The CDC reports that there are 3 million adults and 47,000 US children who have active epilepsy, and the numbers are increasing. The World Health Organization reported in February of this year that 50 million people worldwide have epilepsy and the risk of premature death is three times higher for them than it is in the general population. Arguably, there is as much research interest in cannabis for the treatment of epilepsy as there is any area. There have been a few important breakthrough studies of note.
In the 1980’s, a Brazilian scientist treated 8 epileptic patients with CBD. 50% almost completely stopped seizing; seizure intensity was reduced for another 3 while only 1 person improved in the control group. In 1992, when Mechoulam, the “godfather of cannabis research” discovered that bodies make their own cannabinoids called endocannabinoids and identified the first one as “anandamide” which means “supreme joy” in Sanskrit, he was a senior scientist on a Brazilian CBD epilepsy study.
At the end of 2017, after repeated animal studies had shown that CBD had an impressive anticonvulsive profile without addiction abuse or adverse psychoactive effects and with an increase of CBD enriched extracts in use with epileptic children, three well-constructed trials were completed. A “purified” CBD was found to be superior to placebo in reducing the frequency of convulsive seizures in children with Dravet Syndrome and the frequency of drop seizures in children with Lennox-Gastaut Syndrome. The question remained whether CBD isolate was solely responsible or if its interaction with traditional drugs was the cause for improvement.
In Brazil, near the end of 2018, three Brazilian scientists: Fabricio Pamplona, Lorenzo Rolim da Silva and Ana Carolina Coan reviewed 11 studies covering 670 patients who had been participants in the studies covering six months of trials. The subjects were chosen because they had been resistant to treatment, even after trying 4 -12 medications over a three-year period. The meta-analysis focused on Dravet, Lennox-Gastaut and those seizures caused by CDKL5 deficiency.
Referring to Dravet and Lennox-Gastaut Syndromes, the Medical Director of the Comprehensive Epilepsy Program at Nicklaus Children’s Hospital in Miami adds, “For these forms of epilepsy, ‘we really need’ effective therapies. Even with all the treatments that we have available, over 90% of patients still have seizures that occur despite treatment. There's also a tremendous amount of morbidity that goes along with this disease.”
It is important to note that the type of CBD ingested may affect the effectiveness of it on epilepsy.
For example, there are treatment-outcome differences when comparing Isolate vs Full Spectrum for epilepsy. Referencing the research done by the Brazilian scientists who had been studying epilepsy, the authors also analyzed any differences between CBD-rich extracts or full spectrum hemp, and CBD isolates. 71% of the participants who used CBD-rich extracts or full spectrum hemp had reduced seizure frequency while 46% using isolates experienced reduction in frequency. Both the whole plant extracts and CBD isolates helped cut the number of seizures in half for about 40% of the patients suggesting that single molecule and whole plant hemp were highly effective. Both formulations reduced seizures by 70% in about a quarter of the group and roughly 1 in 10 became entirely seizure free.
The improvement showed differences in degree of effectiveness, but It was the dosage amount and side effects that demonstrated significant differences. The mean dose for people using isolate was 25.3 mg/kg/day whereas the CBD-rich dose was 6.0 mg/kg/day. The whole plant extract was over 4 times more potent. The therapeutic impact of the whole plant was greater than that of the single compound. There were also fewer side effects from the whole plant extract.