A BREAKTHROUGH AGAINST SCHIZOPHRENIA?

It would be a mistake,as Daniele Poimelli, one of the principal researchers
in this work at the University of California, Irvine, reminded us Wednesday,
to read too much into this preliminary finding or to expect a miracle cure.
But the discovery of elevated levels of anandamide, a chemical produced in
the body that acts in a fashion similar to cannabis, in the cerebrospinal
fluid of schizophrenic patients could point the way toward more effective
and less dangerous treatments for schizophrenia and other mental disorders.

We're dealing with hypotheses here, and as Mr. Piomelli was quick to remind
us, in science most hypotheses turn out to be false or at least to require
substantial refinement. But here's why this research is so interesting.

In 1988, as the recent Institute of Medicine report on medical marijuana
pointed out, researchers discovered cannabinoid receptors in the human
brain - proteins that naturally bind to cannabinoids like THC, the
best-understood active ingredient in marijuana. In 1992 researchers
discovered anandamides - a naturally occurring substance produced in the
body (thus endogenous) that acts on cannabinoid receptors in a similar way
to THC.

It is believed that anandamide and the cannabinoid receptors are involved in
pain control, motion control and the immune system, but research is in its
infancy. Mr. Piomelli and his team at UC Irvine discovered some time ago
that anandamide "puts the brakes" on dopamine in the brain. Researchers have
long believed that excessive dopamine activity is associated with
schizophrenia.

So Mr. Piomelli's team studied 10 schizophrenic patients against a control
group and found dramatically elevated levels of anandamide. That could mean
the body has produced extra anandamide to cope with or to mediate excess
dopamine production. The implication is that if a drug could inject
anandamide or stimulate anandamide production it might be more effective
than dopamine blocking drugs used for 40 years to treat schizophrenia. Some
current treatments have horrendous side effects as well.

Whether that research pans out or not, the research now points to the
endogenous cannabinoid system as a hopeful locus of treatment not only for
schizophrenia but for other forms of psychosis.

That doesn't mean schizophrenics should start smoking marijuana. In fact,
while some patients report symptomatic relief from smoking, Mr. Piomelli
warns that it is not uncommon for schizophrenics who begin smoking marijuana
to continue in a heavy binge-like fashion until a psychotic episode comes
on.

But marijuana-like compounds, or perhaps compounds found in marijuana, could
eventually be a key to more effective treatment for schizophrenia. "The
idea," as Mr. Piomelli put it, "is to develop novel medicines that use
marijuana as a model - without the side effects. We want to activate some of
the cannabinoid receptors in the brain without producing the high, the loss
of memory and the lack of motor coordination."

This research highlights the importance of changing the legal status of
marijuana as quickly as possible. California and five other states have
passed laws allowing the use of marijuana by patients with a doctor's
recommendation.

But at the federal level, marijuana remains - inappropriately and probably
illegally - on Schedule I, reserved for uniquely dangerous drugs with no
known medical uses.

Only the federal government can legally supply the plant for medical
research projects, and it has done so only rarely.

As the Institute of Medicine report and the UC Irvine studies suggest,
cannabis has medical potential. Further research could help a variety of
very ill people.