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>>>>>>> HIGHER LEARNING Cannabis for Epilepsy

Epilepsy is a disorder of the brain characterized by recurrent seizure activity for which there are multiple causes. These sources include brain tumors, stroke, head or brain injury, and infections to the central nervous system. Epilepsy is often measured by the severity and frequency of seizure activity.

The World Health Organization estimates that more than 50 million people globally have this disease. The group defines the seizures produced by epilepsy as “brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body (generalized) and are sometimes accompanied by loss of consciousness.”

Children’s Hospital at NYU Langone defines a seizure as “an excessive surge of electrical activity in the brain that can cause a variety of symptoms, depending on which parts of the brain are involved.”

According to a 2019 research study, epilepsy can also cause “deficit sensorimotor [and] cognitive” impairments that “compromise quality of life” and carry an “increased risk of premature death.”

The U.S. Centers for Disease Control and Prevention reports that nearly four million people in the United States suffer from epilepsy. More than half a million of these patients are children who often are afflicted by special childhood varieties of the disease, such as Dravet syndrome and Angelman syndrome. Other variants of the disorder include Landau-Kleffner syndrome, in which children lose their ability to speak and understand speech, and Lennox-Gastaut syndrome, which manifests in multiple types of seizures that are difficult to control.

In the United Kingdom, more than half a million citizens suffer this debilitating condition and nearly 90 new cases are diagnosed each day (about 33,000 per year), according to advocacy group Epilepsy Action. In the United States, about 150,000 new cases of the disease are officially diagnosed each year, according to the Epilepsy Foundation. The majority of diagnoses fall within two distinct and very different age groups: Young children and older adults. The group reports that one in 26 people will develop epilepsy “at some point in their lives.”

Cannabis for Epilepsy

A number of cannabinoids have been found to provide benefit to sufferers of epilepsy—typically in the form of decreased seizure activity—and sometimes via a mechanism involving a reduction in the anxiety that often triggers them.

Cannabis and its derivative components, including cannabinoids such as cannabidiol (CBD) and tetrahydrocannabinol (THC) and a variety of terpenes such as linalool, serve as a metaphorical candle in the night for those who suffer treatment-resistant types of epilepsy for which no effective treatment is available.

A 2019 study entitled “Use of Cannabidiol in the Treatment of Epilepsy: Efficacy and Security in Clinical Trials” that was published in the journal Molecules found that CBD “showed efficacy as an anti-seizure, antipsychotic, neuroprotective, antidepressant, and anxiolytic.”

A 2017 study entitled “Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last?” that was published in the Journal of Epilepsy Research investigated the role of both CBD and THC for epilepsy patients. “Compared with THC, CBD shows a better defined anticonvulsant profile...and is largely devoid of adverse psychoactive effects and abuse liability,” noted the study’s authors.

The researchers concluded that “Evidence concerning the potential anti-seizure efficacy of cannabinoids reached a turning point in the last 12 months with the completion of the first highquality placebo-controlled trials of a purified oil-based liquid CBD preparation in patients with Dravet syndrome and LennoxGastaut syndrome.”

The study noted one of the problems with modern healthcare in states and provinces where medical cannabis is legal: Doctor ignorance and opposition. “96% of respondents among the general public felt that there was sufficient safety evidence about cannabis products, whereas only 34% of physicians considered this to be the case.”

Licensed Caregiver Testimonial

Research data regarding the efficacy of cannabis for diseases like epilepsy is complemented by the testimonials of frontline workers such as doctors, nurses, and registered caregivers.

Colleen Kibler is a licensed cannabis caregiver in Maine under the state’s medical marijuana program. She also serves as manager of a retail dispensary and is the formulator of a nationally distributed hemp-based skincare product. Kibler is also a seizure patient who has successfully employed cannabis in the treatment of her condition. The following interview was conducted in December 2020.

Curt Robbins: “As a licensed caregiver and based on y0ur experience with patients, what are the major efficacies gained when those with epilepsy consume cannabis?”

