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Epilepsy – Medical Marijuana Research Overview

The following information is presented for educational purposes only. Medical Marijuana Inc. provides this information to provide an understanding of the potential applications of cannabidiol. Links to third party websites do not constitute an endorsement of these organizations by Medical Marijuana Inc. and none should be inferred.

Overview of Epilepsy and Cannabis Treatment

Epilepsy is a central nervous system disorder characterized by a disruption in brain nerve activity  that causes seizures, convulsions, strange sensations and a loss of consciousness. Affecting 1 in 26 people in the United States, the disorder can range in severity from relatively benign to disabling or life threatening10. The occurrence of a single seizure doesn’t necessarily mean that a person has epilepsy. The call for the diagnosis of epilepsy arises after the experiencing two or more unprovoked seizures at least 24 hours apart.

While genetics, infectious diseases, head trauma and brain conditions can cause epilepsy to develop, there is no identifiable cause in about half of those who are diagnosed. The disorder can affect those of any age, but most commonly develops during early childhood or after the age of 609. There is no cure for epilepsy, so the focus of treatment is on limiting seizures.

Research has shown that cannabis, particularly its non-psychoactive cannabinoid cannabidiol (CBD), to be a safe and well-tolerated therapeutic treatment for reducing or even eliminating seizure activity3. Studies have demonstrated cannabis to be effective at managing seizures in both children and adults7.

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Cannabis’ Effects on Epilepsy: What Research has Found

Cannabis’ Potential in the Global Epilepsy Market

Major Findings

Most of the breakthrough research investigating cannabis’ effect on epilepsy focus on CBD and its demonstrated ability to reduce or even eliminate seizure activity3,4,5,6,7,11,17,19,20,26,28. CBD and tetrahydrocannabinol (THC) have shown to indirectly and directly interact with the endocannabinoid system’s cannabinoid receptor 1 (CB1), which dampens neurotransmission and produced an overall reduction in neuronal excitability. While more research still needs to be done, scientists also theorize that CBD manages seizure frequency through a combination of methods, including binding to TRP channels, activating 5HT1A receptors, and inhibiting adenosine reuptake. Researchers also believe it’s antioxidant and anti-inflammatory properties are beneficial in its anti-seizure effects8.

In one questionnaire study, 84% of parents reported that cannabis treatments reduced their child’s seizure frequency. Of those that had positive results, 11% of them responded that their child was able to reach complete seizure freedom, while 42% reported a greater than 80% reduction in seizure frequency. The parents also reported additional beneficial effects, such as increased alertness, better mood, and improved sleep25.

Another survey found that CBD-enriched cannabis brought about a reduction in seizure frequency in 85% of children with epilepsy, while 14% experienced complete seizure freedom. The children also reported an improvement in sleep (53%), alertness (71%), and mood (63%)18.

A study examining the effect of CBD-enriched medical cannabis on children with epilepsy found that 89 percent of children reported a reduction in seizure frequency with CBD treatment. The children also reportedly saw improvements in behavior and alertness, language, communication, motor skills and sleep29.

A case report of a young epileptic girl found that medical marijuana brought the child’s seizure frequency from nearly 50 convulsive seizures per day to 2-3 nocturnal convulsions per month. In addition, the child was able to wean off the additional antiepileptic drugs she had been taking23.

Most recently, an Australian survey found cannabis reduced the frequency of seizures in 90% of adults and 71% of children27.

While traditional antiepileptic medicines are in most cases effective for seizures, they often come with a number of adverse side effects. A research review concluded that cannabinoids have shown to produce anticonvulsant effects in preclinical and preliminary human studies while eliciting fewer adverse effects that other antiepileptic drugs8.

PUBLISHED CLINICAL STUDIES

New Study Examines Why and How Parents of Children with Epilepsy Disorders Turn to Cannabis for Solutions (September 24, 2017)

CBD Proves Beneficial for Childhood Epilepsy in First Large-Scale Clinical Trial (June 5, 2017)

New Randomized Controlled Trial Finds CBD May Reduce Pediatric Seizure Frequency by 50% (April 24, 2017)

Cannabis Cuts Seizure Frequency in 86% of Patients with Refractory Epilepsy (April 7, 2017)

New Study to Investigate CBD’s Effects on Kids’ Epilepsy (March 23, 2017)

Cannabis Reduces Seizures in 9/10 Adults with Epilepsy, Survey Finds (March 22, 2017)

Is Cannabis Medicinally Beneficial? New Assessment of 10,000 Studies Says Yes (January 18, 2017)

Seizure Frequency and Severity Reduced by CBD Oil, Study Finds ( December 7, 2016)

Cannabis-Derived Drug Reduces Seizure Frequency in Epileptic Children (July 13, 2016)

Patients Are Finding Relief with Medical Marijuana, Several Studies Find (June 29, 2016)

