Medical cannabis, CBD, and THC all have possible side effects. Food & Drug Administration (FDA) approved EPIDIOLEX (cannabidiol, CBD) oral solution. CBD oil has become a trendy cure-all, treatment of epilepsy is the only daily dose of pharmaceutical grade cannabidiol (CBD) experienced. Information about the use of cannabis oil for epilepsy to gain seizure control.
cbd side epilepsy cannabidiol effects
Despite its potentially misleading headline, the Mail's reporting of the study is accurate and makes clear it relates only to the rarest form of epilepsy. This was a randomised controlled trial RCT aiming to see whether cannabis oil cannabidiol could reduce seizures in people with Lennox—Gastaut syndrome.
This is a notoriously hard to treat form of epilepsy and most people with it will need help with day-to-day activities. The trial was double-blind and with a placebo control, so neither participants nor researchers knew what they were taking.
A double-blind RCT is the best way of investigating the effectiveness of a possible new treatment. The size of any benefit would need to outweigh any possible risks to make it a viable treatment. It recruited people with Lennox—Gastaut syndrome aged from 2 to 55 years who were taking regular antiepileptic drugs and experienced at least 2 drop seizures a week.
The main outcome of interest was the number of drop seizures experienced over 28 days. The researchers also looked at other types of seizure and adverse effects. A total of participants were included, who were of average age 15 years and were taking around 3 antiepileptic drugs. Before the study started, they were experiencing between 80 and 90 drop seizures per month. There was a similar difference with other types of seizure. Side effects such as sleepiness, poor appetite and diarrhoea were common across all groups.
In total, 6 patients in the cannabidiol groups and 1 in the placebo group withdrew from the trial because of side effects. The most common side effect related to cannabidiol was raised liver enzymes.
Lennox-Gastaut syndrome is hard to treat and people with it generally have a poor outlook, despite treatment. Seizures are common, and most children have developmental delays.
This trial provides evidence that cannabidiol may help improve drop seizures. However, the question is whether this improvement is great enough to make it a feasible and safe treatment. The study looked at effects on seizure frequency, but it's possible this improvement wouldn't make much difference to the child's development as they grow into adulthood.
There is also the important question of the potential harms from this treatment, particularly given its effects on the liver. These may become more marked if treatment was continued in the longer term.
There could also be additional side effects. A new treatment option for this hard-to-treat condition would be welcome, but this would need to be considered by experts in the field. Again, the media headlines were potentially misleading: Cannabis oil could treat epilepsy: Landmark study reveals it can reduce the severity of fits by more than 40 per cent.
The Association of British Neurologists is drawing up guidance for adults. The guidance states that non-licensed medicinal cannabis should only be considered for children who:. The BPNA states that the current best evidence for medicinal cannabis is CBD, a highly purified liquid, which has been licensed in the US by the Food and Drug Administration and is currently going through the application process for a licence from the European Medicines Agency. The reason that the BPNA is only recommending CBD is that there is some evidence to show that this newly developed drug can be effective in reducing some type of seizures in Dravet and Lennox Gastaut syndromes.
Three double blind randomised controlled trials of pure CBD in children and young people with these syndromes has shown a greater reduction in monthly seizures compared to placebos. There was also a greater reduction in drop seizures in people taking CBD compared to those on a placebo. Further open label studies have shown that it may also have an anti-epileptic effect in the epilepsies in general.
While some studies have also suggested that THC may have an anti-epileptic effect, animal studies suggest it can also trigger seizures. There is no evidence from randomised controlled clinical trials for products with higher proportions of THC more than 0. Concerns have also been raised about the effect of THC on the developing brain in children and young people. Evidence suggests that chronic exposure to THC can affect brain development, structure and mental health.
There is also no good scientific evidence to support suggestions that the addition of THC in combination with CBD increases the efficacy of cannabis-based medicinal products for children. We welcome the rescheduling of these products from Schedule 1 to Schedule 2 that will enable their investigation in clinical trials.
The BPNA also recommends that where children are already taking other cannabis-based products that contain higher proportions of THC, they should be transitioned on to CBD until strong evidence for these products can be produced through clinical trials. The Government has no plans to legalise the use of cannabis for recreational purposes.
Possession of cannabis is illegal. This includes cannabis for medical use unless it has been prescribed for you. Cannabis-based medicinal products can only be prescribed by a specialist. A GP cannot prescribe the medication but could refer you to a specialist.
The specialist will discuss all other treatment options with you first before considering a cannabis-based product. A prescription for medicinal cannabis would only be given when all other treatment options have been tried or are considered unsuitable, and would only be given if the doctor considers it to be in your best interests. MHRA is working with individual companies to ensure that CBD-based products that make medicinal claims should be licensed and meet safety, quality and efficacy standards to protect public health.
Cannabis oil may help treat rare type of epilepsy
Epidiolex contains cannabidiol (CBD) from the marijuana plant. It is approved to How It Works Side Effects, Risks, and Interactions. View All. The 2 primary phytocannabinoids are THC and CBD.3,5 A direct agonist of the CB1 and CB2 receptors, the psychoactive effect of THC is secondary CB1. Only certain patients have access to the cannabis-based oil under Texas' cannabidiol oil, or CBD oil, available to some epilepsy patients.