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Drug Resistant Epilepsy and Cannabis
Courtney Dickson
English 102
Andrea Banks
November 16, 2016
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Cannabis is a hot topic in society today. Cannabis is legal in twenty-six states and the District of Columbia for the use of medical marijuana. Seven of those twenty-six states and the District of Columbia have adopted more expansive laws to legalize marijuana for recreational use. As of November 8, 2016, three more states, California, Massachusetts, and Nevada all passed measures legalizing marijuana for recreational use as well. In Arizona, specifically it is legal to use cannabis for medical reasons, but recently Prop 205 did not pass, therefore recreational use of marijuana is still illegal. The United States of America is slowly moving towards at minimum legalizing marijuana use for medical purposes. Cannabis has proven to be helpful for many medical reasons. It can help with pain and nausea, increasing one's appetite when someone is going through Chemotherapy and is struggling to want to eat or keep the food down, as well as helping with controlling and/or decreasing seizures. One controversial subject is giving children cannabis. There is a large divide between everyday people, politicians, and the state and federal law on whether cannabis should be legal, if it should be given to children, and what effects it has on children and their developing brain. Drug resistant epilepsy and cannabis could help a child with their debilitating seizures and bring back quality of life to the child and their families.
Epilepsy is a neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain. As of the year 2013, 1% of children under the age of 18
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years of age have been diagnosed with form of epilepsy or seizure disorder, which is around 750,000 children. (cdc.gov/epilepsy/basics/fast-facts.htm) According to the CDC 0.6% of these children have active epilepsy, which is about of 460,000 children. (cdc.gov/epilepsy/basics/fast-facts.htm)
"Drug resistant epilepsy is defined as a failure of adequate trial of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve substantiated seizure freedom." (google.com/search?q=Epilepsy+definition&ie=utf-8&oe=utf-8#q=drug+resistant+epilepsy+definition) There are too many types of drug resistant epilepsy to name every one, but two types of common drug resistant epilepsy is Dravet syndrome and febrile infection-related epilepsy syndrome or FIRES. "Dravet syndrome is a rare genetic epileptic encephalopathy (dysfunction of the brain). It begins in the first year of life in an otherwise healthy infant. Prior to 1989, this syndrome was known as epilepsy with polymorphic seizures, polymorphic epilepsy in infancy (PMEI) or severe myoclonic epilepsy in infancy (SMEI). " (google.com/search?q=Dravets+syndrome&ie=utf-8&oe=utf-8) "FIRES presents with an acute phase with super-refractory status epilepticus and all patients progress to a chronic phase with persistent refractory epilepsy. The typical outcome is severe encephalopathy or death." (ncbi.nlm.nih.gov/pubmed/27655472) In some (not all) cases of drug resistant epilepsy, the use of cannabidiol (CBD) has decreased epileptic seizures by over half, which in a specific case, such as Charlotte Figi from Colorado, she was
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having up to 300 debilitating seizures per day and after her parents made the decision to give her cannabidiol (CBD) her seizures were reduced to 1-2 per week and gave her a quality of life she had never been able to experience before.
Cannabis is a plant grown from the earth, used by many for recreational purposes. Medical marijuana is sold in dispensaries around the world in many forms. Forms of cannabis sold are bud, eatables, which is when the cannabis is baked into sweet treats such as brownies, cupcakes, ice cream and even hard candies. There is another form of cannabis, which is much safer for children with seizures. This form is called cannabidiol (CBS). "Cannabidiol (CBD) (INN) is one of at least 113 active cannabinoids identified in cannabis. It is a major phytocannabinoid, accounting for up to 40% of the plant's extract." (google.com/search?q=cannabidiol+definition&ie=utf-8&oe=utf-8) This oil is extracted form the cannabis plant and does not contain tetrahydrocannabinol (THC). Tetrahydrocannabinol (THC) is responsible for the euphoric effects, which is why people feel "high" when they smoke the bud of the cannabis plant. Since cannabidiol (CBD) does not contain tetrahydrocannabinol (THC), treating children with seizures with a small amount of cannabidiol (CBD) the child would not get "high" and research has shown it decreases the amount of seizures, some having between 200-300 seizures per day to 1-2 seizures per week.
