One of the key, unequivocally demonstrated benefits of CBD is centered around its ability to reduce, mitigate, or eliminate the primary symptoms of epileptic seizures. In 2017, Emilio Perucca, in conjunction with the National Neurological Institute in Pavia, Italy, compiled a large study of relevant information involving CBD and its effects on epilepsy.
The study, though full of medical terminology and advanced neurological concepts, explains various aspects of the influence of CBD as an anticonvulsant. With seizures, stopping convulsions is a key focal point of an effective medication. Convulsions, however, are a symptom, rather than a source. While anticonvulsants are an important ingredient in dealing with seizures, they will only logically continue until the source of the epilepsy is treated or mitigated. An ideal medicine for seizures would treat both the symptoms and the root causes of the issue.
The information contained within the Italian study is thorough, and there’s quite a lot of reading material to absorb. However, the study communicates quite clearly that a positive response exists in enough trial studies to establish a positive correlation between CBD use and the minimization of epilepsy.
Though the study draws connections involving cannabinoids in general and their effects on epilepsy, the information compiled involving CBD is intricately woven between circumstances, neurology, social trends, and existing information. The study highlights clinical findings from around the world.
One of the most interesting aspects of this study is that, though CBD is clearly associated with CB receptors in the brain that handle various tasks involving neurological health, the direct response associated with CBD is not necessarily specific to those receptors. Though clear and consistent evidence exists that CBD is a potentially-potent anticonvulsant, the exact reasons that it works are still somewhat of a mystery. While it’s clear that CB receptors play an important role in processing CBD, a chain of events happen throughout the brain that make it difficult for neurologists to isolate and identify every relevant interaction throughout the brain.
When compared to THC, the primary psychoactive compound associated with marijuana, CBD does not present significant examples of triggering seizures. The effects of THC have, however, been shown to induce seizures alongside mitigating them in some cases. For the sake of patient safety, testing THC on patients suffering from seizures presents an ethical dilemma. The administration of THC in clinical studies might cause severe negative effects on patients that have adverse reactions, so CBD offers a more reliable means of delivering treatment to sufferers of epilepsy. In the event they are treated with THC, a portion of those patients may have seizures, while a portion of them may have their symptoms reduced.
Simple Facts & Findings
The most critical detail involved in this study is that CBD showed greater results as an anticonvulsant than placebo control groups. While this shows promise in the future treatment of epilepsy with CBD, there is also a clear issue involving CBD and additional medications.
Epilepsy sufferers on specific medication, such as clobazam, may experience dual benefit from both their prescribed medication and CBD. In the territory of medicine, supplementing a medication with another medication is not at all uncommon, but with new studies and tests, this presents an extreme field of possibility for researchers to work through. The initial conclusion of this study, in this regard, is that CBD must be tested against other medications before the full spectrum of potential is understood. CBD may interact poorly with some medication and exceptionally well with others.
However, there are various findings from the study that are worth noting. For example, one of the tests involved in seizure production is “induced shock,” where electrical currents are used to agitate the brain’s electrochemistry and trigger a seizure. This is primarily done with mice. A study conducted by the National Institute of Neurological Disorders and Stroke found that the administration of CBD reduced sensitivity towards electrical shock, meaning the brain of the mice could handle more electricity before a seizure with appropriate doses of CBD. Though more testing is required, this would suggest that CBD is used in one of the brain’s mechanisms for handling excess electrical currents, which is a known source of seizures.
Some CBD enthusiasts prefer to smoke the flowers and concentrated extractions, while others prefer to use tinctures and infused food to ingest the phytocannabinoid. Between these two, smoking CBD allows the body to absorb more of the molecule, while orally consumed CBD is mostly wasted. Estimates for orally ingested CBD range from six to ten percent absorption, while smoking produces anywhere from eleven to forty-five percent. However, smoking is an unattractive option for plenty of patients, and higher-concentration tinctures and infused food are the only methods they’d prefer, outside of pharmaceutical productions.
Rifampicin, an enzyme inducer, has reportedly been used to speed up the absorption of CBD while also allowing it to be released into the body at a more steady rate. The study suggests that more information should be gathered, while other enzyme inducers should be tested for similar or superior responses. It also is important to mention that terpenes can have synergistic effects with CBD. Terpenes are a special class of molecules that occur in lots of different plant matter, and there is a great range of them. Synergistic terpenes naturally enhance the effects of phytocannabinoids, so these also provide room for growth in the understanding of CBD as a treatment option for various medical issues.
Seizure Mitigation: Early Results
With CBD therapy, 55% of patients in a US-based study reported an approximate 50% reduction in seizures. Over a span of 272 adult patients, a full 10% reported being seizure-free during CBD therapy.
However, conditions that cause seizures, such as Lennox-Gaustat syndrome and Dravet’s syndrome, are not limited to seizures as their only symptoms. Fatigue, alertness, quality of sleep and overall quality of life are influenced by the underlying causes of the syndrome. With CBD therapy, some of these issues were resolved in a small subset of the patients, which was generally under 15%.
When compared to THC, the primary compound of focus in medical marijuana, adverse symptoms were reported in as high as 79% of the cases. While not all of these cases involved increased seizure frequency, some of them were, and others still had abrasive symptoms that made THC an unattractive option for treatment. With results like these, clear evidence suggests that there is a need to focus on CBD in an isolated setting, and high-THC medical marijuana strains are not at all an ideal prescription for all epileptics. Additionally, an epileptic taking medical marijuana, if the studies are accurate, is at risk of taking on even more neurological health complications as opposed to an epileptic that focuses on high-CBD options.
Discrepancies & Final Thoughts
A consistent, prominent issue that occurs with CBD testing would appear to be a lack of rigorous data collection. With some of these studies, advanced reports were not taken, nor were sufficient examinations of vital information throughout the day. While the reports still show a significant edge of CBD over placebo, having measurements of vital signs, blood examinations, and other relevant information is necessary to draw further conclusions about the working mechanisms behind the effectiveness of CBD.
Furthermore, as CBD comes from a naturally occurring plant, the exact balance of phytocannabinoids is near-impossible to measure or administer perfectly. For example, two plants grown 100 miles apart, though grown from seeds of the same parent plant, can produce different terpene and phytocannabinoid content from something as simple as soil composition. This makes it excessively difficult for researchers to have continuous, measurable results that highlight exactly which molecules in specific concentrations amplify the beneficial effects of CBD.
The conclusion of the data made available in this study suggests that CBD is, in fact, a relevant option for sufferers of epilepsy. As with any medicine or medication, specific results cannot be guaranteed. But seizures are a terribly painful, extremely exhausting experience. Having an affordable, widely available product with the ability to potentially eliminate seizures is a tremendous step forward in medical progress.
But more importantly, given the number of different conditions that CBD is showing promise for, collectively speaking, CBD is shaping up to become as significant of a household staple as ibuprofen. More research is necessary, but if the trend continues, CBD will likely hold its place in society as a powerful medicine that never deserved to be criminalized.