Marijuana for the treatment of epilepsy

medical-marijuanaMarijuana has been used for the treatment of medical conditions for over 4000 years. The medical use of marijuana is currently a hotly debated topic. There are some anecdotal reports of patients using marijuana to treat seizures. The popular media has recently run stories about patients using marijuana for their epilepsy. Some patients describe that marijuana improves their seizure control, while others indicate that marijuana exacerbates seizures. Given all the attention about marijuana and epilepsy, it is not surprising that patients are, with increasing frequency, asking the Minnesota Epilepsy Group’s opinion about treating seizures with marijuana.

The purpose of this article is to highlight a recent study which reviews the literature in tremendous detail in order to answer the following questions:

1) Does marijuana improve seizure control?
2) Is marijuana safe?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639568/pdf/i1535-7511-13-2-81.pdf

STUDY DESIGN
The authors did a very extensive review of the literature- in order to identify all papers that performed randomized control trials assessing marijuana in the treatment of epilepsy.

RESULTS
The study found: ” four randomized reports which included a total of 48 patients, each of which used cannabidiol as the treatment agent. (Cannabidiol is an important extract of marijuana). One report was an abstract, and another was a letter to the editor. Anti-epileptic drugs were continued in all. Details of randomisation were not included in any study. There was no investigation of whether control and treatment groups were the same or different. All the reports were low quality. “

As far as seizure control, little information is provided: One study reported two of four treated patients becoming seizure free for 3 months. The other studies either reported no benefit, or the effect was not clearly stated.

CONCLUSIONS
“No reliable conclusions can be drawn at present regarding the efficacy of cannabinoids as a treatment for epilepsy. The dose of 200 to 300 mg daily of cannabidiol was safely administered to small numbers of patients, for generally short periods of time, and so the safety of long term cannabidiol treatment cannot be reliably assessed.”

Thus, at this time, there is a lack of scientific evidence to recommend marijuana for the treatment of epilepsy. To quote the American Epilepsy Society:

“The lack of information does not mean that marijuana is ineffective for epilepsy. It merely means that we do not know if marijuana is a safe and efficacious treatment for epilepsy. Healthcare professionals, patients, and caregivers are reminded that use of marijuana for epilepsy may not be advisable due to lack of information on safety and efficacy, and that, despite some states legalizing the use of medical marijuana, it is against Federal Law to possess or use marijuana.  In addition, little is known about the long term effects of using marijuana in infants and children, and chronic exposure during adolescence has been shown to have lasting negative effects on cognition and mood.  Such safety concerns coupled with a lack of evidence of efficacy in controlled studies result in a risk/benefit ratio that does not support use of marijuana for treatment of seizures at this time. The American Epilepsy Society is supportive of well-designed research to determine the safety and efficacy of marijuana in the treatment of epilepsy.”

http://www.aesnet.org/press-room/consensus-statements/marijuana-and-epilepsy

Please send in your comments on this important topic! Thank you!

Written by James White, MD

Dr. White has been practicing as a full-time epileptologist since 1999. His practice focuses on optimizing the diagnosis and treatment of patients with seizure disorders. Dr. White’s special interests include patient education, improving the side-effect profile of seizure medications, and epilepsy surgery.

12 Responses to “Marijuana for the treatment of epilepsy”

  1. Lorry J. Witte, RN, BA, CCRC, CCRA September 10, 2013 at 11:33 am

    Dear Dr. White:

    Thank you for your summary of current scientific evidence re: marijuana for the treatment of epilepsy. The article is timely, well written and helpful.

    Sincerely,
    Lorry

    • Thank you Lorry. I really appreciate your comment. I do think that this is an important issue. More information-especially up-to-date and accurate information, can really help.

      Thank you!

      Jim White

  2. I am not a Neurologist. I have never sampled marijuana. However, the last thing that a person with a seizure disorder would want at the time of a seizure is be LESS in control of his/her body.

