Treating Illness with Medical Cannabis

The term epilepsy is generally reserved for those patients with generalized seizures. Unfortunately, a relatively large proportion of those suffering form epilepsy respond poorly to anti-epileptic drugs (AED’s) with break through seizures and adverse side effects. Additionally, many epileptics end up developing resistance to AEDs, require higher doses of drugs and multiple drugs which eventually leaves them unable to function.

Studies and Observations Supporting the use of Cannabis as an Anti-Seizure Agent

Case studies, observational studies and a few clinical studies have shown benefits of cannabis with minimal (and relatively benign) side effects. For example;

1. In 1978, Mechoulam and Carlini conducted a randomized experiment on nine epileptic patients. Four of the patients were administered 200 mg of CBD daily. The remaining five patients were administered a placebo. Two of the four patients who received the 200 mg/daily dosage of CBD became seizure free. The placebo patients continued to experience unchanged seizure activity.
2. In 1981 Carlini and Cunha used a placebo controlled study to examine 15 adult patients whose seizures were uncontrolled by conventional treatment. Of the 8 patients who received CBD four exhibited no sign of seizure, one “improved markedly,” one “improved somewhat,” one showed no improvement, and one withdrew from the study. Of the placebo-treated patients, one showed “a little improvement,” whilst six showed no change. Four of the CBD-treated patients reported that CBD caused some sedation. The investigators concluded that CBD could be of benefit to patients with secondary generalized epilepsy for whom existing medicines were ineffective.
3. In 2013, Porter and Jacobson examined the results of parental surveys on high CBD strains of cannabis use in children that had treatment-resistant epilepsy. Their findings: “The average number of antiepileptic drugs (AEDs) tried before using cannabidiol-enriched cannabis was 12. Sixteen (84%) of the 19 parents reported a reduction in their child’s seizure frequency while taking cannabidiol-enriched cannabis. Of these, two (11%) reported complete seizure freedom, eight (42%) reported a greater than 80% reductions in seizure frequency, and six (32%) reported a 25-60% seizure reduction. Other beneficial effects included increased alertness, better mood, and improved sleep. Side effects included drowsiness and fatigue….”
4. A high profile story about the use of CBD for seizures involves the case of Charlotte Figi. Charlotte suffers from a rare form of epilepsy called Dravet syndrome. Charlotte was experiencing about 300 seizures per week since she was a little baby. This terrible disease did not respond to over 12 medications and left her malnourished and wheelchair bound.
   Fortunately, Charlotte’s parents heard about the benefits of CBD oil and started giving this to her. She has responded fantastically and immediately and now only gets one or two seizures each week. She is no longer malnourished, no longer wheelchair bound and is the proverbial “poster child” for the use of CBD in epilepsy. Charlotte’s story has made national news
5. Charlotte’s story has spawned the creation of “The Realm of Caring Foundation”. This non-profit organization has reported that 85 percent of the children studied experience a greater than 50% reduction in seizures activity.
   There have been countless other reports extolling the benefits of cannabis as a therapeutic agent in epilepsy. Many of these reports have been summarized the paper Cannabis Therapeutic: Compendium Cannabis in the Management and Treatment of Seizures and Epilepsy published in 2014 and written by Ben Whalley, Ph.D. Dr Whalley is a pharmacist and has written and co-written multiple scientific, peer-reviewed papers on the potential effect of cannabis in relieving seizure disorders.

According to Whalley (2014), “most of the available human evidence suggests that both a reduction in incidence and severity of seizures, as well as physical and behavioral improvements in children and adults treated with either cannabis or its 25 preparations (e.g. CBD solution), can be achieved.

The Science Behind the Benefits of Cannabis for Seizures

There are many potential mechanisms by which cannabidiol (CBD) can reduce seizures in susceptible individuals via its ability to regulate nerve excitation;

(1) CBD regulates helps to regulate/control the intracellular levels of calcium – calcium is a major stimulator of nerve excitation

(2) CBD blocks (antagonizes) 5 Hydroxytryptophan receptors which helps inhibit the generation of seizures

(3) CBD helps your central nervous system (CNS) maintain higher levels of adenosine by reducing adenosine reuptake which then increases inhibitory CNS signals and helps suppress seizures

There are also numerous other effects of CBDs that may reduce seizure activity that are not related directly to CBD’s anti-convulsant properties. For example – CBDs have been shown to modulate (control) your immune system and inflammatory responses, reduce pain, enhance sleep, and reduce anxiety.

In summary, CBD’s anti-seizure effects are most likely due to several different mechanisms.

CBD has an excellent side-effect profile and can help other anti-epilepsy drugs (AEDs) work better. Consequently, CBD treatment can have beneficial effects as an anti-seizure medicine by itself. Additionally CBDs can reduce the dosage needed to produce therapeutic responses and the undesirable side effects of AED treatments.