Epilepsy is a neurological disorder that affects people of all ages. It is unpredictable and can cause other health problems if not properly addressed. Epilepsy is a spectrum condition with a broad range of seizure types that vary from person to person. This is why each individual with epilepsy may need a specific type of care. The public has a limited understanding of epilepsy, which in turn poses more problems for the afflicted.
This chronic illness is characterized by recurrent, unprovoked seizures usually linked to brain injury but can also be hereditary. Seizures, which are sometimes likened to episodes of electrical storms in the brain, vary from person to person. Patients can anticipate the onset of a seizure before it happens. Changes in behaviour, odd sensations or anything out of the ordinary can signal an upcoming episode. Taking medication beforehand, as well as implementing safety measures or seizure drills, can help a patient survive without any further injuries. However, a seizure can also occur without warning, which is why even a slip in the shower can have fatal consequences. An estimated 65 million people worldwide suffer from epilepsy. As many as 3.4 million are living with this illness in the U.S., including at least 470,000 children. One in 26 Americans is predicted to develop epilepsy in their lifetime. Over 150,000 new cases are diagnosed each year. One-third of patients suffer with uncontrollable seizures due to lack of available treatment. Six out of ten are triggered by an unknown cause.
According to the National Institute for Neurological Disorders and Stroke, more than 20 antiepileptic drugs, or AEDs, are available. The options depend upon age, lifestyle, type of seizure, severity, frequency and pregnancy status. There are two types of drugs being used to treat epilepsy: narrow-spectrum AEDs and broad-spectrum AEDs. Some people have to take more than one medication. Narrow-spectrum AEDs target specific seizures occuring in an identified part of the brain. Broad-spectrum AEDs are for patients who have more than one type of seizure. Proper medical guidance before taking any of these drugs may provide more effective results.
CBD OIL: A HOLY GRAIL FOR EPILEPTICS?
Cannabidiol, or CBD, is only one of the many components of cannabis. It is the non-psychoactive counterpart of tetrahydrocannabinol, or THC. CBD, which is derived from cannabis, has made the most impact in medicine, since it does not carry a euphoric feeling.
On June 25th of this year, the U.S. Food and Drug Administration approved Epidiolex CBD oral solution for the treatment of Lennox-Gastaut syndrome and Dravet syndrome. Among the types of epilepsy, these two are the most severe. Lennox-Gastaut affects mostly children ages three to five years old and is characterized by uncontrollable contraction of muscles. Progression of this illness leads to learning disabilities and delayed motor skills. Dravet syndrome is a rare genetic condition that appears early in infants and is fever-related. It progresses to other seizures like muscle spasms. Patients may endure a life-threatening state of continuous seizures called “status epilepticus.” Poor language and motor skills development as well as hyperactivity are common in children affected by Dravet syndrome.
The FDA conducted controlled clinical trials involving 516 patients. Epidiolex taken with other anti-epileptic medications provided the most promising results. It is important to note that this was the first time a non-synthetic anti-epileptic drug was approved and that it was a major leap forward for cannabis medical research. “This approval serves as a reminder that advancing sound development programs that properly evaluate active ingredients contained in marijuana can lead to important medical therapies. The FDA is committed to this kind of careful scientific research and drug development,” states FDA Commissioner Scott Gottlieb.
CBD treatment is not without side effects, however. Patients who underwent Epidiolex clinical trials experienced sleepiness, elevated liver enzymes, diarrhea, rashes and fatigue among other results. It all boils down to responsible medication, which includes frequent interaction with qualified medical experts so as to prevent misuse, especially when the patient is a minor.
Currently, CBD is a Schedule I substance under the Controlled Substances Act, and the Drug Enforcement Administration is still required to make a scheduling determination. Regardless of the many legal hurdles that cannabis research may have to clear, the approval of cannabidiol in the treatment of seizures is a very clear victory.