Recently, the world of science and medicine has been receptive to exploring unconventional therapeutic approaches to treating complex conditions. This is evident in the growing scientific curiosity concerning the use of cannabidiol (CBD) in epilepsy management.
» Learn more about using medical cannabis for epilepsy.
In recognition of the relatively incurable nature of epilepsy and its resulting strain on patients, wards, and healthcare professionals, scientists have sought more efficacious means of treatment. And in this ardent quest for novel treatment, it came to light that CBD could mitigate the intensity and frequency of seizures, where traditional therapies falter.
This article will explore the nexus between CBD and epilepsy and reveal the legal stance on CBD therapy, its limitations, and potential side effects.
Epilepsy is an age-long disease that has, for centuries, perplexed medical experts. It is a chronic, non-communicable neurological malfunction that affects the brain’s electrical activities, resulting in sudden and uncontrollable surges of the body’s electrical impulses. These surges manifest as seizures involving the involuntary movement of a part or the whole body. And they could range from mild to intense convulsive episodes.
According to the World Health Organization, 50 million people are affected by this disease worldwide, with an estimated diagnosis of at least 5 million people yearly. The origins of their conditions vary widely among the patients diagnosed every year. In contrast, some individuals may experience epilepsy due to head trauma, severe brain injury, or genetic syndromes. Others may suffer the condition due to infections such as meningitis, tumors, strokes, or structural abnormalities within the brain. But for many others, the root cause of their epileptic condition remains a perplexing puzzle, requiring further research.
Epilepsy manifests differently in individuals. It could take on numerous forms like focal seizures that only affect certain brain regions, absence seizures that may cause brief lapses in consciousness, or generalized seizures that overwhelm the entire brain. These seizures traverse a broad spectrum and impact patients and their caregivers heavily.
Patients could experience physical injuries during seizures, leading to bruises, fractures, or head traumas. Psychologically, the strain of living with the condition could evoke emotional distress like anxiety, isolation, depression, and cognitive and memory impairments. The effect could also be social, subjecting them to discrimination, ostracization, stigma, and misconceptions surrounding their conditions.
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There are a handful of conventional treatment methods geared toward taming the unpredictable nature of epilepsy. Anti-epileptic drugs (AEDs) are the cornerstone of epilepsy management. They are designed to stabilize the chemical and electrical activity in the brain, and they come in different types: lamotrigine, topiramate, levetiracetam, sodium valproate, etc. Now, it is worth noting that AEDs do not cure epilepsy—they can only suppress and prevent seizures from happening. Plus, they do have nasty side effects, which could range from headaches, drowsiness, and agitation to pregnancy loss, rashes, swollen gums, tremors, and hair loss.
AEDs are not suitable for every epileptic condition. They only work in 7 out of 10, and surgery is often required when they fail to work. The surgery involves removing a part of the brain after several tests have been conducted. But then, surgery does not stop seizures immediately, and it will take a while for a person to feel normal after the procedure. Thus, epileptic individuals may still have to take AEDs for a year or two after surgery.
In the event that AEDs and surgery fail to control the seizure, other anti-epileptic treatment methods include vagus nerve stimulation (VNS), deep brain stimulation (DBS), and a ketogenic diet, all of which come with side effects.
Cannabidiol, commonly known as CBD, has surprisingly emerged as a remarkable ally to epilepsy treatment. Considering the historical cannabis stigma, CBD’s association with epilepsy might seem counterintuitive. However, due to its non-intoxicating nature, its pharmacological properties have revealed CBD’s ability to provide potential therapeutic benefits.
As of 2014, there was no scientific evidence to support the use of cannabis in epilepsy treatment. However, in 2016, there was an open-label study of the effects of CBD on 214 child patients who were resistant to traditional pharmaceutical anti-epileptic treatment. This study by Dr. Orin, which lasted for 12 weeks, proved a reduction in the frequency of motor seizures from 30.0 to 15.8. Subsequent studies and clinical investigations have revealed CBD’s intrinsic ability to reduce seizures.
The groundbreaking studies have yielded promising results, ultimately approving the first CBD-based anti-epilepsy medication – Epidiolex. It was approved by the FDA in 2018 as a transformative treatment option for certain forms of drug-resistant epilepsy, such as Dravet syndrome and Lennox-Gastaut syndrome. Though derived from the cannabis plant, Epidiolex is safe for patient use and does not induce the euphoric effects of CBD’s counterpart, THC. Its safety thus thrives on a healthy CBD: THC ratio.
The journey of CBD’s acceptance as a potential therapeutic ally in managing epilepsy has been bumpy. And the absence of uniformity in laws on the legality of CBD doesn’t help either. The legal status of CBD at the federal level in the United States has been heavily influenced by the stigma surrounding cannabis. As a result, CBD derived from cannabis is considered a Schedule 1 substance and is thus illegal.
Upon the Farm Bill of 2018’s passing into law, things began to change. Hemp was removed from the list of controlled substances, legalizing the cultivation and sale of hemp-based products containing less than 0.3% THC. Also, the endorsement of CBD-favorable bills in different American states, like the passing of the medical cannabis bill in Kentucky and the hemp bill in Florida, all seem to be a step in the right direction. Moreover, the approval of Epidiolex offers further validation of CBD’s therapeutic potential.
The FDA’s approval of CBD medication for specific forms of epilepsy heralds great tidings for epileptic patients and healthy CBD users who have suffered the CBD stigma. However, it should be noted that Epidiolex is not foolproof. Its applicability is limited to certain epileptic syndromes and comes with side effects. Thus, it is always advised that CBD treatment should only be attempted upon medical recommendation.
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