Epilepsy

Seizures occur when a part of the brain becomes overly excited or when nerves in the brain begin to fire in an abnormal way. An abrupt imbalance between the triggers of excitatory signals and inhibitory signals causes the excitatory forces to take over. This excitation then spreads to surrounding cells which all start firing in the same abnormal way. Balance, or homeostasis, is disrupted.

Medications cannot cure epilepsy, but they may limit the seizure intensity or frequency. However, a third of epileptic patients fail to become seizure free even after trying and tolerating two or more appropriately prescribed anti-epileptic drugs. [32]

Epilepsy and Your Endocannabinoid System

The direct activation of CB1 receptors in the brain reduces seizure severity, thus limiting activity and protecting nerve tissue. Brain seizure activity triggers a neuroprotective, on-demand release of endocannabinoids. [49]

Abnormal changes in cells in the hippocampus are a cause of medial temporal lobe epilepsy, which is one of the most common forms of epilepsy. Animal and human studies show that cannabinoids seem to be protective of normal hippocampal cells, and may make the abnormal cells less active. [26]

Cannabinoids decrease glutamate synthesis throughout the central nervous system, which in turn decreases inflammation and seizure activity. [18]

CB1 receptor density is increased in the brains of epileptics, and this increase in endocannabinoid activity is considered a function of the ECS to dampen seizure activity. [67]

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Medical Cannabis Guidelines

It is important to note that there are some drug-drug interactions when using cannabis with anti-epileptic drugs (AEDs) because some AEDs, and most cannabinoids, are metabolized by the same Cytochrome P-450 system in the liver. Competition for these degrading enzymes can affect the serum levels of AEDs, so patients using cannabis in addition to prescribed AEDs should be monitored, and dosage adjustments may be needed. [25]

DOSING STRATEGY

Many patients start with CBD, as it is non-intoxicating and seems to work better for more patients than THC, though THC has also been shown to be effective. [32] It is important to start low and slowly increase the dose, and to monitor other medications with a qualified healthcare professional.

Desired Effect

Seizure Control

Active Compound

CBD [59], THC [59], THCA [59]

Delivery Method

Sublingual, Oral
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Desired Effect

Decrease Need for Rx Medication--Epilepsy

Active Compound

CBD [25]

Delivery Method

Sublingual, Oral
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Epilepsy and Cannabis: An Overview

Historical documentation for the use of cannabis to treat epilepsy ranges from 2900 B.C. in ancient Sumeria, through case studies from 19th century England, into the early days of the United States.

Epilepsy, Endocannabinoids, and Phytocannabinoids

We know that cannabinoid receptors are particularly dense in the central nervous system, and while we do not yet completely understand all the mechanisms that explain the anti-seizure effects of cannabis, we do have theories.

Effects, Side Effects, Adverse Effects

The effects of cannabis can be as variable as the individual patients who use this medicine.

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