Cannabis for paediatric epilepsy: challenges and conundrums

Chen, Kerrie-Anne; Farrar, Michelle A.; Cardamone, Michael; Lawson, John A.

doi:10.5694/mja17.00699

Cited by 8 publications

(9 citation statements)

References 43 publications

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“…For example, the molecular mechanisms through which CBD prevents seizures are currently debated on, but several potential molecular targets other than cannabinoid receptors have been identified. In particular, CBD is a partial antagonist of G protein-coupled receptor 55 (GRP55), identified as an endocannabinoid target (Ryberg et al, 2009), which could be involved in the decrease of neuronal excitability, through an action on gamma-aminobutyric acid-ergic (GABAergic) neurotransmission (Devinsky et al, 2014; Musella et al, 2017; Chen et al, 2018). CBD also regulates calcium (Ca2+) homeostasis by acting on mitochondria stores (Ryan et al, 2009), and blocks low-voltage-activated (T-type) Ca2+ channels, modulating intracellular calcium levels (Ross et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain

Ternay¹,

Naassila

Nourredine³

et al. 2019

Front. Pharmacol.

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Background: Cannabidiol (CBD) is a natural component of cannabis that possesses a widespread and complex immunomodulatory, antioxidant, anxiolytic, and antiepileptic properties. Much experimental data suggest that CBD could be used for various purposes in alcohol use disorder (AUD) and alcohol-related damage on the brain and the liver. Aim: To provide a rationale for using CBD to treat human subjects with AUD, based on the findings of experimental studies. Methods: Narrative review of studies pertaining to the assessment of CBD efficiency on drinking reduction, or on the improvement of any aspect of alcohol-related toxicity in AUD. Results: Experimental studies find that CBD reduces the overall level of alcohol drinking in animal models of AUD by reducing ethanol intake, motivation for ethanol, relapse, anxiety, and impulsivity. Moreover, CBD reduces alcohol-related steatosis and fibrosis in the liver by reducing lipid accumulation, stimulating autophagy, modulating inflammation, reducing oxidative stress, and by inducing death of activated hepatic stellate cells. Finally, CBD reduces alcohol-related brain damage, preventing neuronal loss by its antioxidant and immunomodulatory properties. Conclusions: CBD could directly reduce alcohol drinking in subjects with AUD. Any other applications warrant human trials in this population. By reducing alcohol-related steatosis processes in the liver, and alcohol-related brain damage, CBD could improve both hepatic and neurocognitive outcomes in subjects with AUD, regardless of the individual’s drinking trajectory. This might pave the way for testing new harm reduction approaches in AUD, in order to protect the organs of subjects with an ongoing AUD.

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Section: Introductionmentioning

confidence: 99%

Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain

Ternay¹,

Naassila

Nourredine³

et al. 2019

Front. Pharmacol.

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“…More research on the effects of cannabis use on human hormonal markers and clinical outcomes is necessary, and is expected as cannabis continues to become legalised in more countries. 24 It is unclear whether the precocious puberty seen in our patient is a direct result of activation of the HPG axis by Δ9-THC.Untilamorerobustevidencebaseisestablished, clinicians should be cautious of hormonal consequences of cannabis-related products, particularly as children with brain abnormalities may be more susceptible to these effects.…”

Section: Case Reportmentioning

confidence: 85%

Development of central precocious puberty following cannabinoid use for paediatric epilepsy: causal or coincidence?

Krishnan

Agwu²,

Kallappa³

et al. 2021

BMJ Case Rep

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Research suggests a role for cannabidiol oil in managing certain forms of paediatric onset epilepsy. However, studies on the impact of cannabis on the hypothalamo-pituitary-gonadal (HPG) axis have conflicting results. Delta-9-tetrahydrocannabinol (Δ9-THC) acutely inhibits gonadotropin-releasing hormone in the hypothalamus, reducing testosterone levels by 65% in rhesus monkeys. Additionally, there have been reports of pubertal arrest and delayed puberty in male cannabis users. In contrast, other studies have reported higher testosterone levels following long-term cannabis use.A 2-year-old boy presented with testicular enlargement, increased penile length and growth of coarse pubic hair developing over 6 months. His mother procured cannabidiol oil online, which he started taking 7 months earlier for severe epilepsy refractory to medical management. Subsequent investigations confirmed central precocious puberty. While it is unclear whether the precocious puberty is a direct consequence of HPG axis activation by Δ9-THC, this case demonstrates a temporal association between cannabis use and development of precocious puberty.

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“…Desde tempos antigos [1][2][3] a Cannabis sativa tem sido utilizada pelos seus efeitos sedativos, hipnóticos e anti epilépticos 1,2 em vários continentes 1 . Dentre as substâncias com efeitos biológicos da maconha se destacam o Tetrahidrocanabinol (THC) e o Canabidiol (CBD) 1,3 .…”

Section: Introductionunclassified

Tratamento da epilepsia com canabidiol: uma revisão da literatura / Cannabidiol treatment of epilepsy: a literature review

Silva¹,

Rolindo²,

Silva³

et al. 2021

Braz. J. Hea. Rev.

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RESUMOObjetivo: revisar ensaios clínicos para avaliar a eficácia do tratamento de epilepsia utilizando Canabidiol. Métodos: Foram filtrados artigos publicados entre janeiro de 1980 e novembro de 2020. As bases de dados utilizadas foram PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO) e os seguintes descritores foram usados: Cannabidiol AND Epilepsy. Foram incluídos ensaios clínicos randomizados e excluídos outros tipos de estudos, como revisões sistemáticas, revisões de literatura não sistemáticas, estudos experimentais em animais, além de artigos não disponíveis em versão completa, que não abordavam o tratamento da epilepsia ou que não estavam escritos em inglês. Resultados: Foram encontrados 285 artigos nas bases de dados mencionadas e utilizando os critérios de exclusão restaram 15 artigos. Conclusões: Provavelmente o CBD possui baixa toxicidade, tanto em administrações agudas quanto no tratamento crônico. Os efeitos adversos mais comuns foram: sonolência, vômito, diarréia, convulsões e perda de apetite. Foi evidenciado o aumento das transaminases hepáticas, principalmente quando associado ao uso de ácido valpróico. Os efeitos adversos são maiores até a 12ª semana e a partir dela eles se mantêm estáveis. Em dois estudos a frequência das convulsões não diminuiu com o tratamento. Houveram relatos da diminuição da intensidade das crises convulsivas com o uso de CBD. Dentre as limitações desta revisão estão a amostra pequena de pacientes em alguns estudos, pesquisas open-label, vieses de seleção e participação e população heterogênea.Palavras chaves: Canabidiol. Epilepsia. Uso terapêutico.

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Cannabis for paediatric epilepsy: challenges and conundrums

Cited by 8 publications

References 43 publications

Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain

Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain

Development of central precocious puberty following cannabinoid use for paediatric epilepsy: causal or coincidence?

Tratamento da epilepsia com canabidiol: uma revisão da literatura / Cannabidiol treatment of epilepsy: a literature review

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