Cannabis, More Than the Euphoria: Its Therapeutic Use in Drug-Resistant Epilepsy

Abstract

A significant number of epilepsy patients are refractory to conventional antiepileptic drugs. These patients experience considerable neurocognitive impairments that impact their quality of life and ability to function independently. This need for alternative treatment has generated increased interest in cannabis use as a therapeutic option in these patients. This review seeks to analyze data presented on the pharmacology, safety, and efficacy of cannabis use in patients with drug-resistant epilepsy (DRE) and to propose any future recommendations regarding its use. PubMed was used to retrieve all published studies and articles which evaluated the use of cannabis in epilepsy. The two foremost phytocannabinoids of cannabis showing anticonvulsant properties are tetrahydrocannabinol (THC) and cannabidiol (CBD). Due to the psychoactive properties of THC, most studies focused on CBD use in these patients. The use of CBD as an adjunct resulted in decreased seizure frequency, and secondary benefits observed included improvement in mood, alertness and sleep. Adverse events (AEs) reported were drowsiness, diarrhea, increased transaminases and worsening of seizures. It can safely be concluded that there is a significant benefit in DRE patients using CBD as adjunctive therapy. However, further controlled and adequately powered studies are needed to assess the pharmacokinetics and impact of the long-term use of cannabis.

Pharmacokinetic Investigation of Commercially Available Edible Marijuana Products in Humans: Potential Influence of Body Composition and Influence on Glucose Control

“…Aside from recreational use, marijuana and other Cannabis sativa L. products have been purported to have multiple medicinal benefits [ 13 , 14 ]. These include pain management [ 15 ], the treatment of Inflammatory Bowel Disease [ 16 ] and epilepsy [ 17 ], decreased nausea associated with some cancer medications [ 18 ], and potential protection from diabetes [ 19 , 20 , 21 , 22 , 23 ]. The latter claim is based on large epidemiological studies reporting on decreased incidence of diabetes in habitual and former marijuana users.…”