Does Cannabis Provide Neuroprotection Against Epilepsy

Do Cannabinoids Confer Neuroprotection Against Epilepsy?

In Texas, Epilepsy is a qualifying condition for treatment with low dose THC under the Compassionate Use Act. It is estimated that standard medications fail to reduce seizure intensity or frequency in as many as thirty percent of patients.

At Compassionate Telemedicine in Austin Texas, we provide virtual consults with board-certified physicians who are also cannabis specialists the help you decide if adding medical cannabis to your seizure disorder treatment can help you.

What Is Epilepsy?

Epilepsy is a disorder of the brain characterized by lighting storms of electrical activity between different neural pathways within the brain. Typically, a seizure will start when a group of excitable neurons start firing - like crackling embers in a campfire - and when the kindling gets out of control, the neuronal firing spreads as the brain fires like a tiny electrical storm. Sometimes the storms are small and contained - and these seizures are called absence seizures, where the patient stares off into space for several minutes and then come back to consciousness with no memory of what happened. For other patients, the electrical storm spreads throughout different parts of the brain, where it the neural firing causes muscles to contract and twitch (called a tonic/clonic seizure). In advanced forms of seizure disorder, the electrical storm rages through the brain, causing the patient loose consciousness and all neuromuscular control.

Can Cannabis Control Seizures?

While the jury is still out, there is a significant body of scientific literature demonstrating that cannabinoids provide neuroprotection against brain excitability. They seem to induce at least partial restoration of neurotransmitter dysfunction, inducing a calming, anticonvulsant effect. A large body of dat suggests that cannabinoids can be harnesses was antiepilectifc agents [77-82].

Unfortunately, placebo-controlled studies are needed to before a definitive answer can be given about the ability of cannabis to soothe epileptic symptoms. Lately, CBD has begun to be used to treat intractable epilepsy in children. Recently published data (observational) also su sport the anti-seizure effect of CBD in adolescents. A recent study looking in hind sight at children’s medical charts who received oral cannabis extract at a Colorado epilepsy centre found reduced seizure frequency up to 57% of patients as well as improved behavioral/alertness (33%), language (10%), and motor skills (10%). In Israel, a 2016 study that evaluated multiple studies of patients with treatment -refractory epilepsy found that administration of a CBD exact of a 20:1 CBD:THC ratio for 3 months or more induced seizure relief in 89% of children and improved behavioral/alertness, communication, motor skills and sleep [88].

What is Epidiolex and Can It Treat Epilepsy?

In 2013, the FDA approved a standardized CBD extract called Epidiolex as an experimental treatment for pediatric epilepsy. A group of 10 epilepsy centers collected prospective, control-trialed data for the drug’s effectiveness in control of severe forms of treatment-resistant epilepsy. According to preliminary results, Epidiolex reduced seizure frequency by 54% over a 12 week period when used in conjunction with more traditional anti-seizure medications. Data from another open-label trial in 2015 [93], also showed an almost 40% reduction in seizures in adolescents receiving Epidiolex, suggesting that CBD may provide seizure relieve safely in young adults with highly treatment-resistant epilepsy.

How Much Does Epidiolex Cost?

The actual price you’ll pay depends on your insurance covers. Because it is new drug, without a genetic alternative it is very expensive. Epidiolex is prices at $32,500 annually

How Much Does Low Dose THC Treatment Cost in Texas for Seizure Disorder and Epilepsy?

In many studies of medical cannabis used in treatment of pediatric epilepsy, medical cannabis with a 20:1 CBD:THC ratio is used at varying dose strengths and frequencies.

A frequent adult dosing regimen used at Compassionate Telelemedicine might included a 1 ml dose three times a day, costing about $160. The dispensaries are highly monitored in Texas and must provide chemical analysis and quality content of their products to maintain their certification in the state of Texas. Furthmore, choosing use holistic cannabis allows for different ratios of THC and CBD to be tailored for maximal effectiveness in each patient.

