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CBD: A Epilepsy and Seizure Medication

CBD is short for Cannabidiol which is a naturally occurring compound in the cannabis plant. CBD makes up to 40% of the plant extract and has promising results in treating many ailments including anxiety, depression, pain, cognitive disorders, diabetes, obesity, gastrointestinal disorders, to name but a few. CBD has certain neuroprotective mechanisms and also has anti-cancer properties. Some diseases in which CBD is extensively being used include epilepsy and Lennox-Gastaut syndrome.    

What Is Epilepsy?

The terms seizures, epilepsy, and convulsions are used interchangeably. During a seizure, a person may have an impairment or loss of consciousness, behavioral abnormalities, sensory disturbances, abnormal motor activity, or autonomic dysfunction.

The normal functioning of the brain is a balance between excitation and inhibition. Any disruption of this balance will result in a seizure. The inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and the excitatory amino acids glutamate & aspartate are crucial in maintaining stability in the brain’s neuronal activity. It is believed that the excess or scarcity of either of these will cause abnormal firing of neurons and thus, a seizure.

 

CBD vs THC

The cannabis plants contain over 100 biologically active compounds called cannabinoids. The most abundant of all these chemicals are THC and CBD which are extensively studied for their role in the body. Marijuana and other cannabis extracts that have a high content of tetrahydrocannabinol (THC) are generally utilized for recreational purposes. Because of their intoxicating effects, they’re unsuitable for medical benefits, primarily because THC is associated with many undesired effects such as sedation and poor coordination. These effects are quite opposite to what is needed in epilepsy patients.

Pure CBD extract, on the other hand, has no such negative psychoactive effects and can thus be used for its anticonvulsant benefits. CBD has anticonvulsant, anti-anxiety, analgesic, antiemetic, immune-modulating, anti-inflammatory, neuroprotective, and anti-cancer properties. Although CBD oil has been gaining popularity due to its ability to cure a lot of diseases, the treatment of epilepsy is the only effective modality that has gathered a conclusive amount of research evidence on its effectiveness.

Role Of CBD In Epilepsy

CBD acts on two different types of receptors called cannabinoid receptor type 1 (CB1) and 2 (CB2) that are widely distributed throughout the endocannabinoid system. Naturally, these receptors are the site of action for arachidonic acid derivatives, also called as “endogenous cannabinoids”. The CB1 receptors are mainly found in the neurons whereas the CB2 receptors are present in macroglial cells - supporting cells in the CNS that are responsible to remove damaged neurons and maintain CNS health. Thus, the binding of CBD to these receptors modulates the function of the endocannabinoid system that brings about the changes in neuronal functions.

The excessive neuronal firing and the transmission of these impulses from one neuron to another are the causes of abnormal brain activity and seizure. Uncontrolled release of neurotransmitters - the chemical substances that conduct signals from one neuron to another - play a major role in epilepsy provocation. Studies have revealed that endocannabinoids play an important role in controlling nerve transmission and modulating the rate of neuronal firing.

CB1 receptors are located at presynaptic terminals of both the glutamate (excitatory neurotransmitter) and GABA (inhibitory neurotransmitter) releasing nerves. The binding of CBD to these receptors results in inhibition of neurotransmitter release. Since the glutamate concentration is reduced in synapses, the uncontrolled excitation of neurons is thus blocked.Cannabinoids have numerous and complex pharmacological properties.

THC has a strong affinity for CB1 receptors that bring contributes to its psychoactive and anti-epileptic properties. CBD on the other hand weakly binds to CB1 receptors and thus has no psychoactive effects. The anti-seizure effects of CBD at clinically relevant concentrations are considered to be augmented by other mechanisms such as adenosine reuptake and G-protein coupled receptor interaction.

Research Evidence

A trial conducted in 2017 by Devinsky that included 120 children and young adults with Dravet syndrome and drug-resistant epilepsy and were divided into treatment group and placebo group. Patients in the treatment group received 20 mg/kg/day of CBD for a period of 14 weeks. The frequency of seizures was reduced from 12.4 to 5.9 in the patients who were given CBD. Also, 43% of the patients in the treatment group had a >50% reduction in the frequency of seizures. Patients having seizures without convulsions were not affected by CBD therapy remarkably. In the treatment group, 5% of the patients also became seizure-free during treatment.

Another study that included 162 patients with Dravet syndrome and Lennox-Gastaut syndrome was published in 2016. The patients were treated with 2–5 mg/kg of CBD per day with a titrated dose of up to 50 mg/kg/day for a period of 12 weeks. The study found a 36.5% reduction in seizures with the greatest reduction recorded in patients with atonic and focal seizures.

 

Conclusion

CBD is a natural and better alternative to treating many ailments, especially neurological disorders. The evidence regarding the use of CBD for epilepsy and related disorders is quite compelling and has taken a center stage for potentially better clinical outcomes. Talk to your physician about using CBD before starting to make amendments to your epilepsy medications. You can find out our CBD products here 

 

References

Blair RE, Deshpande LS, DeLorenzo RJ. Cannabinoids: is there a potential treatment role in epilepsy? Expert Opin Pharmacother. 2015;16:1911–4.

Goffin K, Van Paesschen W, Van Laere K. In vivo activation of endocannabinoid system in temporal lobe epilepsy with hippocampal sclerosis. Brain. 2011;134(Pt 4):1033–40.

Hofmann ME, Frazier CJ. Marijuana, endocannabinoids, and epilepsy: potential and challenges for improved therapeutic intervention. Exp Neurol. 2013;244:43–50.

Ibeas Bih C, Chen T, Nunn AV, et al. Molecular targets of cannabidiol in neurological disorders. Neurotherapeutics. 2015;12:699–730.

Mechoulam R, Parker LA. The endocannabinoid system and the brain. Annu Rev Psychol. 2013;64:21–47.

Reddy DS, Golub VM. The pharmacological basis of cannabis therapy for epilepsy. J Pharmacol Exp Ther. 2016;357:45–55.

Rosenberg EC, Patra PH, Whalley BJ. Therapeutic effects of cannabinoids in animal models of seizures, epilepsy, epileptogenesis, and epilepsy-related neuroprotection. Epilepsy Behav. 2017;70(Pt B):319–27.

Rosenberg EC, Tsien RW, Whalley BJ, Devinsky O. Cannabinoids and epilepsy. Neurotherapeutics. 2015;12:747–68

Solimini R, Rotolo MC, Pichini S, Pacifici R. Neurological disorders in medical use of cannabis: an update. CNS Neurol Disord Drug Targets. 2017;16:527–33.

 

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