A new study published in the Sept. 10 issue of the New England Journal of Medicine, has revealed that a chemical found in marijuana can help in preventing epilepsy seizures. However, since law forbids the use of marijuana, research efforts in the direction have been hampered.
One of the main active ingredients found in marijuana is Cannabidiol, but this is not the ingredient that makes people high. Lead author Dr. Daniel Friedman, a neurologist and epilepsy specialist at NYU Langone Medical Center in New York City said that it has already been found to prevent seizures in animal studies and in an ongoing human trial. But, since marijuana is a schedule I controlled substance, the U.S. Drug Enforcement Agency classifies it as a drug with “no currently accepted medical use and a high potential for abuse.” So, large scale trials that could prove the effectiveness and safety of Cannabidiol in epilepsy is difficult.
Phil Gattone, Epilepsy Foundation President and CEO said that the current federal laws have limited our understanding of marijuana’s potential effectiveness as an anti-seizure medication.
Friedman and co-author Dr. Orrin Devinsky opined that even though the long-term and short-term side effects of using cannabis and Cannabidiol, we do know the impact of uncontrolled epilepsy, and that reason must be considered when looking at the use of cannabis. There are about 20 different anti-seizure drugs in the market. Despite that about 30% of people suffering from this condition have uncontrolled seizures.
A major brain receptor that responds to marijuanacannabinoid receptor 1, or CB1seems to have anti-seizure effects when activated. The CB1 receptor is most strongly activated by THC, the chemical in Cannabidiol that causes intoxication. But, a review of animal studies found that non-intoxicating cannabidiol shows the most promise in preventing seizures, the researchers said.
In an ongoing human trial that involves Epidiolex which is a British-made cannabis extract that’s 99 percent cannabidiol, it is seen that the chemical can be effective in humans. For the trial, several institutions in the United States received compassionate use waivers from the U.S. Food and Drug Administration. Friedman said that almost 2 in every 5 patients suffering from severe treatment-resistant epilepsy experienced a 50 percent reduction in the frequency of their major seizures. Not just that, some of the patients with epilepsy who have never had prolonged periods of seizure freedom became seizure-free, at least in the short-term of this study.
Excited with these results, three companies have begun developing cannabidiol-based drugs. However, it is also presumed that since it was an open-label trial, the results might be a bit biased. Since, both the patients and the researchers knew what drug was being administered; so people may have experienced some improvement because they expected the drug to produce positive results.
Also there are some concerns regarding marijuana’s effect on the developing brain. There are studies that show that it can alter the structure of the brain in young people. To counteract that Friedman said that it is known severe epilepsy also affect brain development, and it is widely believed that some of the approved anti-seizure medications may also affect the brain. So, a risk- benefit calculation is all that can be resorted to until there are more long-term safety data.
A good news for the researchers here is that the director of the U.S. National Institute on Drug Abuse said that her agency will support future cannabidiol (CBD) research.
Dr. Nathan Fountain, chair of the Epilepsy Foundation Professional Advisory Board, said he hopes the upcoming clinical trials will solve the unresolved queries that are there regarding cannabidiol use.
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