Anti-convulsant Properties of CBD Shows Promise as Effective
Therapy for Epilepsy
For most people, their first introduction to Cannabidiol (CBD) was when they heard the story about Charlotte Figi and how her parents successfully treated her severe from of epilepsy called Dravet syndrome with a high CBD strain of cannabis. This strain original called “Hippie’s Disappointment” because of it’s low THC content, the Stanley brothers who developed the strain eventually named it after her, sprouting a grass-roots movement of parents and caregivers wanting to try CBD as a safe and effective treatment option.
Since then more and more children and adults have shared their success stories, causing CBD to become one of the most talked about, most popular, and most sought after forms of treatment for both children and adults suffering from seizure disorders such as epilepsy.
The reason why CBD has become a force de majeure of sorts is due to its powerful anti-convulsant properties with CBD fast becoming a medicine that is irreplaceable for families struggling to treat loved ones suffering from epilepsy.
So let’s have a look at what epilepsy is, why it is that CBD is such a powerful anti-convulsant, and why is it critical that clinical research and trials continue to investigate it as an effective and legitimate treatment for epilepsy and other types of seizure disorders.
What Is Epilepsy?
Epilepsy is a type of neurological disorder that is characterised by recurring seizures that can vary in intensity and effect. These seizure are generally caused by disturbances in particular cortical regions within the brain’s circuitry, particularly the prefrontal cortex. Think of epilepsy as a kind of electrical storm where neurons misfire and cause an overload of electrical activity 1.
Epilepsy is the one of the most common of the serious neurological disorders in the world, affecting roughly 1 in every 100 people in the United Kingdom (UK) alone. For many of the 87 people being diagnosed with epilepsy every day in the UK, the cause of their condition isn’t clear 2. However, for about half of the people diagnosed there seems to be a cluster of common underlying causes which can include:
- Brain infections such as meningitis
- Severe or traumatic brain injury
- Problems during birth such as a lack of oxygen to the brain
For most epileptics, anti-epileptic medicines (AEDs) are prescribed to help reduce the severity and frequency of seizures. However, after prolonged use, these become ineffective and for most epileptics, treatment becomes a rollercoaster of having to try different medicines in an attempt to manage the condition. In severe cases, brain surgery is the only option left.
CBD As Anti-Convulsant
Seizures occur either when synaptic and voltage-gated inhibitory conductances are blocked, or when synaptic and voltage-gated excitatory conductances are activated. Simply put, epileptic activity happens when the mechanisms that are supposed to stop too much electrical activity in the brain doesn’t work, or when electrical activity is overexcited 3, 4, 5. It thus follows that seizures should be able to be reduced or stopped through one of two opposite manipulations: either increasing inhibition 6, or decreasing excitation 7.
As with many diseases, the endocannabinoid system seems to play a pivotal role in epilepsy, and seizure generation, maintenance and control 8. Evidence is also showing that the endocannabinoid system is altered in epileptics - although it is unclear whether this difference is what causes the seizures, or if it’s altered because of the epileptic seizures themselves 4. What is clear however, is that when phytocannabinoids, and especially CBD is introduced into the system, seizure activity reduces, or in some cases, even stops it completely.
The exact mechanism of action of CBD is unclear, but there is evidence showing that it changes the development of epileptogenesis, as well as modulate and alter seizure activity 9, 10. When CBD is introduced into the body, neuronal excitability decreases through the inhibition of glutamatergic excitation of CA1 pyramidal neurons in the hippocampus from conditional CB1 receptors. Glutamate is the principal excitatory neurotransmitter in the central nervous system, so, by inhibiting glutamate release, CBD provides neuroprotection via CB1 receptor-mediated inhibition of glutamtergic transmission 11. In other words, CBD reduces and stops seizures because it not only increases the body’s ability to inhibit excessive electrical activity, but it also decreases neuronal excitation reducing the electrical storm that causes seizures.
The Need for Continued Research
Although there is an increased understanding of the anti-convulsant properties of CBD and how it helps inhibit and control epileptic activity in the brain, we do not understand exactly how it works. For instance, what causes endocannabinoid levels to change and increase in response to seizures? Which of the endocannabinoids are the most important target for cannabinoid based epileptic therapies? Can cannabinoid therapies target the critical areas in the prefrontal cortex, and how do we do that?
That is why it is of vital importance that this type of research continues, with clinical trials for CBD and cannabinoid based therapies needing to be a priority. CBD is a safe, non-toxic treatment option for both children and adults alike. And unlike pharmaceutical anti-convulsants, enhancing the cannabinoid system through phytocannabinoids may prove to be a more effective, natural and side-effect free treatment option.
Epilepsy is very common, more common than many of us realise. It is an incredibly troublesome - sometimes potentially deadly - disorder that disrupts the lives of not only epileptics, but often impacts on the quality of life of family, friends and caregivers. Pharmaceutical anti-epileptic medicines often times have suboptimal response rates with a narrow therapeutic index, but it also has severe side-effects such as dizziness, drowsiness, cognitive impairment, liver damage, colitis as well as movement and behavioural disorders to name but a few 12. In addition, after prolonged use, these medicines become ineffective due to a build up of tolerance.
In contrast, CBD and other cannabinoids have been shown to be safe and effective treatment options that do not present with the negative side-effects associated with pharmaceuticals. And unlike pharmaceuticals, CBD does not seem to trigger the same buildup of tolerance. In fact, CBD seems to have the exact opposite effect; a phenomenon called reverse tolerance. The reason for this is that technically CBD does not bind to any one endocannabinoid receptor, thus avoiding the problems of tolerance altogether. This makes CBD a long-term treatment option without having to get on the try-different-drugs rollercoaster ride that so many epileptics have to go through.
No wonder then that CBD is increasingly becoming the go-to option for parents, care-givers and patients alike.