Study: Cannabis & Epilepsy

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An October 2018 peer-reviewed research study conducted in the United Kingdom and entitled "Cannabis and Epilepsy" that was published in the journal Practical Neurology investigated the potential efficacy of various chemical components of cannabis and hemp in the treatment of epilepsy.

"We have seen a surge in interest in the medicinal use of cannabis and cannabis extracts for people with epilepsy," reported the study. The researchers noted that reports exist "from ancient and medieval times" that document the use of cannabis to treat epilepsy.

Understanding Epilepsy

According to the Mayo Clinic in Rochester, Minnesota, epilepsy is a "central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness." The famous clinic reported that this disease afflicts both males and females equally and that people from "all ethnic backgrounds and ages" may have epilepsy.

Epileptic Seizures Vary Widely

Seizure activity, as a symptom of epilepsy, varies widely. "Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs," noted the Clinic. It also stressed that a single seizure does not necessarily mean that one has epilepsy. "At least two seizures without a known trigger (unprovoked seizures) that happen at least 24 hours apart are generally required for an epilepsy diagnosis," reports the Clinic.

"According to the World Health Organization, approximately 50 million people worldwide have epilepsy."

Conventional treatments include "medications or sometimes surgery" that are intended to control (decrease) seizure activity. "Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away," reported the Clinic. It noted that some, but not all, children with the disease outgrow it and live disease-free adult lives.

Epilepsy Statistics

According to the World Health Organization, approximately 50 million people worldwide have epilepsy. It is one of the "most common neurological diseases." The organization noted that almost 80 percent of those with epilepsy "live in low- and middle-income countries."

According to the U.S. Centers for Disease Control and Prevention, about 1.2 percent of the total population in the United States has "active epilepsy" (2015 figures). This equals approximately 3.5 million people with epilepsy in the U.S., which breaks down to three million adults and nearly half a million children. It reported that 0.6 percent of children aged 17 or younger feature active epilepsy. "Think of a school with 1,000 students—this means about six of them could have epilepsy," reported the public health service organization.

History of Cannabis for Epilepsy

"During the 19th century, the introduction of medicinal cannabis into Western medicine was driven by the experiences and studies of William O'Shaughnessy, from his time working in India with the East India Company," reported the study. The scientists noted that O'Shaughnessy's publications led to acceptance of the use of cannabis in Victorian England. During this period, a number of prominent doctors researched the use of cannabis for many different conditions, including epilepsy.

"The research reported that, during much of the 20th century, research into the efficacy of cannabis for any disease or condition was limited due to its prohibition."

The study reported that, during much of the 20th century, research into the efficacy of cannabis for any disease or condition was limited due to its prohibition. Then, in 2018, two important events occured that contributed significantly to the state of research about cannabinoids such as cannabidiol (CBD) for epilepsy.

Medical cannabis pioneer William O'Shaughnessy

The first event was the June 2018 approval of Epidiolex (a CBD oral solution) by the U.S. Food and Drug Administration for use in children suffering Lennox-Gastaut and Dravet syndrome. "This is a landmark as it represents not only the first FDA approval for a drug specifically trialled in Dravet syndrome, but also the first drug that contains a purified substance derived from marijuana," reported the scientists.

The second event was passage of the 2018 Farm Bill in the United States, which broke 81 years of hemp prohibition and enabled more relaxed regulatory oversight at both the federal and state levels in the United States.

This allowed hemp-derived CBD and other cannabinoids (including delta-8 THC, delta-10 THC, HHC, and THC-O Acetate) to be legally sold throughout the United States, not just where adult-use or medical cannabis laws have been passed. More important, the 2018 Farm Bill has loosened the regulatory oversight that applies to hemp-derived cannabinoids and terpenes and is allowing them to more easily be researched.

Epilepsy Medications Desperately Needed

The study reported that between one-third and 40 percent of those who suffer epilepsy "do not respond to traditional medication regimens." If the epilepsy patient also suffers a condition such as autism, their resistance to conventional epilepsy therapies and drugs is even greater.

Many plant-based drugs—including aspirin and digoxin—are both "characterised by the presence of their adverse side effects and drug interactions, rather than the lack of them."

The scientists noted that many industry professionals and patients seek out medications that are "more 'natural' and less 'toxic.'" They explained how the general public perceives a "strong correlation with plant-based medications and a supposition that these have milder side effects and make safer drugs." They reported that many plant-based drugs—including aspirin and digoxin—are "characterised by the presence of their adverse side effects and drug interactions, rather than the lack of them." "Cyanide, of course, is a natural drug," added the researchers.

CBD for Epilepsy

The scientists reported that CBD medical benefits for epilepsy patients "via multiple mechanisms" and that this capability may "represent a novel poly-pharmacological approach to the disease."

Image courtesy Leafwize Naturals

The study noted that CBD has been purported to deliver neuroprotective and anti-inflammatory effects, "both of which would be attractive traits in an anti-epilepsy drug." The research hypothesized that this "broad mode of action" exhibited by CBD "may well be a benefit rather than a curse."

CBD has been purported to deliver neuroprotective and anti-inflammatory effects, "both of which would be attractive traits in an anti-epilepsy drug."

The research stated that data indicates that a combination of CBD and pharmaceutical drug clobazam "may produce a synergistic augmentation...and enhanced seizure control," but that future research is necessary to prove this, including "well-designed preclinical studies" and "rigorous clinical trials." "CBD is not a panacea, but nor is it our first step toward inevitable societal doom," reported the study.

THC for Epilepsy

The study examined previous research conducted about the potential efficacy of the psychoactive cannabinoid tetrahydrocannabinol (THC) for epilepsy and seizure control. One review of 34 studies involving "six disparate animal species" found that THC "demonstrated an anticonvulsant action" in 62 percent of study subjects and had no effect on seizure activity in 32 percent of subjects.

"THC is also likely to influence seizure activity via anti-inflammatory and antioxidant actions," reported the study. Unlike CBD, however, the ability of THC to deliver heavy psychoactivity and sometimes, if dosed incorrectly, intoxication is a concern--particularly when administered to children. "The consequences of high-dose THC on the juvenile and still-developing brain are currently unknown," noted the study's authors.

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