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The Therapeutic Role of CBD in Epilepsy

Once again, we scoured the US National Library of Medicine and National Institute of Health archives for research into the the effects of CBD, one of the major cannabinoids in hemp, cannabis or marijuana to find this gem at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707667/ that investigates the role of CBD in epilepsy entitled “Cannabidiol: Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders.”

The stated objective of this paper is to “To present a summary of current scientific evidence about the cannabinoid, cannabidiol (CBD) with regards to their relevance to epilepsy and other selected neuropsychiatric disorders.” What’s interesting about this paper is that it seeks to gain scientific insight into the abundance of anecdotal data and preclinical evidence that supports the use of CBD in the treatment of epilepsy.

The two major compounds in cannabis are the psychoactive delta-9-tetrahydrocannabinol (THC) and the non-psychoactive cannabidiol (CBD). The research indicates that CBD shows promise as an anticonvulsant with a favourable or minimal side-effect profile. Interestingly, CBD is already approved as a treatment for conditions as diverse as spasticity, nausea, and pain. Unlike ΔTHC, CBD does not activate the CB1 and CB2 receptors, which explains its lack of psychotropic activity.

The history of cannabis in therapy goes back as far as around 2700 BCE where China it was used to treat menstrual disorders, gout, rheumatism, malaria, constipation, and absent-mindedness. In medieval times, Islamic physicians used cannabis to treat nausea and vomiting, epilepsy, inflammation, pain, and fever. Western medicine used cannabis widely in the 1800s; before aspirin, it was a common analgesic drug. More recently, it is used to treat glaucoma, pain, nausea and vomiting, muscle spasms, insomnia, anxiety, and epilepsy.

The evidence for efficacy has yet to be proven beyond anecdote for various conditions, however, the best research data supports its use in painful HIV-associated sensory neuropathy, chronic pain, chemotherapy-induced nausea and vomiting, and spasms in patients with multiple sclerosis. There is also evidence to suggest that CBD actually reduces addictive behaviour and normalizes drug-induced abnormalities.

CBD is the only non-THC phytocannabinoid to have been assessed in studies for its anticonvulsant effects. It has proven beneficial in neurological disorders including seizure and epilepsy. It was notable that one study of illicit cannabis use supported the notion that cannabis use appeared to be a protective factor against first seizures in men. Strangely, however, this result in men appeared to be statistically insignificant in women. Many studies of CBD safety in humans have demonstrated that it is well tolerated across a wide dosage range.

Cannabidiol research has shown evidence for anti-seizure properties and a favourable side-effect profile to support further development of CBD-based treatments for epilepsy. Additionally, CBD may also be effective for a wide range of central nervous system disorders that may complicate the lives of individuals with epilepsy. Decades of prohibition have left cannabis-based treatments in a legal grey area that has posed challenges for the development of CBD-based drugs for epilepsy and other disorders. Despite this, a growing acceptance of the benefits of cannabis-based treatments has eased the path for studies of CBD.