Although use of cannabis in epilepsy declined in the A few other reports suggestive of beneficial effects on seizures of of purified CBD In some countries, well. Information about the use of cannabis oil for epilepsy to gain seizure control. The most well known are two cannabinoids: CBD - cannabidiol - and Further open label studies have shown that it may also have an anti-epileptic effect in the While some studies have also suggested that THC may have an. "Compared to other drugs used to treat epilepsy, I think Epidiolex, which is No one is exactly sure why CBD has this beneficial effect, both Devinsky and Hernandez said. "I think we need more studies," Devinsky said.
of for results CBD which are some epilepsy? studies used What the
Each type of treatment Purified CBD vs. CBD-rich extracts is coded with a different color, according to the legend. Same data as Table 1 , except for one study 10 due to unreported data.
The mean dose, regardless of treatment was The average daily dose reported for purified CBD was Moreover, there was no difference among subtypes of epileptic encephalopathies Dravet and Lennox-Gastaut syndromes , although the data implies that patients from these two genetic-related epileptic syndrome are more sensitive to CBD treatment Supplementary Table 1. They shall not be negligible, since they provide a significant improvement in quality of life for the patients and their family members.
Secondary endpoints were reported for patients in the selected papers. Unfortunately, not all studies considered such endpoints during their development. Arguably, these effects occurred as a consequence of the seizures reduction, but in many cases they occurred before or even in the absence of significant reductions of epileptic seizures considering each case individually.
There were no reports of secondary health aspects in studies of purified CBD 6 — However, it's impossible to conclude that no improvements on secondary endpoints occurred with this type of treatment; rather, it is more likely that the study didn't focus on this clinical phenomenon.
This is true, at least, for the effects in mood improvement, awareness, sleep quality, and self-control. This data suggests that secondary positive events described for CBD are attributed to this substance, and not only due to the reduction in the frequency of seizures Table 3. Although treatment with CBD products is regarded as at least equally safe in comparison to regular anti-epileptic drugs, CBD is not devoid of adverse effects Importantly, in this case, we are considering only patients of studies that mentioned the occurrence of adverse effects.
To improve accuracy, if the study did not mention adverse events, we considered that it was not reasonable to assume that there were no adverse events and, therefore, the whole study was excluded of the analysis. Two studies containing only 20 patients were excluded according to this criterion 7 , 8. Counter-intuitively, there is also an advantage of CBD-rich extracts in relation to purified CBD regarding the occurrence of adverse events.
Uncommon or rare adverse events include thrombocytopenia, respiratory infections and alteration of the liver enzymes Table 4. Negative secondary effects of treatment with CBD-rich Cannabis extracts and purified CBD described as secondary endpoints in the clinical studies.
The present meta-analysis study confirms the anecdotal evidence that CBD treatment improves seizure control in patients with treatment-resistant epilepsy. Pooled together, the data from 11 studies provide strong evidence in support of the therapeutic value of high-CBD treatments, at least as far as this population of patients is regarded. Important to say, not every study reported all the clinical parameters e. The difference in the quality of the studies is also an important limitation that should be taken into consideration.
With the observational non-blinded design, it's impossible to quantify how much of this response would be due to placebo effect.
More objective physiological measures would help to improve accuracy and are welcome in cannabinoid-related clinical studies. As described in the results section, the average dose described by patients taking CBD-rich Cannabis extracts was over 4 times lower than the dose reported by patients taking purified CBD Table 2. The interpretation of higher potency of CBD in combination with other minor compounds is in line with previous reports of synergistic effects between cannabinoid and even non-cannabinoid compounds For instance, King et al.
Similar examples of pharmacological interaction between these cannabinoids were summarized in Russo and Guy Another interesting aspect of cannabinoid pharmacology is that CBD tends to block some of adverse events of THC, like anxiety and paranoia Modern pharmacology suggests that these effects are due to allosteric modulation of CB1 cannabinoid receptors by CBD 39 , Noteworthy, the original description of the physiology of allosteric modulation of these receptors was performed by the main author of the current paper When it comes to adverse events, the same pattern was true: This is counter-intuitive, and we believe that it might be secondary to the dose.
