Hope and caution intertwine as researchers explore the potential of cannabinoids, like THC and CBD, in treating epilepsy. While decades of research show both seizure-provoking and seizure-suppressing effects, the lack of solid clinical evidence leaves many questions unanswered.
Dravet syndrome, a devastating form of childhood epilepsy, has ignited media attention and desperate hope. Yet, reports like the 2017 National Academies' assessment urge caution: "Insufficient evidence" exists to definitively declare cannabinoids as effective epilepsy treatments.
Despite this, research persists. CBD emerges as a leading candidate, with early trials showing promising anticonvulsant effects and minimal adverse reactions. A 2016 trial using Epidiolex (CBD in sesame oil) demonstrated a 43% reduction in convulsive seizures for Dravet patients compared to placebo.
However, challenges abound. The DEA's 2017 Schedule I classification of CBD complicates research and access, particularly in states with restricted medical cannabis laws. Additionally, interactions with existing anti-epileptic drugs need further investigation.
Beyond CBD, other cannabinoids like THCV and CBDV hold potential, but clinical trials are still in their infancy. Synthetic cannabinoids targeting CB1 receptors also show promising results in animal studies.
Adding to the complexity, terpenes like linalool may contribute to anti-seizure activity. Parents of epileptic children, often frustrated by conventional methods, continue to explore various cannabinoid combinations and acidic cannabinoids like THCA and CBDA.
The mechanism of action remains elusive, likely involving interactions beyond just CB1 and CB2 receptors. Unraveling this intricate web of receptors and ion channels will be crucial in understanding how cannabinoids can modulate neural circuitry and control seizures.
Dosage and methods of ingestion vary greatly depending on the disorder and cannabinoid used. Consultations with qualified healthcare professionals are essential due to potential risks of increased seizures and interactions with other medications.
