Sunday, July 9, 2017

Cannabis for Seizure Disorders

Marijuana is increasingly popular as a treatment for seizure disorders (including Dravet’s syndrome and Lennox-Gault syndrome).

Many neurologists seem puzzled that significant numbers of adults who have seizure disorders and parents of children who have seizure disorders are intensely interested in marijuana. As one neurologist asked in a review paper, “Why should patients opt for medical marijuana when we can provide them with medications that are effective for 90 percent of the people who use them?”

The answer to the doctor’s objection, of course, is that some people fall in that other 10 percent. For them, marijuana may be the only hope of escaping a catastrophic disease, of saving their own or a child’s life. Because the issues of medical marijuana for treating seizure disorders are complex and intensely important to its users, this section will devote extra space to some of the basic considerations for its use.

Even before the legalization of marijuana, Colorado was a state of hope for families who have children with seizure disorders. Hundreds of families quit their jobs, sold their homes, and moved from all over the country to pursue a treatment that in Colorado was at least somewhat legal (although it was a federal offense to transport a child there to get it).

For hundreds of families, marijuana, particularly strains of marijuana that are especially high in the chemical CBD, was the answer. Not usually a “cure” for seizure disorders (only about 1 child in 9 goes into complete remission after starting medical marijuana), the dramatic effects of marijuana treatment became the staple of television news reports and a major incentive for other states to loosen restrictions on pot. Even the State of Texas has legalized research into the use of marijuana for treating the most intractable forms of seizure disorders in children, despite the fact that it has no legal cannabis dispensaries and no working research labs.

Not every family that puts its hopes on cannabis for treating seizure disorders, however, gets the same results. One of the odder results of the legalization of marijuana in Colorado has been that parents who moved to Colorado to get medical marijuana for their children tend to get much better results that parents from Colorado whose children have epilepsy.

One survey of parents of children who were being given CBD-enriched cannabis products to treat epilepsy found that:

84 percent of parents reported a reduction in the number of seizures,
32 percent of parents reported a 25-60 percent reduction in the number of seizures,
42 percent of parents reported a greater than 80 percent reduction in the number of seizures, and
11 percent of parents reported complete freedom from seizures.

The number of parents reporting complete freedom of seizures was about equal to the number of parents who reported no benefit at all, 16 percent. However, even higher percentages of children were seizure free (about 25 percent) when their parents got a special formulation of marijuana oil made form a strain of a proprietary strain ofmarijuana called Charlotte’s Web.
Contrastingly, among 237 Colorado children who were put on the medical marijuana registry without input from epilepsy specialists, almost certainly not receiving the right kind of marijuana, fewer than 2 became seizure-free and fewer than 10 percent experienced any benefit at all.

What Is the Evidence That Cannabis Treats Seizure Disorders?

It’s tempting to say that hundreds of marijuana refugees whose children who have epilepsy can’t be wrong, and at least in more severe forms of epilepsy such as Doose syndrome, Dravet syndrome, and Lennox-Gastault syndrome, who get products made from high-CBD strains of marijuana like Charlotte’s Web, they are usually right.

The best-known product for seizures is the previously mentioned Charlotte’s Web. It’s exclusively available from CW Botanicals. This product is not completely THC-free, although it has an unusually low concentration of the psychoactive chemical.

When Charlotte’s Web doesn’t work, it may be that some younger patients may need a product that contains more of the chemical CBDV (cannabidivarin) rather than CBD (cannabidioloic acid). Laboratory tests with animals have found greater efficacy of this lesser-known chemical. British cannabis giant GW Pharmaceuticals patented the use of the chemical for treating temporal lobe seizures and general seizures in 2015. However, the company plans to complete clinical trials of its drug based on CBD, Epidiolex, before it develops a product based on CBDV. The CBDV trials will be conducted in Australia at the Sydney Children’s Hospital Network at a later date.

What can concerned parents do now?

It’s best for parents to work with a licensed dispensary that specializes in treating seizure disorders. You really don’t want to be some new dispensary’s “learning experience. ”

What about marijuana for treating seizure disorders in adults?

“Highless” varieties such as AC/DC and Charlotte’s Web are usually optimal for adults who have seizure disorders, too. Some adults who have epilepsy get good results from Cannatonic.

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