Colleen Kibler: “Thanks to our sweet angel Charlotte Figi, the whole world is talking about CBD as a safe and effective anticonvulsant compound. CBD has now inspired literally thousands of wellness products, many of which involve CBD isolate to reduce cost.

observing that full-spectrum cannabis medicine, featuring hundreds of active compounds, is best for those with seizure disorders. Full-spectrum products help manage medication side effects and symptoms that are typically not properly controlled by CBD isolate alone.

“Daily consumption of full-spectrum tinctures or softgels can significantly reduce seizure activity. Epilepsy patients may also find relief from soreness, muscle tightness, brain fog, headaches, anxiety, sleeplessness, and challenges with mental focus by using cannabis. In my opinion, full-spectrum cannabis tinctures or softgels are among the most important items in the medicine cabinet of any seizure patient.”

CR: “Is treatment of epilepsy about merely reducing seizure reduction? What other symptoms of this common condition can gain help from the terpenes and cannabinoids produced by hemp and cannabis?”

CK: “Treatment of seizure disorders is largely about reducing seizure occurrence, length, and severity. One of the biggest factors contributing to seizure activity—for every patient with whom I’ve worked—is stress and anxiety. I recommend CBD for every seizure patient, regardless of the status of their disorder. Why? Because anxiety reduction is crucial to their wellness and preventing seizures.

“THC can also be used to reduce stress, but it’s critical for patients to know their limits. Too much THC can, paradoxically, increase anxiety. Use of both CBD and THC, in the proper ratio, is key to avoiding a state involving discomfort, excessive anxiety, or a panic attack that can result in a seizure. Full-spectrum patients also find relief from other common symptoms of epilepsy, including headache and muscle fatigue.”

CR: “Is there an optimal path of consumption for epilepsy patients? What are some of the pros and cons of various avenues?”

CK: “Seizure patients need cannabis medicine every day. Many look to capsules or softgels because they are easy to add to a daily med routine. Concentrate or tincture products taken sublingually are absorbed directly into the bloodstream, skipping the liver. For those requiring quick effect, the delay in bioavailability of edibles and capsules is simply unacceptable.

“Inhalants are as efficient as sublingual delivery. Some seizure patients use concentrates, especially in emergency scenarios. Many people have seen videos of children seizing and receiving a dose of concentrate in the mouth via syringe, soon after which their seizure activity slows or ceases. Patients fortunate enough to experience a warning aura often carry an emergency concentrate dose to prevent a seizure. Dabbing, or the vaporization of potent cannabis concentrates, is particularly useful for emergency preventive maintenance for epilepsy patients.”

CR: “What particular terpenes, cannabinoids, and cultivars (stains) are of particular interest to epileptics based on improved therapeutic outcomes?”

linalool has been found to block glutamate receptors in the brain, which can greatly reduce the chances of seizure activity. Second, because stress and anxiety are major contributing factors to seizure activity, keeping these levels in check is one of the paths to wellness for epileptics. Inhaled linalool is known to reduce anxiety by directly interacting with GABAA receptors.

“There are a few popular marijuana strains that contain rich levels of linalool. One is Lavender, which is a beautifully spicy and floral cultivar that is sweetly sedative. LA Confidential is a strong indica for which many find incredibly uplifting cerebral effects for a couple of hours, before the high melts into drowsiness.

“Lastly, for epilepsy patients who can tolerate a sativa and desire a more cerebral high, I recommend Amnesia Haze. This strain is known to be beneficial for adult ADD/ADHD patients because it inspires productivity and focus. It’s excellent for activities that involve both the mind and the body, such as exercise and sex.”

SOURCES: Silvestro S, Mammana S, Cavalli E, Bramanti P, Mazzon E. Use of Cannabidiol in the Treatment of Epilepsy: Efficacy and Security in Clinical Trials. Molecules. 2019;24(8):1459. Published 2019 Apr 12. doi:10.3390/molecules24081459

Curt Robbins is a technical writer and instructional designer who has been developing science-based training content for Fortune 200 enterprises for more than 30 years. Robbins has developed more than 600 educational articles regarding cannabis and its various health components, including cannabinoids, flavonoids, terpenes, and the human endocannabinoid system. He currently serves as Director of Course Development for Higher Learning LV™ in Lake Las Vegas, Nevada. Robbins can be found on Twitter at @RobbinsGroupLLC and Instagram at curt_robbins_cannabis_writer.

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