By Angela Johns, PhD
Epilepsy is the world’s most common serious brain disorder and is characterised by spontaneous, recurrent seizures. Epilepsy can occur as a result of a genetic disorder or an acquired brain injury such as trauma or a stroke.
A seizure is a sudden surge of electrical activity in the brain. Not all seizures involve convulsions. Epilepsy takes many forms and seizures occur in many ways including changes to sensation, awareness, behaviour or movement.
Epilepsy is usually treated by medication and in some cases by surgery, devices or dietary changes. However, up to 40% of people with epilepsy do not respond to medication.
Can Medical Cannabis help Epilepsy?
There are over 80 compounds known as ‘cannabinoids’ that can be extracted from the cannabis plant (Cannabis sativa). The best known cannabinoid in cannabis is called tetrahydrocannabinol or THC. This cannabinoid is responsible for the psychoactive effect or ‘high’. Alternative cannabinoids e.g. cannabidiol or CBD have been found to have many of the same benefits of THC but without the negative psychoactive effects.
There has been a lot of discussion regarding epilepsy and treatment with medical cannabis(1-3).
Despite more than 2000 years of historical use of cannabis up until the early 1900’s when cannabis was prohibited, today we have limited case studies and reports from families of their experiences of using various strains of cannabis oils and tinctures in people with epilepsy.
The good news, is that researchers have just published some important findings (4), showing that regular doses of medicinal cannabis can reduce seizures in children with a form of severe epilepsy called Dravet Syndrome. Dravet syndrome is a complex disorder where children suffer from severe seizures that are resistant to many epilepsy medicines resulting in a high death rate. The study used a natural compound found in cannabis that was given in a liquid form to the children. It did not contain mind altering properties. Some of the patients reported mild to moderate side effects such as diarrhoea, vomiting or feeling tired.
Additionally, another clinical trial is currently being run for adults with focal epilepsy (seizures that affect only one part of the brain, sometimes called partial or localised seizures).
As medicinal cannabis is now becoming legal in many parts of the world for medicinal use, there is an increasing interest for those experiencing poorly controlled seizures.
The results so far seem promising, however, in order for medical cannabis to be more widely prescribed, then randomised clinical trials in patients need to be performed to ensure that a safe and effective dose can be delivered in both children and adults.
The Australian Federal Government has now approved the use of medicinal cannabis but only through approved providers and is currently only being considered where proven treatments have been tried and proven to be unsuccessful in managing patient’s symptoms.
The Therapeutic Goods Administration (TGA) of Australia have guidelines for the use of medical cannabis in the treatment of epilepsy based on the current scientific evidence available and it is worth speaking to your doctor to obtain the latest current research and available treatments of cannabis based medicines for epilepsy.
Upadhya D, Castro OW, Upadhya R, Shetty AK. Prospects of Cannabidiol for Easing Status Epilepticus-Induced Epileptogenesis and Related Comorbidities. Molecular neurobiology. 2018.
- Neale M. Efficacy and safety of cannabis for treating children with refractory epilepsy. Nursing children and young people. 2017;29(7):32-7.
- MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. European journal of internal medicine. 2018;49:12-9.
4. Devinsky O, Cross JH, Wright S. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. N Engl J Med. 2017;377(7):699-700.