Medical Marijuana for Seizures

Cannabis clinicians treating epileptic patients in three medical marijuana states – California, Washington and Maine – have reported their findings in a peer-reviewed article that underscores the complex challenges and unique therapeutic potential of cannabis oil concentrates. In this uncontrolled observational study involving 272 patients, some degree of seizure reduction was noted in 86 percent of cases. Ten percent (26 patients) experienced complete seizure remission.

In addition to documenting the efficacy of “artisanal” (meaning not FDA-approved) cannabis preparations for seizure reduction, the article highlights the need for flexible treatment protocols involving different cannabinoid ratios, an approach that implicitly calls into question single-molecule strategies favored by Big Pharma.

What follows are excerpts from “The current status of artisanal cannabis for the treatment of epilepsy in the United States,” by Dustin Sulak, Russell Saneto, and Bonni Goldstein in the journal Epilepsy & Behavior:

Of 272 combined patients from Washington state and California, 37 (14 percent) found cannabis ineffective at reducing seizures, 29 (17 percent) experienced a 1-25 percent reduction in seizures, 60 (18 percent) experienced a 26-50 percent reduction in seizures, 45 (17 percent) experienced a 51-75 percent reduction in seizures, 75 (28 percent) experienced a 76-99 percent reduction in seizures and 26 (10 percent) experienced a complete clinical response. Overall, adverse effects were mild and infrequent, and beneficial side effects such as increased alertness were reported. The majority of patients used cannabidiol (CBD)-enriched artisanal formulas, some with the addition of delta-9-tetrahydrocannabinol (THC) and tetrahydrocannabinolic acid (THCA).

The authors maintain that artisanal cannabis products should be considered for patients with refractory epilepsy that have a low likelihood of responding to FDA-approved anti-epileptic drugs. Moreover, a combination of cannabinoid compounds – not just CBD – may be more effective for seizure reduction.

The patient population that considers herbal cannabis as a treatment for epilepsy is heterogeneous in etiology, currently predominantly pediatric, and has seizures that are usually refractory to multiple conventional treatments . . . The cannabinoids may reduce seizures via numerous mechanisms of action that warrant further investigation, including THC’s reduction of glutamate exotoxicity via the CB1 receptor, CBD’s modulation of numerous non-cannabinoid receptors, and several proposed targets of THCA. Objective measurement of treatment response can be challenging, and subjective reports of the efficacy of artisanal cannabis can be strongly influenced by the placebo effect, especially in patients that have invested significant resources into securing access to these formulas.

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By Project CBD on February 28, 2017

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