  3. Dear Dr. White:
    I have been an epileptic since the age of 11, am now 48. I have a VNS & am also on several medications and still have seizures 2-3 times monthly. I have grand mal but only when I sleep, they are very severe have broken several bones & sometimes just feel lethargic a day or two after. I found your article very interesting. Thank you.

    Sincerely

    Kitty

  4. I am very interested in finding out further information on the use of medical marijuana for the treatment of Epilepsy. I have a son that is now 26 years old and has suffered his whole life with this rare form of Epilepsy called Lennox Gaustron Syndrome. We had him under every Neurologist in Mobile,Alabama and took him to Birmingham to UAB to see Doctors. He started having these seizures at around 12 months old, and he had any where from 500 to 600 a day. It caused brain damage from having so many seizures that they could not control. He could not walk, talk, or play as a child and had to wear a seizure helmet at all times because he fell so much busting his head open from the seizures. There has been so many incidents where we thought we had lost him when he would go into these terrible seizures and quit breathing and notcome out of the seizure for what seemed like an eternity. He has always been on large amounts and different kinds of seizure medication that he takes morning and night.I would give anything to help my child to be able to live some type of a quality of life, and not have to be scared to death that every time he goes into a seizure that he may not come out of it. If anyone can share with me any information on this medical marijuana for treating Epilepsy please contact me.

    • I am also a mother of a son who is now 33 yr old, severely disabled and has Lennox-gastaut syndrome. I understand exactly where you are comming from. He has delt with refractory seizures ( not controlled with medication) since he was 5 yrs old, and now is at risk for SUDEP (sudden unexplained death of epileptic patients).He struggles with some type of seizure almost 24-7. His grand-mal seizures usually include very violent convulsions, some of which lasts for several minutes. Many times he can’t breath at all during these episodes, leaving him blue and unconscious. This form of “medical Marijuana for seizure patients is crossbred to be low in the psychoactive ingredient THC and high in cannabidiol “CBD”. With all the recent media attention, and parent concern, the FDA is opening up further research on a select number of patients with a new drug called “epidiolex”. This drug is supplied by GW Pharmaceuticals, a company in the UK who has been studying cannabidiol for several years now. You can google the drug , company and FDA research for more information.

  5. My son had more than 100 seizures a day. He is on 5 anti consultants currently and still had the same number. My wife and I are quite desperately looking for answers for him. He is barely 3 and had been having seizures since before the age of 1. We heard about medical marijuana from articles sent by friends and family. This is something we would seriously consider. Thanks for the article, hope there is a follow up piece as more info becomes available. I am sure there are side effects, but his medicines now have even worse possible side effects, like sudden liver failure and death listed as side effects. Not to mention the side effects of 100 seizures per day.

  6. Well, if it works on Dravets Syndrome, I have to believe that the reaseach has some value and more research should continue to rule it in or out of it’s theraputic benefit for patients with Epilepsy and other disorders that apply. Thanks DR. White! You are a real pro!

  7. I have a son whose seizures have been very resistant to medication. They began when he was 4 and he is now 18. This is despite the four medications he is currently taking to limit his seizures from 30 a day to 3-15 a week. Life in our house is a cycle of ups and downs with very little predictability. The medications he takes now have side effects which I would never accept under normal circumstances. Cannabidiol may have some side effects as well, but I am definitely glad they are studying this as a potential treatment. Given the way seizures and meds already affect my son’s life, he would be happy to be involved in the studies being done, but after checking into that those door’s seem to be closed. Dr. Orrin Devinsky from New York is part of some of this research and here is a link for more information regarding some of it:

    http://faces.med.nyu.edu/research-education/cannabidiol-conference

    If you find out any types of studies on Cannabidiol are happening in Minnesota or surrounding area, please let us know.

  1. […] Here is good article epilepsy and marijuana.  talking about early but small trails that they did. http://mnepilepsy.org/news/marijuana-for-the-treatment-of-epilepsy-what-do-studies-show/ […]

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