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For Doctors & Clinicians

Here at Trifecta, we are well aware of the prescription limitations when it comes to providing patients with medicinal cannabis products. Cannabinoid therapies are often limited to single molecule isolates, such as CBD with MCT Oil, resulting in patients missing out on the 500 other known biologically active compounds within the cannabis plant.

 

This can lead to patients receiving ‘copy-paste’ solutions with varying degrees of efficacy, rather than personally tailored therapies inspired by the person-centred care model. 

 

A pillar of motivation at Trifecta is to reduce the effects and prevalence of polypharmacy, and facilitate a shift in focus from life-long palliative medicine to curative medicine. 

 

If cannabinoids are the clay, then terpenes are the hands that shape it. Whether used individually or as co-activating agents, terpenes magnify not only the therapeutic activity of phytocannabinoids, but also exert powerful effects on our endogenous cannabinoids. They help determine whether a patient feels energised or couch-locked, sedated or social. 

 

When considering the number to treat versus the number to harm, terpenes propose incredible potential in the field of mood disorders such as anxiety and depression. 

The Science

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First, we'll be looking at the efficacy of terpenes on their own (without cannabinoids) and their action on mood disorders.

 

In a randomised, double-blind, double-dummy trial, 539 adults with Generalised Anxiety Disorder participated and received 160 or 80 mg Silexan (comprised of the terpene linalool), 20 mg paroxetine (an antidepressant of the selective serotonin reuptake inhibitor, SSRI), or placebo once a day for 10 weeks. Silexan produced more anxiolytic effects than paroxetine, supporting its potential as a non-addictive alternative to benzodiazepines.

In a study involving restraint-stressed mice, the terpenes a-Pinene, b-Caryophyllene, Cadinene, Guaiol and Eudesmol demonstrated impressive anxiolytic effects through antagonising the hyperfunction of hypothalamic-pituitary-adrenal (HPA) axis and facilitating anti-oxidation abilities of brain tissue. The essential oil containing these terpenes, as in numerous other studies, had no effects on locomotor activity.

This study analysed the anxiolytic properties of limonene in an elevated plus-maze model (EPM) of anxiety in mice. After delivering it through inhalation, limonene displaying a modification of all EPM parameters in the same capacity as intraperitoneally administered diazepam.

In another study using a mouse-anxiety-model, subjects were administered either limonene, ascorbic acid, diazepam or a placebo of saline, with the greatest impact on hippocampus activity being demonstrated by limonene.

It is important to clarify here that although these terpenes demonstrate anxiolytic capacities similar (and in some cases, greater) than benzodiazepines, they do not appear to exert their effects via the same mode of action. For example, this study aimed to inhibit the effects of limonene by co-administering flumazenil (a selective benzodiazepine receptor antagonist), but clinically significant anxiolytic effects were still documented. This indicates that through using terpenes, clinicians may be able to achieve desired anxiolytic effects for patients without connecting to benzodiazepine pathways, offering new methods of treatment that minimise the risk of addiction.

This 2015 study aimed to determine the anti-depressant mechanisms of Linalool and b-Pinene, showing that when taken conjunctively, anti-depressant effects were achieved through interaction with the monoaminergic system.

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The entourage effect.

The "entourage effect" is the phenomenon that occurs when multiple compounds are utilised together, achieving either greater strength, greater duration, or entirely new effects altogether. This phenomena is especially prevalent in the case of cannabis, where chemotypes and cultivars (also known as strains) are dictated by the presence of the compounds within them (specifically, terpenes).

First postulated by Dr. Raphael Mechoulam and Ben-Shabat, their findings helped them to develop the hypothesis that particular organic compounds exert pharmacological effects not only through their own unique pathways, but also through their ability to modulate our endogenous cannabinoids.

This theory gained further credibility through the work of Dr. Ethan Russo, who extrapolated and coined the theory of botanical synergy, in which a dominant molecule is supported, regulated and modulated by the plant derivatives accompanying it. The actions of these organic derivatives, including cannabinoids, terpenes and flavanoids, strongly demonstrate that in order to achieve maximal pharmacological effects, they should be paired together.

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Why Trifecta?

Trifecta’s line of terpene blends are formulated to shape the patient’s experience of their medicinal cannabis products, aiding them in getting the most from their prescription cannabis products. 

Each of our unique terpenoid blends are catered to a different experience; insomnia, anxiety, pain, inflammatory bowel disorders, gastrointestinal distress or mood stabilisation. Every bottle is uniquely formulated to operate with CBD and THC isolates via the ‘entourage effect’.

 

Each blend can be accessed without a prescription, for roughly one sixth of the average cost of CBD. Our blends ensure that medicinal cannabis isolates act stronger, help for longer, and elicit the desired effects for each individual medicinal cannabis patient.

 

They can be used on their own, or as adjuvant therapies alongside current cannabis product offerings. 

 

Trifecta focuses primarily on treatment resistant conditions stemming from clinical endocannabinoid deficiencies, such as endometriosis, fibromyalgia, inflammatory bowel disorders, migraines, insomnia and depression.  

 

If you are interested in becoming a stockist, or have any questions related to the efficacy of our products and the science behind them, please reach out to Cameron at cam@trifectahealthco.com.