Epilepsy and Medical Marijuana. Cannabis for Seizures

Health

Summary

  • Studies have found the CBD, or cannabidiol, extracted from marijuana, can treat a seizure disorder in children called Dravet Syndrome, and other weed preparations may treat certain types of epilepsy in adults.
  • Low THC preparations of weed products with high CBD are legal for the treatment of seizures in 16 states. 29 States and the District of Columbia allow for use of medical marijuana for seizures and other disorders.
  • A study in the New England Journal of Medicine (2017) found CBD effective for treatment of children with seizures from Dravet Syndrome.
  • Charlotte Figi was treated with a CBD preparation for Dravet syndrome and experienced dramatic improvement. Her story was featured in a CNN documentary and word spread.
  • CBD binds to cannabinoid receptors and reduces inflammation and the electrical activity which causes seizures. It is not fully known how it works.
  • Charlotte’s Web, the preparation featured in the CNN documentary has high CBD and very little THC. It is effective for childhood seizures.
  • Adults who want to try a stronger preparation with higher THC levels may benefit from Grape Ape, a very relaxing strain of marijuana.
  • Epidiolex is the CBD drug used in studies and manufactured by GW pharmaceuticals. This strain, when and where available, maybe best for children.  It can be in the form of CBD oil.
  • Regular cannabis can have side effects such as anxiety, panic attacks, and increased seizure frequency in susceptible persons. High CBD strains have fewer side effects but may interact with the drug Depakote and the drug Onfi, both anticonvulsant medications.

Epilepsy and medical marijuana have become part of the focus of the debate about legalization.  Medical Marijuana for Seizures in children has become a large focus of the discussion because marijuana has shown some effectiveness for intractable seizures that don’t respond to conventional treatment.  The main cannabinoids, CBD, and THC, seem to have some effect on some types of seizures.

Cannabis Products Can Reduce the Occurrence and Severity of Some Types of Seizures

A study published in the New England Journal of medicine in 2017, found efficacy for CBD treatment for seizures in a condition called Dravet syndrome, which features childhood seizures.  This study was controlled for placebo effects, and double-blind.  120 children were in the study, each suffering from Dravet Syndrome.  Dravet syndrome is a seizure disorder that begins before the age of 1, and progresses to more serious seizure types.  Seizures lasting longer than five minutes have sometimes induced status epilepticus which can be deadly.  Dravet syndrome can be nonresponsive to common anti-convulsant medication.

The study found a strong effect of CBD or cannabidiol.  This association was first discovered when parents of children with Dravet syndrome begin to treat them with CBD cannabis for seizures.  Sometimes they used cannabis oil for epilepsy.  CBD oil for epilepsy is easier to study as it has been legalized in more states.  During the study, those receiving the CBD treatment derived from pot had a reduction of seizure frequency from 12.4 to 5.9 seizures per month.  Treating symptoms of Dravet Syndrome with research based weed extract preparations has proven effective for many children in the study.

Figure 2. Charlotte Figi.https://www.cnn.com/2013/08/07/health/charlotte-child-medical-marijuana/index.html

Why Does Cannabis Work for Seizures?

The focus of research into cannabis’ effect on seizures has focused on high-CBD preparations.  CBD seems to be the ingredient in cannabis which has the effect of suppressing seizures in children and adults.  However, it may also be the case that CBD works in concert with THC and other ingredients in the marijuana which together causes the positive effect.  Patients with epilepsy who enjoyed smoking weed found independently that it helps control their epilepsy and manage pain.  This is because CBD, THC, and other cannabinoids bind to receptors of the endocannabinoid system in the body.  This binding can block pain symptoms, reduce inflammation, and block the electrical storms that cause seizures.

What Strains Are the Best for Seizures?

Figure 3.https://www.wealthdaily.com/articles/profiting-from-medical-marijuana-stocks/7953

It is well agreed upon that for seizures, a high CBD strain is most effective.  Charlotte’s Web is a strain named after a 10 year old little girl with epilepsy that was successfully treated by a high CBD preparation.  Her dramatic improvement became an internet sensation and inspired others to treat their  children with CBD for epilepsy.  She also inspired this high CBD strain of marijuana, with only 0.3% THC.  The high CBD content makes it perfect to treat seizures.  CBD is not psychoactive and produces no high.

For adults who made need a stronger punch to treat their seizures, they may want to use high THC strains.  A high THC strain which has become popular to promote relaxation is Grape Ape.  This strain must be handled carefully due to the high THC content and its psychoactive properties.

Figure 4.http://postnow.blog.palmbeachpost.com/2015/04/01/as-charlottes-web-crawls-toward-approval-some-say-patients-need-higher-thc-strain-of-weed/

For children who may need to take it in a medication form, studies have been done with a CBD preparation called Epidiolex made by GW pharmaceuticals.  It may be in the form of CBD oil.  It is currently being studied and will likely be on the market soon.

Cannabis Side Effects

Cannabis can have side effects which have to be weighed against the benefits it provides.  Side effects of regular cannabis containing THC can include anxiety, panic attacks, lethargy, memory loss, and fatigue.  The most serious side effects is increase in seizures or status epilepticus, a prolonged seizure which may lead to fatality.  However, most who use cannabis for seizures will be using high CBD strains.  These have fewer side effects and are less severe.  High CBD preparations may cause some faintness, watery stool, tiredness, and not wanting to eat.  Studies also revealed drug interactions which included raised liver enzymes when taken with valproic acid, an anticonvulsant and mood stabilizer known better as Depakote.  CBD also seemed to interact with the anti-seizure medication called clobazam.

Can Weed Cause Seizures?

In susceptible persons, high THC preparations, and rarely high CBD weed can have the side effect of increasing the frequency and intensity of seizures.  This is rare.  However, weed does not appear to cause seizures in people who do not have epilepsy.  The Epilepsy Foundation takes a hopeful but cautious approach to cannabis use for seizures, insisting more research is needed and early results look promising.

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