How CBD Is Used in Medication To Treat Epilepsy

How CBD Is Used in Medication to Treat Epilepsy

In June 2018, The Food and Drug Administration (FDA) approved a medication called Epidiolex to treat seizures from two specific epileptic diseases. What makes this medication different from other seizure drugs is that it is the first FDA approved drug to contain cannabidiol (CBD).

CBD is one of the chemical compounds found in the Cannabis sativa plant, which includes both marijuana and hemp plants. CBD differs from tetrahydrocannabinol (THC) because it doesn’t cause the “high” associated with marijuana.

According to an article in US News & World Report, doctors are unsure exactly why CBD helps control seizures, but they do know that CBD blocks a receptor that other medications don’t. Every nerve cell has receptors that receive messages from neurotransmitter chemicals produced within the body.

Seizures can occur when a specific receptor, called the GPR55 receptor, are stimulated and lose their inhibition. CBD blocks the GPT55 receptor. Patients with Lennox-Gastaut syndrome and Dravet syndrome, two rare forms of epilepsy that trigger these receptors, may benefit from the use of CBD medication.

Lennox-Gastaut Syndrome

This rare, severe form of epilepsy is detected in children between three and five years of age. Scientists have found that brain malformations or inherited genetic conditions may be underlying reasons for Lennox-Gastaut syndrome.

Cognitive problems, delays in development, such as taking longer to learn to sit, crawl or walk, and intellectual disabilities can occur. Children with Lennox-Gastaut can have several types of seizures: tonic seizures with sudden muscle stiffness, atonic seizures, or “drop attacks,” with a sudden loss of muscle tone; and clonic seizures with sustained jerking of the body or body parts.

Atypical absence seizures involving staring spells in which people can only partially respond to others, and movements such as blinking, chewing, and lip-smacking, may also occur.

A recent study published in the New England Journal of Medicine divided children and adults with Lennox-Gastaut syndrome and atonic or drop seizures into three groups. One group received high dose CBD, another received lose dose CBD, and a third group received a placebo or no CBD at all. Participants did not know which group they were in during the study.

The study lasted 14 weeks. The results showed that the average reduction in drop-seizure frequency was nearly 42% in the higher-dose CBD group, about 37% in the lower-dose CBD group, and 17% in the placebo group. For patients experiencing these types of seizures, the CBD offered measurable relief.

Dravet Syndrome

Another rare, severe form of epilepsy, Dravet syndrome, has been diagnosed in otherwise healthy children under one year of age. It usually starts with a lengthy seizure and fever, and once present, is a life-long disease. Scientists have determined that a mutation in the SCN1A gene causes Dravet syndrome.

Children with Dravet syndrome have frequent and sometimes multiple types of seizures, including focal seizures, which start in one area of the brain, and generalized convulsions. Their seizures do not usually respond well to medication control.

Another study in the New England Journal of Medicine reported that 120 participants with Dravet syndrome, whose seizures were resistant to medications, were assigned to either a group that received daily doses of CBD or a group that did not. As another blind study, participants were unaware of their placement in either group.

Here again, the study lasted 14 weeks. The group receiving CBD overall saw a decrease in seizures from 13 to 6 per month. The placebo group had a statistically insignificant drop from 15 to 14 seizures per month. 5% of the CBD group also reported being completely seizure-free during the study.

While medication containing CBD has been approved for these two seizure disorders, more study is needed to determine its effectiveness with other seizure disorder types. Doctors caution parents against using commercially available, over the counter CBD products, which may or may not contain the appropriate amount of CBD or be useful with other seizure types.