Since patients taking CBD-rich extracts reported lower CBD dose, it's reasonable to expect lower side effects, including those related with the oil vehicle itself, like gastrointestinal discomfort or abdominal pain. Uncommon or rare adverse events include thrombocytopenia, respiratory infections, and alteration of the liver enzymes. There was a worsening of the seizure burden in some cases, but this is uncommon and cannot be necessarily attributed to the treatment.
Uncommon or rare events reported occurred in combination with other anti-epileptic medication, particularly valproic acid and clobazam, and may be related to drug interaction, and not due to direct CBD toxicity.
Data from a recent study suggested that CBD tends to reduce the occurrence of adverse events, in general, when used as an add-on therapy to other anti-convulsants In that cohort with patients, CBD reduced the occurrence of fatigue, sleepiness, irritability, insomnia, appetite loss, aggressiveness, nausea, dizziness, anxiety, confusion, weight loss, vomiting, and obsessive behavior in 5—10 times.
Among an extensive list, the only adverse events that actually increased with the addition of CBD were weight gain and increased appetite about 2 times higher. In conclusion, this meta-analysis suggests that treatments using CBD are effective and safe, at least in the population of patients with treatment-resistant epilepsy, considering risks, and benefits inherent to the treatment of this severe neurological condition.
A considerable share of patients obtains benefits from this treatment, and the adverse events, when they occur, are fairly mild. Apparently, CBD-rich Cannabis extracts are more potent and have a better safety profile but not higher efficacy than products with purified CBD.
The lack of standardization among Cannabis extracts does not allow us to infer which characteristics of the product provide this therapeutic advantage. Controlled studies with standardized Cannabis extracts are necessary to confirm if these compounds contribute per se or synergistically for the anticonvulsive effect of Cannabis and its derivatives. FP gathered data, analyzed results, and wrote the manuscript. LdS and AC helped with data organization and manuscript writing.
FP is responsible for the development of Cannabis-based products at Entourage Phytolab. AC received monetary compensation for consulting work performed for Entourage Phytolab. LdS works at Bedrocan. The Supplementary Material for this article can be found online at: The ruling was contrary to existing evidence, which suggests the chemical is safe and could have multiple important uses as medicine. Many cannabis advocates consider it a miracle medicine , capable of relieving conditions as disparate as depression, arthritis and diabetes.
The perception of its widespread medical benefits have made the chemical a rallying cry for legalization advocates. The primary psychoactive ingredient in marijuana is tetrahydrocannabinol THC. But THC is only one of the scores of chemicals — known as cannabinoids — produced by the cannabis plant. So far, CBD is the most promising compound from both a marketing and a medical perspective. While studies have shown CBD to have anti-inflammatory, anti-pain and anti-psychotic properties , it has seen only minimal testing in human clinical trials, where scientists determine what a drug does, how much patients should take, its side effects and so on.
Despite the government ruling, CBD is widely available over the counter in dispensaries in states where marijuana is legal. Luke's Health—Sugar Land Hospital, we recommend filling out the following contact form: Are we likely to see more snakes, and snake bites, as the weather warms up?
Spinal cord tumor survivor: In honor of International Day of Women and Girls in Science, we asked some of our Progress Notes editors to share why they are pursuing a career in medicine, the challenges they have faced and more. Measles by the numbers: A look at the risk your child is in at school: Compassionate Cultivation partners with Xabis, a cannabis processing company, to extract, purify and distill CBD oil.
Taylor Kirk, director of cultivation, hangs cannabis to dry at Compassionate Cultivation. Chris Woods, director of process, extraction, and testing at Xabis, uses a machine to extract pure plant oil from cannabis. The machine uses a carbon dioxide CO2 extraction process in a closed-loop system to recapture more than 90 percent of the CO2 used. After extraction, several steps including purification, distillation and chromatography will yield oil with cannabinoid purities as high as 99 percent.
They were astounded by how quickly, and how well, the treatment worked. University of Houston UHouston. Harris Health System harrishealth.
What the Science Says: CBD Clinical Trials
CBD also interacts with some other seizure medicines. cannabis that act on cells in the body (called cannabinoid receptors) to cause some effect. only CBD product that has been rigorously studied and approved to be used as a medical. Only certain patients have access to the cannabis-based oil under Texas' restrictive law CBD oil provides symptom relief without intoxicating effects. For many who have used CBD oil, the newly available treatment has. Refractory epilepsy is also known as uncontrolled the use of CBD as a therapy on patients whose This simple observational study identified some very encouraging findings.