Marijuana and Epilepsy
Could a plant that was introduced to the United States by early settlers provide relief for people with epilepsy today? Marijuana (Cannabis sativa) has been grown in the United States since the early 1700s. Settlers brought the plant from Europe to produce hemp. Its use as a medicine was recorded in a reference book from 1850 titled “United States Pharmacopeia”.
According to a recent paper in The Journal of the International League Against Epilepsy (Epilepsia), marijuana was used to treat a variety of conditions in ancient China as far back as 2,700 B.C. They included:
There is also evidence it was used in medieval times to treat:
Marijuana was given the status of a “schedule 1” drug class in the U.S. in 1970. As a result, studying how safe and effective it is as a medicine has been difficult for researchers.
Many people suffering from epilepsy say marijuana stops their seizures, but there is little scientific evidence. Researchers must apply for a special license from the Drug Enforcement Administration in order to study marijuana. They need permission to access to a supply kept by the National Institute for Drug Abuse. These challenges have slowed research.
However, there have been a handful of studies conducted in the U.S. since 1970. Other studies, even some ongoing, have been done around the world.
The findings reveal that the most well-known active ingredient in marijuana, tetrahydrocannabinol (THC), is just one of a group of compounds which have medicinal effects. Another, known as cannabidiol (CBD), does not cause the “high” associated with marijuana. It is emerging as one of the plant’s leading medicinal compounds.
Based on these initial studies, there are many studies currently ongoing throughout the US and other countries that are trying to answer the question of whether a drug formulation of CBD can help control seizures.
Both THC and CBD are in a group of substances called cannabinoids. They bind to receptors in the brain and are effective against pain associated with conditions like multiple sclerosis and HIV/AIDS. By attaching to receptors, they block the transmission of pain signals. CBD binds to more than just pain receptors. It appears to work on other signaling systems within the brain and has protective and anti-inflammatory properties.
Exactly how it works in epilepsy isn’t fully understood. But there have been small studies that show the results of using CBD. Studies of mice published in Epilepsia have shown mixed results. While some found CBD was effective against seizures, others did not. This may be due to the way the drug was given, since some methods work better than others.
The idea of using the compounds found in marijuana to treat epilepsy is gaining appeal. Researchers must confirm its effectiveness, and solve the problem of strength and how to give it. Potency can vary widely from plant to plant. Inhaling the drug versus eating CBD can alter the strength as well.
While there is a mounting consensus among people with epilepsy that medicinal marijuana is effective, researchers caution that the side effects need to be better understood. It’s also not known how CBD might interact with other medications.
Like most anti-seizure medications, marijuana has been shown to affect memory. This might lead to missed doses, which can mean that seizures return. A study in the Proceedings of the National Academy of Sciences suggested that cannabis use in children can result in a measurable drop in cognitive abilities.
Side effects might also depend on how the drug is taken. Smoking it would pose a risk to the lungs, while eating it would not.
Talk to your doctor if you are suffering from epileptic seizures and are not responding to traditional treatments. They can explain your options and provide information about medical marijuana use if you live in a state that allows it.
There are still other options if your state has no provision law for medical marijuana. Your doctor can share the latest research news with you and help you determine if a clinical trial for new forms of treatment or therapy might be right for you.
Some people who suffer from epilepsy believe that marijuana stops their seizures. Two compounds found in the drug, THC and CBD, may have medical benefits.
Marijuana (Cannabis) and Epilepsy
MARIJUANA (CANNABIS) AND EPILEPSY
The Virginia government “decriminalized” the cannabis derivative CBD (cannabidiol) and THC-A (a synthetic form of THC) in March, 2015. However, cannabis and its derivatives remain schedule 1 drugs regulated by the US Drug Enforcement Agency (DEA). Schedule 1 drugs are illegal by definition under federal law. So, it can’t technically be legal in Virginia, but only “decriminalized”. This brochure provides some information; you should talk to your epilepsy specialist for more information.
What is cannabis?
Cannabis is the plant name for marijuana. The main components of cannabis are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC causes the “high” that is associated with smoking marijuana. CBD does not cause these effects. Most marijuana plants have little CBD and a lot of THC because they were grown for their psychoactive properties. However, some cannabis plants are high in CBD. CBD is most commonly available as an oil.