Sources

  1. Amada, N., Yamasaki, Y., Williams, C.M., and Whalley, B.J. (2013, November 21). Cannabidivarin (CBDV) suppresses pentylenentetrazole (PTZ)-induced increases in epilepsy-related gene expression. Peer J, 1:e214; doi 10.7717/peerj.214. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840466/.
  2. Blair, R.E., Deshpande, L.S., Sombati, S., Falenski, K.W., Martin, B.R., and DeLorenzo, R.J. (2006, June). Activation of the cannabinoid type-1 receptor mediates the anticonvulsant properties of cannabinoids in the hippocampal neuronal culture models of acquired epilepsy and status epilepticus. The Journal of Pharmacology and Experimental Therapeutics, 317(3), 1072-1078. Retrieved from http://jpet.aspetjournals.org/content/317/3/1072.long.
  3. Blair, R.E., Deshpande, L.S., and DeLorenzo, R.J. (2015, September). Cannabinoids: is there a potential treatment role in epilepsy? Expert Opinion on Pharmacology, 16(13), 1911-4. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845642/.
  4. Cilio, M.R., Thiele, E.A., and Devinsky, O. (2014, June). The case for assessing cannabidiol in epilepsy. Epilepsia, 55(6), 787-90. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/epi.12635/full.
  5. Cunha, J.M., Carlini, E.A., Pereira, A.E., Ramos, O.L., Pimentel, C., Gagliardi, R., Sanvito, W.L., Lander, N., and Mechoulam, R. (1980). Chronic administration of cannabidiol to healthy volunteers and epileptic patients. Pharmacology, 21(3), 175-85. Retrieved from https://goo.gl/JKQU41.
  6. Detyniecki, K., and Hirsch, L. (2015, October). Marijuana use in epilepsy: The myth and the reality. Current Neurology and Neuroscience Reports, 15(10), 65. Retrieved from http://link.springer.com/article/10.1007%2Fs11910-015-0586-5.
  7. Devinsky, O., Cilio, M.R., Cross, H., Fernandez-Ruiz, J., French, J., Hill, C., Katz, R., Di Marzo, V., Jutras-Aswad, D., Notcutt, W.G., Martinez-Orgado, J., Robson, P.J., Rohrback, B.G., Thiele, E., Whalley, B., and Friedman, D. (2014, June). Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia, 55(6), 791-802. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707667/.
  8. dos Santos, R.G., Hallak, J.E., Leite, J.P., Zuardi, A.W., and Crippa, J.A. (2015, April). Phytocannabinoids and epilepsy. Journal of Clinical Pharmacology and Therapeutics, 40(2), 135-43. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/jcpt.12235/full.
  9. Epilepsy (2014, November 22). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/epilepsy/home/ovc-20117206.
  10. Epilepsy Statistics. (2014, March). Epilepsy Foundation. Retrieved from http://www.epilepsy.com/learn/epilepsy-statistics.
  11. Filloux, F. M. (2015). Cannabinoids for pediatric epilepsy? Up in smoke or real science? Translational Pediatrics, 4(4), 271–282. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729003/.
  12. Friedman, D., and Devinsky, O. (2015, September 10). Cannabinoids in the Treatment of Epilepsy. The New England Journal of Medicine, 373(11), 1048-58. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMra1407304.
  13. Hill, T.D., Cascio, M.G., Romano, B., Duncan, M., Pertwee, R.G., Williams, C.M., Whalley, B.J., and Hill, A.J. (2013, October). Cannabidivarin-rich cannabis extracts are anticonvulsant in mouse and rat via a CB1 receptor-independent mechanism. British Journal of Pharmacology, 170(3), 679-92. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792005/.
  14. Hill, A., Mercier, M., Hill, T., Glyn, S., Jones, N., Yamasaki, Y., Futamura, T., Duncan, M., Stott, C.G., Stephens, G.J., Williams, C.M., and Whalley, B. (2012). Cannabidivarin is anticonvulsant in mouse and rat. British Journal of Pharmacology, 167(8), 1629–1642. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525866/.
  15. Hill, A.J., Williams, C.M., Whalley, B.J., and Stephens, G.J. (2012, January). Phytocannabinoids as novel therapeutic agents in CNS disorders. Pharmacology & Therapeutics, 133(1), 79-97. Retrieved from http://www.sciencedirect.com/science/article/pii/S016372581100180X.
  16. Hoffman, M.E., and Frazier, C.J. (2013, June). Marijuana, endocannabinoids, and epilepsy: potential and challenges for improved therapeutic intervention. Experimental Neurology, 244, 43-50. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3332149/.
  17. Hosseinzadeh, M., Nikseresht, S., Khodagholi, F., Naderi, N., and Maghsoudi, N. (2016, April). Cannabidiol Post-Treatment Alleviates Rat Epileptic-Related Behaviors and Activates Hippocampal Cell Autophagy Pathway Along with Antioxidant Defense in Chronic Phase of Pilocarpine-Induced Seizure. Journal of Molecular Neuroscience, 58(4), 432-40. Retrieved from http://link.springer.com/article/10.1007%2Fs12031-015-0703-6.
