Medical marijuana, also called medical cannabis, is
derived from the whole cannabis plant. Its effect on epilepsy has recently been
summarized.1 Cannabinoids are in cannabis; these chemicals act on
the body and on the brain cells. Tetrahydrocannabinol (THC) and cannabidiol
(CBD) are the two main cannabinoids. THC binds to brain receptors and creates
the “high” or psychoactive effect. CBD, however, does not have this psychoactive effect.
Epidiolex, a mostly
purified plant-based cannabidiol oil derived from the cannabis plant is
a liquid that is administered orally. It was beneficial in treating people with
notoriously-difficult-to-control-seizures in Dravet and Lennox-Gastaut
Syndromes. The US Food and Drug Administration (FDA) approved it in 2018. In
2020, Epidiolex was also approved to treat seizures in the tuberous
sclerosis complex.
Marijuana products sold in dispensaries and online, however,
are NOT approved or regulated by the FDA because they can vary in quality and
contents.
How the different compounds in marijuana affect
neurologic diseases and epilepsy syndromes is not yet understood. When CBD was
added to the benzodiazepine clobazam (Onfi), the combination improved the
positive effects on seizures in children and adults with Dravet and
Lennox-Gastaut Syndromes. Researchers theorize CBD may slow the sending of
messages to the brain, change calcium levels in the brain that affect signals
between cells, or it may reduce inflammatory effects in the brain.
There can be side effects of this treatment including
fatigue, nausea, diarrhea, liver dysfunction and an increase in suicidal
thoughts.
Seizure frequency in approximately 30% of people with
epilepsy is difficult to control, so Epidiolex may be considered in a
treatment plan after evaluation by epileptologists and epilepsy centers.
Remember that epilepsy-health includes taking your
antiseizure medications as prescribed, getting enough rest and sleep,
minimizing alcohol and do not take illicit street drugs.
1)
A.D.Patel
Can medical marijuana help control seizures? Brain and Life.org: p 23;
June/July 2021
Lance Fogan, M.. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is a medical mystery and his first novel. It is a mother’s dramatic family story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.
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