The Impact of Cannabis on Managing Epilepsy

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Approximately one-third of patients with epilepsy have seizures that are resistant to antiepileptic medications. Drug-resistant epilepsy is associated with reduced quality of life, serious psychosocial consequences, and cognitive problems [1]. Traditional treatments can come with serious side effects like osteomalacia and anemia [2]. Patients need a better alternative to the current ways we treat epilepsy.  


There is a possibility medical cannabis could fill that void. 

Clinical studies are gathering evidence on how cannabis interacts with the body and conditions like epilepsy. In addition to patients finding relief in medical cannabis products, there is a growing scientific understanding of how cannabis might manage epilepsy. Cannabidiol (CBD), in particular, has shown good safety and tolerability and up to 77.6% seizure reduction with only mild adverse effects. [3] 

Medical cannabis isn’t new; in fact there is evidence dating as far back as 2700 BCE that cannabis has been used therapeuticallyToday, cannabis is used to treat a number of symptoms and conditions like glaucoma, pain, nausea and vomiting, muscle spasms, insomnia, anxiety, and epilepsy [4]. 

In clinical trials so far, CBD has been found to be more effective in managing epilepsy than other cannabinoids. The potential anticonvulsant properties in cannabis have shown promising results, especially in drug-resistant epilepsy [5]. There is still a lot to learn about cannabis medicines and how they interact with complex conditions like epilepsy.  

 

What the Research Says

As regulations around cannabis change globally, there has been an increase in the research of medical cannabis and pharmaceutical drugs containing cannabis. An abundance of preclinical evidence and anecdotal human data support the use of cannabinoids in the treatment of epilepsy. In particular, CBD has shown promise as an anticonvulsant and with less adverse side effects than traditional treatments [6]. 

A 2015 interventional trial looking into the use of CBD in drug-resistant epilepsy found that patients had a reduction in monthly seizures. The group of patients taking 50mg/kg/day of CBD found a 36.5% reduction in monthly seizures. The greatest reductions recorded was in patients with atonic and focal seizures [7] 

In a 2017 randomized controlled trial, researchers found that CBD was helpful in reducing seizure frequency in children. The patients in the treatment group received 20mg/kg/day for drug-resistant Dravet syndrome, a complex childhood epilepsy disorder [8]. 

In many trials CBD is used with a patient’s other epilepsy medications so whether CBD is itself antiepileptic or a potentiator of traditional antiepileptic medications has yet to be determined [9]. More research is still needed and future trials could evaluate the efficacy of CBD in treating seizures due to specific conditions or causes.

 

Potential Side Effects

Just like other treatments, medical cannabis can have mild side effects in some patients. The most commonly reported negative outcomes from using ingested cannabis oils are diarrhea, vomiting, fatigue, pyrexia, convulsions, and somnolence [10]  

Patients also need to be aware of potential drug interactions between cannabis and other prescription drugs. CBD can interfere with the efficacy of other medications, particularly those that use the CYP450 enzymatic pathway in the body. Similar to how grapefruit juice can interfere with medications that use this pathway, CBD might carry similar risk [11]  

There have been preliminary findings that orally administered CBD can make certain epileptic drugs like clobazam more potent. 2015 study found that using CBD oil increased the bioavailability of clobazam, which made it possible to lower the dose of the drug [12]. Since certain drugs can interact with cannabis, treatment should be closely monitored by a healthcare provider.

 

Talk to your Doctor

You should always consult a physician before using cannabis to treat a medical condition, especially for complex conditions like epilepsy.  

Medical professionals can provide guidance and answer any questions a patient might have. A physician is also vital to determining if medical cannabis will interact with your current medications, monitor your progress, and make any adjustments necessary.  

Always consult your healthcare professional before making changes to any kind of medication, including cannabis. 



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