Medically refractory epilepsy continues to be a challenge worldwide, and despite an increasing number of medical therapies, approximately one in three patients continues to experience seizures…some violent and even life-threatening. Cannabidiol (CBD), one of many constituents of the cannabis sativa plant, has received renewed interest in the treatment of epilepsy. While highly purified CBD awaits Health Canada and U.S. Food and Drug Administration (FDA) approval, artisanal formulations of CBD are readily available and are seeing increased use in patient populations.
In the big world of big science, anecdotal evidence isn’t really evidence. Double blind lab testing, peer reviewed articles, and eventual federal health approvals are where it’s at for pharmaceutical manufacturers and, eventually, medicinal cannabis / CBD hemp producers.
But, in a recent University of Saskatchewan study,
preliminary results suggest medicinal cannabis oil can greatly reduce or completely stop seizures in children experiencing severe and drug-resistant epilepsy.
The trial in Saskatoon involved patients with severe forms of epilepsy who were taking prescription anticonvulsants. Four patients were between the ages of four and six years, one was between the age of seven and 10, and two were between the of one and three years of age. The doses were delivered orally or through a gastrostomy tube and the cannabis oil extract was meant to be an add-on to an existing therapy.
In advanced human clinical trials to date, there’s good evidence that CBD is of benefit for specific epilepsies, such as
Dravet syndrome and
Lennox Gastaut syndrome. An advantage for the pharmaceutical industry is that these rare diseases with no immediate cure can be
fast-tracked for drug development. On this basis,
in June 2018, the FDA approved the “first drug comprised of an active ingredient derived from cannabis to treat rare, severe forms of epilepsy and pediatric seizure disorders”, in turn, granting a licence for CBD (under the tradename
Epidiolex) to treat these forms of epilepsies. (The FDA had previously approved synthetic THC to treat chemotherapy-related nausea.)
European approval followed a little over a year later.
Patients report many benefits of CBD, from relieving insomnia, anxiety, spasticity, and pain to treating potentially life-threatening conditions such as epilepsy. One particular form of childhood epilepsy is the aforementioned Dravet Syndrome – almost impossible to control, but responds dramatically to a CBD-dominant strain of cannabis called
Charlotte’s Web.
According to
data recently published in the New England Journal of Medicine, the drug can reduce seizures by more than 40 percent.
(Click image to enlarge. Courtesy www.neurologia.com)
In the early 1960s, Raphael Mechoulam, a Bulgarian-born Israeli chemist, asked a simple question: How does marijuana make you high? The biochemistry of major psychoactive molecules from other recreationally used drugs, like cocaine and opium, was already understood. But scientists still didn’t know how cannabis worked. Mechoulam was the first scientist to map the chemical structure of both cannabidiol and delta-9-tetrahydrocannabinol, or THC.
Two decades later, Allyn Howlett, a scientist then at St. Louis University Medical School, used a radioactive THC equivalent to trace
where cannabinoids ended up in the brain and discovered what she would later call CB1 receptors. They were subsequently found in the kidneys, lungs and liver, too. White blood cells of the immune system, the gut and the spleen also have another type of cannabinoid receptor, known as CB2.
To date, research has found more than 100 active components in cannabis. Tetrahydrocannabinol (THC) is the psychoactive chemical that goes along with cannabis consumption. CBD-dominant strains have little or no THC, so patients report very little if any alteration in consciousness. This is where the long-term health and pharmaceutical benefits lay.
Going to the Dogs
Epilepsy in dogs is sadly common, and these seizures can manifest as anything from a twitch to uncontrollable shaking. They might be over quickly, or can last for several minutes. The causes of seizures vary from dog to dog.
Recent findings from a pilot study to assess the use of CBD oil for dogs with epilepsy are “promising and exciting,” according to
a recent release from Colorado State University.
The study, led by Dr. Stephanie McGrath, a neurologist at Colorado State University’s James L. Voss Veterinary Teaching Hospital and sponsored by
Applied Basic Science Corporation, assessed the short-term effects of CBD on seizure frequency. Of the dogs that received CBD in the clinical trial, Dr. McGrath’s team found that an eye-popping 89% had a reduction in the frequency of seizures, the release states.
The CBD oil used in the study was derived from hemp plants, which produce 0.3% or less of THC. The compound is not considered to be marijuana and can be used for research purposes.
While the exact way in which CBD contributes to a reduction in seizures and how it affects the electroconvulsive shock (ECS) seizure threshold is still unknown, other forms of research have led to the idea of CBD having the ability to affect the receptors which can help calm the neurons firing during a seizure. But to date, these studies are far from confirmed as there is still a large amount of unknown as dozens of research studies continue to move forward throughout the world, today.