Cannabis For The Treatment Of Epilepsy

Approximately 30 – 40% of patients with epilepsy continue to experience seizures despite adequate trials of anti-epileptic drugs (AEDs). Many of these patients are not candidates for epilepsy surgery or other non-pharmacological interventions. These patients frequently resort to non-conventional therapies with recent focus on Cannabis popularized by anecdotal reports and media. In the last few years several States have approved various forms of “medical cannabis” for the treatment of epilepsy and other medical conditions but the science behind such uses is incomplete. The goals of this presentation are to provide the audience with evidence of efficacy of Cannabis for the control of neuronal excitability based on animal studies of various epilepsy models, discuss the potential side effects of Cannabis products in humans, and to discuss available human data from the available studies including data from the open-label compassionate use of CBD oil (Epidiolex; GW Pharmaceuticals) in the State of Alabama. The discussion will include preliminary results of our extensive data collection including the effects of CBD oil on the EEG of the enrolled patients, the observed interactions with other AEDs, and the observed efficacy. In particular, we will discuss the lack of negative effects of CBD oil on the EEG of the studied patients (pre-CBD to on-CBD comparison) including lack of changes in EEG characteristics or reactivity; we will discuss the observed interactions between CBD oil and clobazam and its metabolite desmethylclobazam and the implication of this interaction for the management of patients with difficult to control epilepsies; we will discuss available human neuroimaging (fMRI) data; finally, we will discuss the effect of CBD oil on seizure frequency and severity in patients participating in the State of Alabama CBD program and compare it to the data from other studies.