  18. Hussain, S.A., Zhou, R., Jacobson, C., Weng, J., Cheng, E., Lay, J., Hung, P., Lerner, J.T., and Sankar, R. (2015, June). Perceived efficacy of cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy: A potential role for infantile spasms and Lennox-Gastaut syndrome. Epilepsy & Behavior, 47, 138-41. Retrieved from http://www.epilepsybehavior.com/article/S1525-5050(15)00157-2/fulltext.
  19. Jones, N. A., Hill, A. J., Smith, I., Bevan, S. A., Williams, C. M., Whalley, B. J., and Stephens, G. J. (2010). Cannabidiol Displays Antiepileptiform and Antiseizure Properties In Vitro and In Vivo. The Journal of Pharmacology and Experimental Therapeutics, 332(2), 569–577. Retrieved from http://doi.org/10.1124/jpet.109.159145.
  20. Jones, N.A., Glyn, S.E., Akiyama, S., Hill, T.D., Hill, A.J., Weston, S.E., Burnett, M.D., Yamasaki, Y, Stephens, G.J., Whalley, B.J., and Williams, C.M. (2012, June). Cannabidiol exerts anti-convulsant effects in animal models of temporal lobe and partial seizures. Seizure, 21(5), 344-52. Retrieved from http://www.seizure-journal.com/article/S1059-1311(12)00057-X/fulltext.
  21. Karlócai, M. R., Tóth, K., Watanabe, M., Ledent, C., Juhász, G., Freund, T. F., & Maglóczky, Z. (2011). Redistribution of CB1 Cannabinoid Receptors in the Acute and Chronic Phases of Pilocarpine-Induced Epilepsy. PLoS ONE, 6(11), e27196. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208595/.
  22. Lorenz, R. (2004, February-April). On the application of cannabis in paediatrics and epileptology. Neuroendocrinology Letters, 25(1-2), 40-4. Retrieved from http://www.nel.edu/pdf_/25_12/NEL251204A02_Lorenz_.pdf.
  23. Maa, E., and Figi, P. (2014, June). The case for medical marijuana in epilepsy. Epilepsia, 55(6), 783-6. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/epi.12610/full.
  24. NINDS Epilepsy Information Page. (2015, July 17). National Institute of Neurological Disorders and Stroke. Retrieved from http://www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm.
  25. Porter, B.E., and Jacobson, C. (2013, December). Report of a parent survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant epilepsy. Epilepsy & Behavior, 29(3), 574-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157067/.
  26. Rosenberg, E.C., Tsien, R.W., Whalley, B.J., and Devinsky, O. (2015, August 18). Cannabinoids and Epilepsy. Neurotherapeutics, Epub ahead of print. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604191/.
  27. Suarez, A.S., Todd, L., Bowen, M.T., Allsop, D.J., McGregor, I.S., Ireland, C., and Lintzeris, N. (2017). An Australian nationwide survey on medicinal cannabis use for epilepsy: History of antiepileptic drug treatment predicts medicinal cannabis use. Epilepsy & Behavior, http://dx.doi.org/10.1016/j.yebeh.2017.02.005. Retrieved from http://www.epilepsybehavior.com/article/S1525-5050(17)30073-2/fulltext.
  28. Szaflarski, J.P., and Bebin, E.M. (2014, December). Cannabis, cannabidiol, and epilepsy–from receptors to clinical response. Epilepsy & Behavior, 41, 277-82. Retrieved from http://www.epilepsybehavior.com/article/S1525-5050(14)00413-2/fulltext.
  29. Tzadok, M., Uliel-Siboni, S., Linder, I., Kramer, U., Epstein, O., Menascu, S., Nissenkorn, A., Yosef, O.B., Hyman, E., Granot, D., Dor, M., Lerman-Sagie, T., and Ben-Zeev, B. (2016, February). CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience. Seizure, 35, 41-4. Retrieved from http://www.seizure-journal.com/article/S1059-1311(16)00005-4/fulltext.
  30. Vilela, L.R., Gomides, L.F., David, B.A., Antunes, M.M., Diniz, A.B., Moreira, F.D., and Menezes, G.B. (2015). Cannabidiol rescues acute hepatic toxicity and seizure induced by cocaine. Mediators of Inflammation, Article ID 523418, 12 pages. Retrieved from https://www.hindawi.com/journals/mi/2015/523418/.
  31. Wallace, M.J., Wiley, J.L., Martin, B.R., and DeLorenzo, R.J. (2001, September 28). Assessment of the role of CB1 receptors in cannabinoid anticonvulsant effects. European Journal of Pharmacology, 428(1), 51-7. Retrieved from http://www.sciencedirect.com/science/article/pii/S0014299901012432.
  32. Wallace, M.J., Martin, B.R., and DeLorenzo, R.J. (2002). Evidence for a physiological role of endocannabinoids in the modulation of seizure threshold and severity. European Journal of Pharmacology, 452(3), 295-301. Retrieved from http://www.sciencedirect.com/science/article/pii/S0014299902023312.
  33. Wallace, M.J., Blair, R.E., Falenski, K.W., Martin, B.R., and DeLorenzo, R.J. (2003, October). The endogenous cannabinoid system regulates seizure frequency and duration in a model of temporal lobe epilepsy. The Journal of Pharmacology and Experimental Therapeutics, 307(1), 129-37. Retrieved from http://jpet.aspetjournals.org/content/307/1/129.long.
  • September 21, 2015