Medical Cannabis May Improve Treatment of Epilepsy
Despite progress in legalizing medical marijuana, incorporating it into clinical trials for epilepsy to prevent seizures remains difficult.
About 1 million epileptic Americans -- many of which are children -- still experience seizures while being treated with approved medications, causing parents to consider medicinal marijuana for a treatment option, according to a recent study.
With claims that marijuana and its derivatives help prevent seizures from occurring, researchers sought to explore if these benefits could be confirmed.
"There was a lot of media attention about how medical marijuana is good for epilepsy," said study co-author Samba Reddy, PhD, RPh. "We became interested in finding out whether there was scientific evidence in the literature to support the claims of these people who have seen great benefits."
In the current study published in the Journal of Pharmacology and Experimental Therapeutics, researchers looked at 2 major active components of marijuana: delta 9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is a psychoactive component and CBD has shown in animal models to have some anti-seizure potential.
Furthermore, it is not responsible for causing a “high” and is not addictive. Researchers found that derivatives of marijuana high in CBD — with a negligible amount of THC – has the potential to help patients with epilepsy.
Although there are products that contain CBD such as, Epidiolex and Realm Oil, the efficiency of these products have not been proven and the legalities of it are relatively unclear. There are also homemade compounds available, but it can be hard for patients to decipher exactly what they are getting, since it these products do not have to be held to manufacturing procedures and protocols and are not approved by the FDA.
"It is critical to know how CBD controls seizures, so pharmaceutical companies can design novel synthetic compounds for epilepsy that could surpass the hurdles of mixed CBD extracts," Dr. Reddy said.
- Learn more about the potential impact of medical marijuana on specialty pharmacy
Although there has been progress in legalizing marijuana -- with it becoming legal in 4 states and medical marijuana becoming legal in 23 states plus Washington, DC -- it is still difficult to incorporate it into a standard manufacturing process and clinical trials for epilepsy.
This is because cannabis is a Schedule 1 substance, meaning it’s extremely difficult to get permission to use it for research on humans. Currently, there are only 19 clinical trials that are testing its effects on epilepsy.
A new study is being performed at the University of Colorado Anschutz Medical Campus to test Charlotte’s Web on Dravet epilepsy patients. Charlotte’s Web is a specific strain of medical marijuana that has high CBD and low THC.
Researchers will be looking to compare the genetics of patients who have had their seizures decrease by at least 50% as a result of the drug, versus those who did not. This study will be useful to explore how CBD and genetic factors interact in Dravet epilepsy patients.
However, the most helpful type of study would be a randomized, placebo controlled, double-blinded clinical trial, with patients who randomly receive CBD or a placebo, the researchers wrote.
Since there isn’t much available data for the use of medical marijuana on epileptic patients, the American Epilepsy Society (AES) reported that they could not draw any conclusions about its use at this time.
The Epilepsy Foundation encourages patients to explore all options for treatment and to discuss it with their physician to find the best quality care, as well as following the laws in their individual states.
"Despite all of the controversy about medical marijuana as a potential therapy for epilepsy, most people agree that what we need is greater rigorous scientific study into cannabinoids to prove or disprove their safety and efficacy,” Dr. Reddy said.
Further epilepsy coverage can be found on Specialty Pharmacy Times' new sister site, NeurologyLive.