Cannabinoid Therapy in Epilepsy Treatment
Cannabinoid-based therapies have gained increasing recognition within the medical community due to their significant therapeutic potential for a range of conditions, particularly those where conventional treatments fall short. Epilepsy is one such condition, where cannabinoids like CBD and THC have shown promise in reducing seizure activity and providing relief for patients who may not respond to traditional treatments.
Epilepsy is a chronic neurological disorder marked by recurrent seizures, which are triggered by abnormal electrical activity in the brain (Andell et al., 2020). These electrical disruptions can manifest as various physical symptoms, such as involuntary jerking movements or periods of blank staring, often followed by confusion or a postictal state. Seizures are typically classified into two broad categories: focal seizures, which affect a localized area of the brain, and generalized seizures, which involve both hemispheres. While there are many potential causes for epilepsy, medical experts identify brain injuries, structural changes, genetic factors, infections, vaccinations, and developmental disorders as key contributors (Andell et al., 2020, Berg, 2002).
Challenges in Epilepsy Treatment
Current treatments for epilepsy include over 30 anti-seizure medications, offering a range of options for controlling seizures. However, it is important to note that approximately one-third of people with epilepsy do not respond to existing therapies (Perucca, 2021). As a result, the search for alternative treatments has led to the exploration of cannabinoid-based therapies. Simply put, patients need something that is more effective!
One FDA-approved cannabinoid medication for epilepsy is Epidiolex, which contains CBD and is used to treat rare and severe forms of epilepsy, such as Dravet Syndrome and Lennox-Gastaut Syndrome. Clinical studies and animal models have shown that CBD effectively reduces seizure activity, particularly myoclonic, clonic, and tonic seizures (Tellez-Zenteno et al., 2022). This anticonvulsant effect is largely attributed to the activation of key receptors, including CB1 (primarily found in the central nervous system), TRPV1, 5-HT1A, and GPR55 receptors (Tellez-Zenteno et al., 2022). When these receptors are activated, they help downregulate overactive neurotransmitter activity, thus providing relief from seizure-associated jerking movements.
Additionally, CBD’s neuroprotective effects—largely due to its antioxidant and anti-inflammatory properties—have shown promising potential as part of a broader treatment strategy for epilepsy, offering a way to protect brain cells from damage and inflammation associated with chronic seizure activity.
The Potential of CBDa in Epilepsy Treatment
Another cannabinoid that has shown potential for treating epilepsy is CBDa (cannabidiolic acid), which is the precursor to CBD. CBDa has demonstrated a significantly higher affinity—100 times greater—for the 5-HT1A receptor, a receptor involved in regulating neuronal excitability, mood, anxiety, and seizure activity (3). This enhanced interaction with the 5-HT1A receptor suggests that CBDa may offer an even more targeted approach to reducing seizure frequency and severity.
Given CBDa’s promising pharmacological profile, there is growing interest in the potential for CBDa-based medications to improve epilepsy treatment outcomes. However, further studies are needed to fully understand its efficacy and safety profile in this context, and whether it could offer a more effective alternative to current CBD-based therapies.
Conclusion
The therapeutic potential of cannabinoids—particularly CBD and CBDa—in treating epilepsy is becoming increasingly evident. With their ability to interact with key receptors in the brain and modulate neural excitability, cannabinoids offer a promising option for patients with difficult-to-treat seizures. While Epidiolex has already demonstrated clinical efficacy, ongoing research into CBDa and other cannabinoid derivatives may lead to even more effective treatments in the future. As the scientific community continues to explore these possibilities, cannabinoid-based therapies represent an exciting frontier in the management of epilepsy.
One plant with seemingly endless potential, now that's what I call medicine!
Bee Well,
Brandon Farless
*This information is for educational purposes only, as I am simply sharing information pertaining to these studies. No medical advice or claims are being made on my behalf.
References
1. Andell, E., Arts, W. F., Berg, A. T., Brikell, I., Danielsson, J., Davis, S. M., Fisher, R. S., Ghacibeh, G. A., Gregory, R. P., Guerrini, R., Kalser, J., Killory, B. D., McFarlane, F. A., McTague, A., Mung’ala-Odera, V., … Camfield, C. S. (2020, September 22). Epilepsy. Handbook of Clinical Neurology. https://www.sciencedirect.com/science/article/abs/pii/B9780444641489000119
2. Berg A. T. (2002). Seizure Risk with Vaccination. Epilepsy currents, 2(1), 15–16. https://doi.org/10.1111/j.1535-7597.2002.00002.x
3. Perucca, E. (2021, September 17). The pharmacological treatment of epilepsy: Recent advances and future perspectives - acta epileptologica. BioMed Central. https://aepi.biomedcentral.com/articles/10.1186/s42494-021-00055-z#citeas
4. Tellez-Zenteno, J. F., Citti, C., Paolino, D., Rayamajhi, S., Angelova, V. T., Hu, Y., Shubhra, Q. T. H., Shalabalija, D., Di, J., Perruca, E., Scuderi, C., Hofmann, E. M., Jones, R., … Lakhan, S. E. (2022, September 19). Lipid nano-carriers loaded with cannabis sativa extract for epilepsy treatment – in vitro characterization and in vivo efficacy studies. Journal of Pharmaceutical Sciences. https://www.sciencedirect.com/science/article/pii/S0022354922004178
