In 2018, the question of whether cannabis is a suitable substance for the treatment of epilepsy was almost a big deal, not only in scientific journals, but also in information for medical professionals and patients. Some patients justify their sometimes intensive “smoking” with it. Others started using cannabis only when they could not tolerate the drugs for the treatment of epilepsy or found them ineffective, and assumed that the treatment would be useful. Careful medical research has been carried out on this issue. There are clear results. Because of the complexity of the general public’s situation, Professor Christian E. Elgar has compiled the most important facts about the use of cannabis in the treatment of epilepsy.
What is epilepsy and how does it occur?
Epilepsy is not a distinct and uniform disease. Rather, it is a mixture of brain dysfunctions from the most diverse causes with the common feature of inducing epileptic seizures. Genetic defects, structural damage to the brain, the effects of accidents, brain tumours, strokes, haemorrhages and inflammation are just some of the causes. Epileptic seizures can affect only part of the cerebral cortex (focal seizures) or the whole cortex (generalised seizures). The frequency and severity of seizures varies greatly from patient to patient. In other words, there is no such thing as “epilepsy”; there are many forms of epilepsy.
What is the suitability of cannabis for the treatment of epilepsy?
Let us return to the subject of epilepsy treatments obtained from cannabis (hashish, marijuana, grass). Cannabis belongs to the hemp group and has been used as a therapeutic agent in many cultures for centuries, perhaps for thousands of years. This plant is composed of a number of biologically active substances. Cannabinoid receptors can also be detected in the brain, known as the “endocannabinoid system” and activated not only in response to externally supplied cannabis plant substances, but also by “endocannabinoids” produced by the body. Also, from a modern pharmacological point of view, the components of cannabis have been shown to be good: THC is responsible for the intoxicant effect and has been used successfully in medicine for severe spasms, multiple sclerosis, severe pain in neoplastic diseases, nausea and weight loss in neoplastic diseases. Despite individual case reports, so far no study has shown that THC has a convincing positive effect on certain types of epilepsy.
This is not the case with cannabidiol. Cannabidiol (CBD) has been shown to affect various studies in special patient groups positively. It has been shown to reduce seizures by 50% in almost half of patients with Dravet syndrome, a rare form of childhood epilepsy, and Lennox-Gastaut syndrome, an epilepsy in which patients feel particularly stressed by falls. In the control group, in which no effective drugs were used, about 20% of affected children showed such an improvement. Studies with a larger number of drug-resistant patients and without a control group have shown similar results. In addition, a survey of doctors specialising in epilepsy found that around 50% of them use this substance.
The medicinal properties of CBD as a plant extract have not been fully analysed to date. It is also not clear whether the seizure-suppressing effect is due to a change in the medication the patient is already taking, or whether it is really the effect of cannabidiol.
The present study results are in line with the results of other new drugs in the treatment of epilepsy. Therefore, any euphoria that a miraculous treatment has appeared is not justified. Cannabidiol is another way to improve epilepsy that is difficult to treat.
Cannabis for epilepsy – another medicine that can help
In summary, it must be mentioned that cannabidiol (CBD), a special extract from the cannabis plant, has antiepileptic properties that have been investigated in human studies. It also does not have the same psychoactive effects as THC. It is a complement to conventional medicines and can be manufactured for medical use by pharmacists or obtained at great expense from overseas pharmacies in the USA. Its effects have been proven to be of high quality for certain types of epilepsy. Unfortunately, there is no reason to regard this substance as a “miracle cure”.