Medical marijuana liquid extract may bring hope for children with severe epilepsy

April 13, 2015

Science Daily/American Academy of Neurology (AAN)

A medicinal liquid form of marijuana may show promise as a treatment for children with severe epilepsy that is not responding to other treatments, according to a study released today that will be presented at the American Academy of Neurology's 67th Annual Meeting in Washington, DC, April 18 to 25, 2015.

The study involved 213 people, ranging from toddlers to adults, with a median age of 11 who had severe epilepsy that did not respond to other treatments. Participants had Dravet syndrome and Lennox-Gastaut syndrome, epilepsy types that can lead to intellectual disability and lifelong seizures, as well as 10 other types of severe epilepsy.

The participants were given the drug cannabidiol, a component of marijuana that does not include the psychoactive part of the plant that creates a "high." The drug is a liquid taken daily by mouth. Participants all knew they were receiving the drug in the open-label study, which was designed to determine whether the drug was safe and tolerated well.

Researchers also measured the number of seizures participants had while taking the drug. For the 137 people who completed the 12-week study, the number of seizures decreased by an average of 54 percent from the beginning of the study to the end. Among the 23 people with Dravet syndrome who finished the study, the number of convulsive seizures had gone down by 53 percent by the end of the study. For the 11 people with Lennox-Gastaut syndrome who finished the study, there was a 55 percent reduction in the number of atonic seizures, which cause a sudden loss of muscle tone.

A total of 12 people, or 6 percent, stopped taking the drug due to side effects. Side effects that occurred in more than 10 percent of participants included drowsiness (21 percent), diarrhea (17 percent), tiredness (17 percent) and decreased appetite (16 percent).

Study author Orrin Devinsky, MD, of New York University Langone Comprehensive Epilepsy Center and a Fellow of the American Academy of Neurology, said that these are early findings and larger, placebo-controlled, double-blind trials are needed to measure the effectiveness of the drug.

"So far there have been few formal studies on this marijuana extract," Devinsky said. "These results are of great interest, especially for the children and their parents who have been searching for an answer for these debilitating seizures."

https://www.sciencedaily.com/releases/2015/04/150413183743.htm

Content of illicit cannabis extracts used to treat children with epilepsy revealed

Families who turned to black market did not get CBD-rich products; majority reduced seizures

July 5, 2018

Science Daily/University of Sydney

A pioneering study has found Australian parents who turned to medicinal cannabis to treat children with epilepsy overwhelmingly (75 percent) considered the extracts as "effective." Contrary to parental expectations, extracts generally contained low doses of cannabidiol (CBD) -- commonly considered to be a key therapeutic element and that has been successfully used in recent clinical trials to treat epilepsy.

The research, which commenced two years ago by the University of Sydney's Lambert Initiative for Cannabinoid Therapeutics, not only sheds light on the composition of cannabis used in the community but also reveals the legal, bureaucratic, and cost issues faced by families who relied on the products, as well as demonstrating the barriers to accessing medicinal cannabis.

The study found that the main psychoactive ingredient in cannabis, tetrahydrocannabidiol (THC), and the closely related compound THCA, were present in most extracts, although the quantity was generally not enough to produce intoxicating effects. Just over half the extracts were associated with a seizure reduction of 75-100 percent, which reinforces observations from animal studies and case reports of anticonvulsant effects of THC and THCA. As well, 65 percent were associated with other beneficial effects like improved cognition (35 percent) and language skills (24 percent).

The findings are published today by Springer Nature in its leading journal, Scientific Reports.

Lead author and PhD candidate with the Lambert Initiative at the Brain and Mind Centre, Ms Anastasia Suraev, said just under half the families who used medicinal cannabis reduced their antiepileptic medication.

"Our findings highlight the huge unmet clinical need in the management of treatment-resistant epilepsy in childhood," said Miss Suraev, from the School of Psychology.

Corresponding author and academic director of the Lambert Initiative, Professor Iain McGregor, said: "Although the illicit extracts we analysed contained low doses of CBD, three in four were reported as 'effective', indicating the importance of researching the cannabis plant in its entirety for the treatment of epilepsy.

"And despite the overwhelming presence of generally low levels of THC, concentrations did not differ between samples perceived as 'effective' and 'ineffective'.

"Our research indicates there is a potential role for other cannabinoids, alone or in combination with conventional drugs, in treatment-resistant epilepsy -- and this warrants further investigation so we can hopefully develop safer and more effective medicines."

https://www.sciencedaily.com/releases/2018/07/180705115620.htm