At Compassionate Telemedicine, Dr. Kendrick and her staff are here to help you learn more about now medical marijuana can help control your seizure disorder.

Resources

2. Devinsky O., Sullivan J., Friedman D., Thiele E., Marsh E., Laux L., Hedlund J., Tilton N., Bluvstein J., Cilio M. Efficacy and safety of epidiolex (cannabidiol) in children and young adults with treatment-resistant epilepsy: initial data from an expanded access program.; Abstracts referenced above can be found on the American Epilepsy Society’s Annual Meeting Page.; 2014. pp. 5–9. [Google Scholar]

3. Friedman D., Cilio M.R., Tilton N., Sullivan J., Hedlund J., Rosenberg E., Bluvstein J., Devinsky O. The effect of epidiolex (cannabidiol) on serum levels of concomitant anti-epileptic drugs in children and young adults with treatment-resistant epilepsy in an expanded access program.; Abstracts referenced above can be found on the American Epilepsy Society’s Annual Meeting Page; 2014. pp. 5–9. [Google Scholar]

4. Jones N., Hill A., Hill T., Pérès I., Hadid R., Wright S., Stephens G., Williams C., Whalley B. Assessment of the anticonvulsant effects and tolerability profile of cannabidiol: Gw pharmaceuticals’ preclinical program.; Abstracts referenced above can be found on the American Epilepsy Society’s Annual Meeting Page; 2014. pp. 5–9. [Google Scholar]

5. Devinsky O., Sullivan J., Friedman D. Epidiolex (cannabidiol) in treatment-resistant epilepsy. 2015. (Presentation of preliminary findings from an ongoing multi-site opened label trial of the pure CBD drug Epidiolex towards the control of treatment-resistant seizures in select pediatric epilepsy conditions); AAN 67th Annual Meeting Abstract American Academy of Neurology.; Washington, DC. [Google Scholar]

6. Available at: http://www.gwpharm.com/default.aspx .

7. Vilela L.R., Medeiros D.C., Rezende G.H., de Oliveira A.C., Moraes M.F., Moreira F.A. Effects of cannabinoids and endocannabinoid hydrolysis inhibition on pentylenetetrazole-induced seizure and electroencephalographic activity in rats. Epilepsy Res. 2013;104(3):195–202. doi:10.1016/j.eplepsyres.2012.11.006. [PubMed] [CrossRef] [Google Scholar]

8. dos Santos R.G., Hallak J.E., Leite J.P., Zuardi A.W., Crippa J.A. Phytocannabinoids and epilepsy. J. Clin. Pharm. Ther. 2015;40(2):135–143. doi: 10.1111/jcpt.12235. [PubMed] [CrossRef] [Google Scholar]

9. Blair R.E., Deshpande L.S., DeLorenzo R.J. Cannabinoids: Is there a potential treatment role in epilepsy? Expert Opin. Pharmacother. 2015;16(13):1911–1914. doi: 10.1517/14656566.2015.1074181. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

10. Detyniecki K., Hirsch L. Marijuana Use in Epilepsy: The Myth and the Reality. Curr. Neurol. Neurosci. Rep. 2015;15(10):65. doi: 10.1007/s11910-015-0586-5. [PubMed] [CrossRef] [Google Scholar]

11. Devinsky O., Cilio M.R., Cross H., Fernandez-Ruiz J., French J., Hill C., Katz R., Di Marzo V., Jutras-Aswad D., Notcutt W.G., Martinez-Orgado J., Robson P.J., Rohrback B.G., Thiele E., Whalley B., Friedman D. Cannabidiol: Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia. 2014;55(6):791–802. doi: 10.1111/epi.12631. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

12. Soltesz I., Alger B.E., Kano M., Lee S.H., Lovinger D.M., Ohno-Shosaku T., Watanabe M. Weeding out bad waves: Towards selective cannabinoid circuit control in epilepsy. Nat. Rev. Neurosci. 2015;16(5):264–277. doi: 10.1038/nrn3937. [PubMed] [CrossRef] [Google Scholar]

Author

Dr. Allison Kendrick