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Introduction
Patients with seizures and epilepsy are some of the most challenging patients for any physician.
Medical marijuana specialists are no exception.
Many patients who come to see me for their seizures and epilepsy have often tried many different anti-epileptic drugs (AEDs) with limited success.
Today, I’m going to talk about what we do (and don’t) know about medical marijuana use in patients with seizures and epilepsy.
How does Medical Marijuana work?
So this is a great question, and one that we don’t have great answers to.
There are a few different theories on how medical marijuana helps patients with seizures:
- It is a neuro protectant, reducing oxidative stressors on the brain
- It reduces neuronal excitability, which decreases the likelihood of seizures
Regardless of how it works, there is ample scientific evidence that medical marijuana can help some patients with seizures.
CBD based treatments
As you may have heard, the FDA recently approved Epidiolex for two types of pediatric seizure disorders.
Epidiolex is pure cannabidiol (CBD) isolate. It is not a full spectrum product.
The dosing and data from Epidiolex serves as a useful foundation for treatment of seizure patients with medical marijuana.
In the Epidiolex studies, they determined that typical effective doses were in the range of 5mg/kg/day to 20mg/kg/day.
Also, they also noted that 30% of patients that initially responded to Epidiolex started to develop tolerance, which required higher doses of medication.
What about THC?
For a long time, doctors did not think that THC had any use in seizure patients. However, more and more evidence suggests that there really is an entourage effect with medical marijuana even in epilepsy patients.
They have found that some patients who initially develop tolerance to CBD are able to maintain control of their seizures by adding THC rather than increasing the dose of CBD.
Areas of study
Two main areas of study have emerged in the treatment of seizures with medical marijuana, based on recent published research:
- The role of micro-dosing and dose reduction in seizure treatment
- THCA as a more effective anti-convulsant than CBD or THC
Takeaway
As you can see, there is a lot to consider when evaluating an epilepsy patient and considering treatment with medical marijuana.
From considering the proper strains of marijuana to the proper dose to route of administration to managing tolerance, it’s really important to enlist the help of a doctor experienced with the myriad research on medical marijuana and epilepsy.
Thanks for reading
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