Earlier this week, voters in four states (Arkansas, Florida, Montana, and North Dakota) approved legislation that made medicinal marijuana legal in their respective states. Now more than half the states have approved medical marijuana in some form. It’s fitting that this landmark was reached in the month of November, which happens to be Epilepsy Awareness month.
A growing number of patients with epilepsy and seizure disorders are using medical cannabis to control their seizures. More specifically, cannabidiol (CBD), a chemical compound found in cannabis, has shown to have anti-epileptic and anti-inflammatory properties.
One of the most famous examples of treating epilepsy with cannabis is the story of Charlotte Figi, which was profiled in Dr. Sanjay Gupta’s documentary. When Charlotte was 2 years old she was diagnosed with Dravet Syndrome, a rare, severe form of epilepsy that cannot be controlled by medications. Her parents were able to get Charlotte a medical marijuana card and purchase a strain of cannabis that is high in CBD and low in THC, the compound that produces the mind-altering high that is commonly associated with cannabis. They extracted the CDB and gave it to Charlotte in the form of an oil. Her seizures went from 300 per week to just 2 or 3 per month.
CBD is non-psychoactive, making it a poor choice for recreational users. However, being non-psychoactive gives CBD a significant advantage as a medicine, since health professionals prefer treatments with minimal side effects. A 2011 review published in Current Drug Safety concludes that CBD “does not interfere with several psychomotor and psychological functions.” The authors add that several studies (listed below) suggest that CBD is “well tolerated and safe” even at high doses.
- Dr. Orrin Devinskys forum on CBD and epilepsy
- The Dravet Foundation meeting on CBD held May 2014.
- GW Pharmaceuticals presentation on CBD and Epilpesy: GW_RD_Consolidated_Presentation_(2)
- Ben Whalley: Cannabis_Epilepsy_ben-whalley
- Survey: doctors and patients regarding the efficacy of cannabis based treatments for epilepsy.
Ngoc Minh Le, MD, Medical Consultant at Courtagen and practicing pediatric epileptologist, spoke at the 2016 CannMed Conference about his experience with patients using CBD to control seizure disorders and Dravet Syndrome. He presented the story of one family that moved from Florida to Colorado in order to access CBD oil for their child. That patient went from having seizures every 7-10 seconds to just 2 or 3 per day. Dr. Le has also treated patients who are enrolled in clinical trials of Epidiolex, a synthetic form of CBD produced by GW Pharmaceuticals. Those patients have also responded well.
Although there is lots of anecdotal evidence for the effectiveness of CBD on seizures, more research is needed to fully understand the human mechanisms that are involved and the plant compounds that affect them. Different seizure disorders will likely require different combinations of cannabinoids and terpenoids in order to be effective.
Genetic testing can help guide physicians as to whether cannabis or other anti-epileptic drugs are appropriate for their patients. Genetic testing may also identify genetic markers that can predict whether a patient will respond well to cannabis treatment.
Courtagen and its sister company Medicinal Genomics are in a unique position to explore how a person’s unique genetics can affect their response to cannabis. Courtagen and Medicinal Genomics are currently working with the physicians who are participating in the GW Pharmaceuticals Epidiolex clinical trials to genetically sequence their patients. Courtagen is looking at specific genes within the endocannabinoid system to find which variations influence a patient’s ability to benefit from CBD treatment.
Courtagen has also begun mining its database of neurological patient DNA to look for connections to the endocannabinoid system and patterns that may indicate a response to cannabis treatment.
For more information about research into Cannabis treatment for Epilepsy, please visit the Medicinal Genomics educational web page: http://www.medicinalgenomics.com/dravets/