Cannabidiol and epilepsy: discover the effects in the treatment of the disease

InAlthough the mechanisms of action of the Endocannabinoid System are still not completely known, several scientific studies prove that cannabinoids exert a direct influence on the central nervous system (CNS), acting as modulators in synaptic transmissions.

The use of cannabidiol to treat severe and refractory epilepsy, for example, is already scientifically proven, with significant results in reducing seizures and having a direct impact on patients' quality of life. 

Want to know why cannabidiol works in the treatment of epilepsy? Continue reading and understand the potential of CBD in the management of seizures.

 

Cannabidiol in the treatment of refractory epilepsy

According to World Health Organization (WHO), approximately 50 million people in the world suffer from epilepsy, which represents around 1% to 2% of the world population. The denomination “refractory” indicates those cases in which two or three anticonvulsants were used in optimized doses, without a satisfactory response in reducing seizures.

Especially in these cases, CBD stands out as an optional therapeutic agent, due to its anticonvulsant properties scientifically proven in several studies, culminating in the approval of CBD isolated Epidiolex, for the treatment of severe and refractory epilepsy associated with Lennox Gasteaut and Dravet Syndromes by the FDA ( Food and Drug Administration) and other regulatory bodies around the world.

 

 

Scientific evidence on cannabidiol and epilepsy

The first human study on the use of cannabidiol in epilepsy was carried out in the 1980s by the Brazilian scientist Elisaldo Carlini, specialist in Psychopharmacology, who has dedicated more than 50 years of his life to the research of medicinal cannabis. Carlini's studies showed that cannabidiol has its own pharmacological effects in the treatment of epilepsy, acting independently of the effects of tetrahydrocannabinol (THC).

A carlini research was carried out with a small sample of eight adult patients who used CBD as a therapeutic agent against epilepsy. The results pointed to the complete cessation of seizures in four of these patients and the reduction of seizures in three of them.

Until 2016, many studies on the anticonvulsant potential of CBD were conducted, however, all of a short duration and with a small sample of patients (<15).

The two most relevant, double-blind, randomized, controlled studies, with the largest number of patients, were those that culminated in the approval of Epidiolex CBD alone, for the treatment of severe and refractory epilepsy associated with Lennox Gasteut and Dravet syndromes. Both studies showed that more than 40% of patients had a reduction of more than 50% of seizures. In general, CBD was well tolerated. The most common adverse effects were drowsiness, prostration, loss of appetite and diarrhea.

• 120  Patients with Dravet Syndrome

• 61 CBD and 59 control 

• CBD alone 20 mg/kg/day for 14 weeks – 2x/day

• 43% reduction in seizures >50%

 

• 225  Lennox-Gasteaut patients

• 149 CBD and 76 control 

• CBD alone 10-20 mg/kg/day for 14 weeks – 2x/day

• 41.9% reduction in seizures in the 20mg/kg/day group

• Reduction of seizures of 37.2% in the 10mg/kg/day group

 

 

 

Clinical cases of international repercussion

Some patients with severe and refractory epilepsy, who pioneered treatment with medical cannabis, became internationally known.  One of these characters is the Brazilian Anny Fischer, the first patient in the country legally authorized to import CBD-based products for medicinal use.

Anny has Rett CDKL5 syndrome, a rare genetic disease associated with significant neuropsychomotor delay and severe, difficult-to-control epilepsy. The girl had an average of 80 epileptic seizures per week, which were zeroed when she started treatment with cannabidiol in 2013, at the age of 5.

Another famous case of the successful use of cannabidiol in the treatment of epilepsy is that of the American girl Charlotte Figi, who had up to 300 epileptic seizures a week. Carrier of Dravet Syndrome, Charlotte suffered from seizures since she was three months old, dying in 2020 at the age of 13, victim of pneumonia and complications of her underlying disease.

These cases were very representative for boosting research on medical cannabis in Brazil and worldwide. The results are still very promising when we talk about cannabidiol and epilepsy, showing the potential of CBD in reducing seizures both in number and intensity, and with a good safety and tolerability profile.

 

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