Compassionate access for those living with epilepsy is a relatively new treatment option, and because of that there are many questions surrounding it. Below are answers to some of the more common questions about this treatment option that people in the epilepsy community have.
- Does cannabis help seizures?
- Does cannabis have side effects?
- Should one pursue medical cannabis if all other medications do not work?
- Is medical cannabis safe?
- What medical cannabis research is currently being done?
Evidence from laboratory studies, anecdotal reports, and a small clinical study from a number of years ago suggests that cannabidiol, a non-psychoactive component of cannabis, could potentially be helpful in controlling seizures. However, there are conflicting reports in the literature. So far, no clear, definitive, solid evidence exists to show cannabis helps seizures.
It is difficult to assess the adverse effects of the drug since there is no controlled amount of the medication that has been studied. Therefore, other side effects could occur that are simply not known yet to practicing physicians. Cannabis has a number of effects depending on how it is ingested:
- If smoked, the risk factors associated with smoking apply to cannabis.
- If one takes cannabis preparations that are not smoked, side effects are similar to ones that would be seen with inhaled varieties of the drug. These include appetite stimulation and memory problems.
It is unknown what the long-term side effects are for low or different versions of cannabis, or those that seek to eliminate the psychotropic effects.
The goal of epilepsy treatment is to stop seizures with minimal or no side effects. There are receptors in the brain for cannabis, otherwise known as cannabinoid receptors, in areas that are commonly known to cause seizures (such as the hippocampus and amygdala). There is very little understanding as to what roles these receptors play in seizures. Given the legal issues, the lack of clarity on side effects, and risks associated with the use of the medication, there are better options one could try for epilepsy before resorting to cannabis.
To date, there is very little to no monitoring of cannabis. Therefore, the risk is unknown. Since medical cannabis is now legal in many states, some suppliers are working to develop dependable branded products, even mixes carefully controlled to offer specific percentages of THC or CBD. However, there are no standards or treatment recommendations that can be used to determine the best product. In addition, there are unknown consumer safety protections for these products. They are not regulated like prescription drugs for safety and efficacy by the Food & Drug Administration. There are many issues to be concerned with if using a product legally within your state including, but not limited to, the safety and product monitoring of the grower's operation, pesticides , and privacy issues.
The Food and Drug Administration (FDA) has issued several warning letters to companies that have inappropriately marketed products containing cannabidiol (CBD). Many of these companies have misrepresented the current science on CBD and all of the products contain little to no CBD. You can view the list of companies that were issued warnings at http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm435591.htm.
The Epilepsy Foundation is currently sponsoring a clinical trial for cannabis at New York University. More research must be done on the connection between medical cannabis and epilepsy.
The Controlled Substances Act currently lists cannabis as a Schedule I drug. According to the Drug Enforcement Administration (DEA), cannabis has a high potential for abuse and has no currently accepted medical use in the United States. Cannabis's classification as a Schedule I drug adds considerable complexity, expense, and potential access problems for clinical research.