Cannabidiol in the Treatment of Epilepsy: A Focused Review of Evidence and Gaps

Silva, Guilherme Diogo; Guerra, Felipe Borelli Del; Lelis, Maíra; Pinto, Lécio Figueira

doi:10.3389/fneur.2020.531939

Cited by 25 publications

(13 citation statements)

References 45 publications

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“…MS and primitive brain tumours can cause large cortical lesions resulting in epileptic seizures. This type of epilepsy is difficult to treat, but our data support the hypothesis that a combination of symptomatic drugs can optimize specific therapy, even if the real cause of symptoms is a brain lesion [4] .…”

Section: Discussionsupporting

confidence: 67%

“…It is difficult to find a good combination of drugs to control epileptic seizures without side effects which often results in patients discontinuing therapy at follow-up [5] . Nabiximols can enhance the effect of anti-epilepsy therapy [4,6] , In fact, we successfully reduced anti-epileptic and symptomatic drug doses in our patient with an improvement in cognitive impairment [5] and decrease in seizure frequency.…”

Section: Discussionmentioning

confidence: 71%

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The Utility of Delta-9-Tetrahydrocannibinol Therapy in a Multiple Sclerosis Patient with a Neoplastic Brain Lesion

Fuiani

2021

European Journal of Case Reports in Internal Medicine

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Multiple sclerosis (MS) can sometimes cause uncommon pseudotumoural lesions that produce atypical symptoms, such as motor epileptic seizures which are often pharmacoresistant. In these cases, accurate diagnosis is essential for correct therapy, even if unconventional. We present the case of a brain tumour in a 40-year-old relapsing-remitting MS patient who presented with pharmacoresistant seizures which eventually responded to nabiximols. After various therapeutic approaches, delta-9-tetrahydrocannabinol therapy was introduced with good results. Spasticity improved, pain decreased and we observed a reduction in the number of daily seizures. It is possible that delta-9-tetrahydrocannabinol can enhance the efficacy of anti-epilepsy therapy.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 71%

The Utility of Delta-9-Tetrahydrocannibinol Therapy in a Multiple Sclerosis Patient with a Neoplastic Brain Lesion

Fuiani

2021

European Journal of Case Reports in Internal Medicine

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“…The area for further research should include the efficacy and optimal dose of CBD in adult patients with epilepsy, particularly focal epilepsy, long-term psychiatric and cognitive adverse effects associated with CBD, and strategies to reduce costs and improve access to CBD for people with epilepsy. Increasing the availability of CBD as adjunctive medication against severe forms of epilepsy, may in some cases provide significant benefits [6,9,27]. From the available studies in the pediatric population, synthetic cannabidiol oral solution can be considered safe at all doses tested and generally well tolerated in this population [5,10,21].…”

Section: Discussionmentioning

confidence: 99%

Epilepsy and cannabidiol - a new perspective for seizures treatment

Kozioł

Budzyńska

Leśniewska

et al. 2021

J Educ Health Sport

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BACKGROUND: Despite the fact that the number of antiepileptic drugs is constantly increasing, epilepsy can still be a therapeutic challenge. Approximately one-third of patients with epilepsy have persistent seizures refractory to treatment. The limited number of effective alternatives motivates researchers to seek new solutions. There is some hope for cannabidiol (CBD) preparations.AIM OF THE STUDY: The purpose of this study was to review the most recent available literature on the use of cannabidiol in the treatment of refractory epilepsy in children and adults. For this purpose, the PubMed and Google Scholar databases were reviewed. The phrase "cannabidiol and epilepsy" was used to search the database. After Screening titles and abstracts a total of 19 papers and articles cited in them were received and analyzed in detail. RESULTS: Nowadays there are many CBD related products available in the market, Cannabis sativa and Cannabis indica are the plants used due to their strong therapeutic effects and also seizure control. Regulations regarding the use of raw marijuana, cannabis extracts, and cannabinoid-based drugs vary from place to place. Many studies have been generated on the efficacy of cannabinoid therapy in the treatment of epilepsy. This therapy in patients with Dravet syndrome and Lennox-Gaust syndrome results in a reduction in the frequency of motor and total seizures. The most commonly reported side effects of CBD are drowsiness, seizures and diarrhea, but the therapy is generally well tolerated.SUMMARY AND CONCLUSIONS: Many available studies support the efficacy of CBD as a treatment option to reduce seizure frequency in children with drug-resistant epilepsy, particularly in patients with Dravet and Lennox-Gastaut syndrome. However, there is a lack of reports on the use of CBD in the adult population, which may be an area for further research.

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“…Evidently, CBD may suppress heightened excitability of neurons and exert neuroprotection in epilepsy ( Ryan, 2020 ). Nonetheless, CBD treatment can induce adverse side effects, such as drowsiness, diarrhea, vomiting, and reduced appetite ( Silva and Del Guerra, 2020 ). Therefore, evaluating other therapies that can effectively mitigate the neurological and psychiatric aspects of epilepsy is essential.…”

Section: Multimodal Treatments For Epilepsy: Neuropsychiatricmentioning

confidence: 99%

Multipronged Attack of Stem Cell Therapy in Treating the Neurological and Neuropsychiatric Symptoms of Epilepsy

et al. 2021

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Epilepsy stands as a life-threatening disease that is characterized by unprovoked seizures. However, an important characteristic of epilepsy that needs to be examined is the neuropsychiatric aspect. Epileptic patients endure aggression, depression, and other psychiatric illnesses. Therapies for epilepsy can be divided into two categories: antiepileptic medications and surgical resection. Antiepileptic drugs are used to attenuate heightened neuronal firing and to lessen seizure frequency. Alternatively, surgery can also be conducted to physically cut out the area of the brain that is assumed to be the root cause for the anomalous firing that triggers seizures. While both treatments serve as viable approaches that aim to regulate seizures and ameliorate the neurological detriments spurred by epilepsy, they do not serve to directly counteract epilepsy’s neuropsychiatric traits. To address this concern, a potential new treatment involves the use of stem cells. Stem cell therapy has been employed in experimental models of neurological maladies, such as Parkinson’s disease, and neuropsychiatric illnesses like depression. Cell-based treatments for epilepsy utilizing stem cells such as neural stem cells (NSCs), mesenchymal stem cells (MSCs), and interneuron grafts have been explored in preclinical and clinical settings, highlighting both the acute and chronic stages of epilepsy. However, it is difficult to create an animal model to capitalize on all the components of epilepsy due to the challenges in delineating the neuropsychiatric aspect. Therefore, further preclinical investigation into the safety and efficacy of stem cell therapy in addressing both the neurological and the neuropsychiatric components of epilepsy is warranted in order to optimize cell dosage, delivery, and timing of cell transplantation.

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Cannabidiol in the Treatment of Epilepsy: A Focused Review of Evidence and Gaps

Cited by 25 publications

References 45 publications

The Utility of Delta-9-Tetrahydrocannibinol Therapy in a Multiple Sclerosis Patient with a Neoplastic Brain Lesion

The Utility of Delta-9-Tetrahydrocannibinol Therapy in a Multiple Sclerosis Patient with a Neoplastic Brain Lesion

Epilepsy and cannabidiol - a new perspective for seizures treatment

Multipronged Attack of Stem Cell Therapy in Treating the Neurological and Neuropsychiatric Symptoms of Epilepsy

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