How does medical cannabis or CBD affect epilepsy?

Cannabis is a plant that is causing quite a stir all over the world. This is not without reason, but rather because progress is being made and it is being proven that it is a plant with many uses. A strong point regarding marijuana is that it has great medicinal interest, making it a plant with very high potential. This is demonstrated by recent trials in which a study on marijuana and epilepsy has been conducted, specifically on CBD and epilepsy.

Epilepsy: What is it?

Epilepsy refers to a disorder of the central nervous system or neurological disorder that causes seizures. Seizures are defined as brief changes in normal brain activity that can lead to catatonic episodes or simply cause the person to fall and have tremors. These can last between a few seconds and a few minutes, depending on the type of seizure. There are two main types:

• Seizures that affect both sides of the brain.
• Focal or partial seizures are those that only affect one area of the brain.

This can be caused by different conditions that affect the person’s brain. Some of the best-known include strokes, brain tumors, or certain head injuries, as well as different neurological or genetic diseases.

Symptoms of epilepsy

Some of the symptoms of this pathology include:

• Periods of temporary confusion and absence seizures.
• Stiffness in the muscles.
• Uncontrollable jerking movements in the limbs.
• Loss of consciousness or awareness.
• Different psychological symptoms, including fear, anxiety, or depression.

Latest studies on epilepsy

The latest studies conducted have examined the effect of cannabidiol on different types of epilepsy such as Lennox-Gastaut syndrome, which usually appears in children between 3 and 5 years old, leading to multiple crises that can cause trauma from falling. It is usually linked to developmental delays, mental disabilities, or behavioral disorders.

This study was carried out upon seeing that existing medications improve the quality and lifespan of patients, but generate drug resistance. The novelty in this research is the use of cannabidiol, due to its great medicinal potential, using Epidiolex, which contains CBD in its pure form.

CBD for epilepsy

Cannabidiol is one of the cannabinoids in marijuana, but unlike THC, it does not produce any psychoactive effect. For this, 225 people with epilepsy were chosen in different hospitals in the United States and Europe, and two medications were used: an oral CBD solution and a placebo, in addition to their respective treatments.

The study showed that in both cases there was a real improvement. In the case of patients who used CBD, there was a 37.2% decrease in the seizures produced and a 17.2% decrease in the placebo effect. In other words, it can be seen that the trial yielded very good results in both modalities, especially in the doses that did contain cannabidiol.

Likewise, greater improvement was noted in the worst seizures, the most dangerous ones related to falls. Another interesting fact is that apart from working very well for the patients, it did not cause any kind of adverse effect, making the patients’ condition significantly better.

Medicinal marijuana for epilepsy

Medicinal marijuana is increasingly used by patients with epilepsy who do not respond to drugs, especially in syndromes such as Lennox-Gastaut, Dravet, Doose, and West. However, before using it, one should know that cannabinoids can increase the effects of other medications or interfere with them. Therefore, you must consult with a specialist before using it.

Some of the benefits that CBD provides for epilepsy are the following:

Anticonvulsant effect of cannabis

60% of epileptic seizures are accompanied by different rapid and involuntary contractions, which in the long run can cause damage to brain tissue. Cannabidiol possesses significant anticonvulsant properties due to its relationship with anandamide levels, acting as an antagonist of the CB1 receptors in the central nervous system.

Neuroprotective capacity

The endocannabinoid system plays an important role in the regulation and frequency of seizures. It is believed that this could occur as a result of an imbalance in this system. The most common cause of convulsive seizures is excessive neuronal excitation. Cannabinoids play a fundamental role in regulating neuronal excitation, reducing the severity and frequency of symptoms.

Status epilepticus

This occurs in very severe cases of epilepsy, involving seizures—convulsive or not—that last more than five minutes each, or occur with a frequency of more than one attack every five minutes without the person regaining full consciousness. If immediate attention is not provided, it can cause brain damage and can even be fatal. Cannabinoids, specifically CB1 receptor agonists, can completely suppress all attacks, as well as this status epilepticus. This is because CB1 receptor agonists reduce excessive activity.

Effects of CBD on epilepsy

In addition to reducing epileptic seizures, they achieve great improvement at the cognitive, motor, and emotional levels. In this way, patients are able to increase socialization, reducing anxiety or depression. This also achieves an improvement in the family environment, as the patient is not as sedated.

Studies on CBD and epilepsy

A large number of studies on CBD and epilepsy have been conducted, but some of the most recent ones to highlight are:

• GWPCARE1, 2, and 3 study by Devinsky, Patel, Thiele, (2018), titled “Effect of cannabidiol on drop seizures in the Lennox–Gastaut syndrome.” This phase 3 study evaluated the efficacy of Epidiolex (CBD) in patients with Lennox-Gastaut syndrome and showed a significant reduction in seizure frequency. It also investigated the use of Epidiolex in patients with Dravet syndrome, demonstrating a notable reduction in seizures.

• Jones, Hill, Smith, et al. (2010), a study titled “Cannabidiol displays antiepileptiform and antiseizure properties in vitro and in vivo.” Journal of Pharmacology and Experimental Therapeutics, research in animal models that demonstrated the anticonvulsant effects of CBD and other cannabinoids, providing a basis for clinical trials in humans.
• Study by Patra, Barker-Haliski, White, et al. (2019). “Cannabidiol reduces seizures and associated behavioral comorbidities in a range of epilepsy models” (2019): a preclinical study that explored the mechanisms of action of CBD and its neuroprotective potential in epilepsy models.
• Research by Pertwee R.G. (2008) “The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin” : this study suggested that CBD interacts with several receptors in the brain, including serotonin receptors (5-HT1A), vanilloid receptors (TRPV1), and GPR55 receptors, which could explain its anticonvulsant effects.
• Studies by Thiele, Marsh, French et al. (2018). “Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial“: trials that continue to evaluate the long-term efficacy of CBD and other cannabinoids in different types of epilepsy, as well as their safety profiles.
• Research by Szaflarski, Bebin, Comi, et al. (2020). “Long-term safety and treatment effects of cannabidiol in children and adults with treatment-resistant epilepsies: expanded access program results”. Ongoing studies exploring the use of other cannabinoids, such as tetrahydrocannabinol (THC), in combination with CBD for the treatment of epilepsy.

CBD in dogs with epilepsy

Just as it happens with people, pets can suffer from these problems. The effects of cannabis oil for epilepsy can be a good ally to avoid epileptic seizures in animals, thanks to the ease of calculating the dose and the speed of absorption of the active components. They have an Endocannabinoid System that functions similarly to that of humans, so they respond to medicinal cannabis treatments in a similar way.

However, when using them, you should purchase those made especially for pets and always in the dose recommended by the veterinarian.

In short, it can be said that marijuana is a plant that surprises us more and more. It is important that progress continues on the medicinal side, expanding knowledge about CBD and epilepsy, to manufacture drugs that serve for this and other diseases.