Why is CBD so popular recently?
A young girl with a severe type of epilepsy, called Dravet’s syndrome, was helped dramatically when her parents gave her CBD oil and this was reported in the popular press. At the same time, marijuana was being decriminalized in several states so CBD might become more available.
Is cannabis effective for treating epilepsy?
There are no large randomized controlled studies that show CBD is effective (or safe). There are some preliminary studies suggesting it might be effective for epilepsy. Many people have smoked marijuana in the past and many people now take CBD oil and think it helps their seizures. There are two older studies that suggested CBD reduces seizure frequency; one study had 9 patients in 1978 and the other study had 15 patients in 1980.
Will CBD make you high?
Probably not. In studies done so far, CBD does not cause euphoria, elation, happiness or feelings of being “high”.
What are the side effects of CBD?
The side effects have not been studied. It is popular to think that CBD must be harmless because so many people smoke marijuana “without any problems”. However, this is not correct. Studies of teenagers who smoked marijuana regularly had a lower IQ than those who didn’t and lost IQ points even when tested years after they stopped smoking marijuana. Also, we expect that the dose of CBD to control seizures will be much higher than the dose from recreational use of marijuana so it is not a fair comparison. Finally, the effects of CBD on brain development in young children are not known.
Is CBD legal in Virginia?
Since state laws cannot conflict with federal laws, and cannabis is illegal under federal law, cannabis can’t be legal in Virginia (or any other state) strictly speaking. However, Virginia has passed a law that it will not convict anyone who possesses CBD for the treatment of epilepsy. The law requires that the CBD be of the type that would be used for epilepsy, which means the concentration of CBD is at least 50 mg per ml but it must contain less than 5% THC. Most CBD oils advertised on the internet or in other venues do not contain this much CBD.
Is CBD available in Virginia?
CBD is not a drug and is not manufactured or regulated like a drug since it is not approved as safe and effective by the Food and Drug Administration (FDA). It can now be produced in Virginia without prosecution, similar to an herbal product. However, herbal products do not require any evidence that they are safe or effective and they do not have to follow “good manufacturing practice” which is required of pharmaceutical products. This type of compound is referred to as artisanal CBD oil. Since cannabis has not been legal until now, CBD is not currently available in Virginia even as artisanal CBD. A bigger problem is that artisanal CBD has an unknown amount of CBD and may contain impurities, such as pesticides. Some products sold as CBD oil have been found to not actually contain any CBD when examined by a laboratory. If someone were to take CBD oil, it would make sense to have it tested by a laboratory to determine the concentration of CBD and whether it has any impurities.
What is the procedure for getting CBD in Virginia?
The legislature has specified that physicians can complete a “Defendant’s Certificate” from the Virginia Board of Medicine that patients can carry with them. If a person is arrested for possession of CBD then they can produce this form for the Commonwealth’s Attorney and the judge will release them from the charges.
Is CBD recommended for treatment of epilepsy?
In general, artisanal CBD is not recommended by epilepsy experts because: 1) it is not known whether CBD is effective or safe, 2) there is no source of it in Virginia, 3) it is not available in a consistent concentration, and 4) it may contain unknown impurities. Overall, the risk to benefit ratio of CBD is not as good as for other normally available drugs for treatment of epilepsy. However, for people with epilepsy that persists despite the available therapy, then some people might accept the unknown risk and possible benefit of CBD. This should be done under the guidance of an epilepsy specialist who can consider this among other treatments.
Is there any ongoing research about CBD?
Yes. There are ongoing randomized controlled clinical trials of CBD for treatment of severe forms of epilepsy. It is likely that if the trials show a benefit for CBD and show it to be safe, then it could be approved by the FDA as a regular prescription drug in the next two or three years for the treatment of these severe epilepsies. If it is approved by the FDA, then epilepsy doctors could prescribe it like any other approved anti-seizure medication.
Marijuana (Cannabis) and Epilepsy Handout File: MARIJUANA (CANNABIS) AND EPILEPSY The Virginia government “decriminalized” the cannabis derivative CBD (cannabidiol) and THC-A (a