Гаясович Акжигитов

115419, Москва, ул. Донская, 43

Renat Gayasovich Akzhigitov

43, Donskaya St., Moscow 115419

barms@yandex.ruПочигаеваК. И.PochigayevaK. I.

115419, Москва, ул. Донская, 43

43, Donskaya St., Moscow 115419

РидерФ. К.RiderF. K.

115419, Москва, ул. Донская, 43

43, Donskaya St., Moscow 115419

ТеплышоваА. М.TeplyshovaA. M.

115419, Москва, ул. Донская, 43

43, Donskaya St., Moscow 115419

ДедаевС. И.DedayevS. I.

115419, Москва, ул. Донская, 43

43, Donskaya St., Moscow 115419

ШпакИ. А.ShpakI. A.

115419, Москва, ул. Донская, 43

43, Donskaya St., Moscow 115419

ПашнинЕ. В.PashninE. V.

115419, Москва, ул. Донская, 43

43, Donskaya St., Moscow 115419

ГехтА. Б.GekhtA. B.

115419, Москва, ул. Донская, 43117997, Москва, ул. Островитянова, 1

43, Donskaya St., Moscow 1154191, Ostrovityanov St., Moscow 117997

ГБУЗ «Научно-практический психоневрологический центр им. З.П. Соловьева» Департамента здравоохранения г. МосквыРоссияZ.P. Solovyev Research and Practical Psychoneurology Center, Moscow Healthcare DepartmentRussian FederationГБУЗ «Научно-практический психоневрологический центр им. З.П. Соловьева» Департамента здравоохранения г. Москвы; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияZ.P. Solovyev Research and Practical Psychoneurology Center, Moscow Healthcare Department; N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaRussian Federation202027082020124125130Copyright © Akzhigitov R.G., Pochigayeva K.I., Rider F.K., Teplyshova A.M., Dedayev S.I., Shpak I.A., Pashnin E.V., Gekht A.B., 20202020Акжигитов Р.Г., Почигаева К.И., Ридер Ф.К., Теплышова А.М., Дедаев С.И., Шпак И.А., Пашнин Е.В., Гехт А.Б.Akzhigitov R.G., Pochigayeva K.I., Rider F.K., Teplyshova A.M., Dedayev S.I., Shpak I.A., Pashnin E.V., Gekht A.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1422

The review provides historical information on the medical use of cannabinoids from antiquity to the present day. It presents the most common indications for their use in neurology, oncology, and psychiatry for the treatment of social diseases, such as epilepsy, pain syndromes, spasticity, including multiple sclerosis, Parkinson's disease, depression, schizophrenia, dementia, etc. There are data of the largest-scale and evidence-based studies using cannabinoids to treat epilepsy. The paper depicts the main mechanisms of action of these drugs and gives information about their efficacy and safety, as well as possible adverse events. Limitations and legal aspects are discussed. Systematic reviews and meta-analyses show that today there have been sufficient positive study results worldwide, indicating the validity of the medical use of cannabinoids. At the same time, experimental and clinical studies are needed to further investigate the mechanisms of action of cannabinoids, the characteristics of their pharmacokinetics and pharmacodynamics, efficacy and safety for many severe and disabling diseases.

В обзоре приведены исторические сведения о медицинском использовании каннабиноидов от древности до наших дней. Представлены наиболее часто встречающиеся показания к их применению в неврологии, онкологии и психиатрии для лечения таких социально значимых заболеваний, как эпилепсия, болевые синдромы, спастичность, в том числе при рассеянном склерозе, болезни Паркинсона, депрессии, шизофрении, деменции и др. Отражены данные наиболее масштабных и доказательных исследований применения каннабиноидов для лечения эпилепсии. Представлены основные механизмы действия этих препаратов, сведения об эффективности и безопасности, возможных нежелательных явлениях. Обсуждаются ограничения и юридические аспекты. Как показывают данные систематических обзоров и метаанализов, на сегодняшний день в мире накоплено достаточно положительных результатов исследований, которые свидетельствуют об обоснованности медицинского применения каннабиноидов. Вместе с тем необходимы экспериментальные и клинические работы по дальнейшему изучению механизмов их действия, особенностей фармакокинетики и фармакодинамики, их эффективности и безопасности при многих тяжелых и инвалидизирующих заболеваниях.

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The authors declare that there are no conflicts of interest present.