Under federal law cannabis is classified as a schedule 1 drug, right along with heroin and LSD. Some states have legalized marijuana for medical purposes, as well
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as recreational purposes, such as Colorado and Washington, have seen an increase in their economy. Even with the increase in the economy there is still the issue that even with marijuana legalized in the states, the federal government will not legalize marijuana. As the federal government has classified marijuana as a schedule one drug, along with heroin and LSD, it makes performing studies with cannabis extremely hard.
Studies play an important role in understanding the possible side effects of cannabis on any medical issue, as well the effects the cannabis has on epileptic seizures. Studies help scientist, medical professionals, politicians, and people in general understand its' effect on reducing epileptic seizures and how severe the seizure is on the child. One study performed recently by Orrin Devinsky, a neurologist at New York University Langone Medical Center and his colleagues across multiple research centers published results in The Lancet Neurology, which is the largest to date, there were 162 participants or patients treated with CBD oil. In 36.5% their motor seizures were reduced and in 2% of the patients became completely seizure free. These results are promising, but it is not to say the study is not without fault. Within this study 79% of the patients had adverse effects, such as sleepiness and diarrhea. ("Can Cannabis Treat Epileptic Seizures?" par. 3)
These side effects are not life threatening and can be dealt with, but it depends on the patient and their family and what they are willing to deal with to have less seizures and possibly more quality of life for the child and their family.
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Another study, which was performed in October of 2016 was on tuberous sclerosis complex (TSC), which is the most common neurologic manifestation is epilepsy. Eighteen of the 56 participants who enrolled in the current expanded-access study of cannabidiol (CBD) for patients with treatment-resistant epilepsy carry a diagnosis of TSC. After one month, patients began treatment with CBD and after three months of being treated with the CBD patients went from 22 seizures to around 13 seizures per week. (ncbi.nlm.nih.gov/pubmed/?term=27696387) Although double blind, placebo-controlled trials are still necessary and need to be performed, the studies that have been performed are promising and have suggested cannabidiol (CBD) may be effective and a well-tolerated treatment option for patients with drug resistant epilepsy.
Parents, whom have chosen to give their children cannabidiol (CBD), many times against medical advise from their doctor, have given testimonials of the effects, both bad and good, on their child. While testimonials from parents of children like Charlotte Figi help people to understand what effects cannabidiol (CBD) can have on seizures. Charlotte Figi is a young girl with Dravet syndrome, who was having up to 300 seizures per day, most being tonic-clonic seizures, a very debilitating type of seizure requiring hospitalization was treated with cannabidiol (CBD) and to her parents it was a miracle drug. She had exhausted all pharmaceutical treatments and was out of options, when her mother decided to try cannabidiol (CBD). After treating her daughter with cannabidiol (CBD) her seizures
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were beginning to be controlled. She went from 300 seizures per day to 1-2 seizures per week. Since using the cannabidiol (CBD) Charlotte has not only drastically reduced her seizures on a daily basis but has gained a quality of life she had not experienced in her life up to that point. Before she was using the cannabidiol (CBD) her life revolved around seizure after seizure, now she runs around like a normal child of her age. She plays at the playground and with other children her age and while she still must be careful and her parents are watching diligently for her to have a seizure, she is not focusing on what could happen and instead living a life of a child, just as she deserves.
There are many children with results like Charlotte but there are also children whose parents chose to try cannabidiol (CBD) in hopes it would too help them and it did not. There are some families who have uprooted and moved states just to try cannabidiol (CBD), which their previous state would have sent them to jail if they possessed even a small amount of cannabis or cannabidiol (CBD). Parents are not trying or looking to break the law but they are just trying to help their child with something that could help with reducing seizures. The pharmaceutical drugs given also have side effects that could be detrimental to the child, and not even help to control the frequent seizures. There are commercials on the television who have to list the possible side effects and it is a laundry list ranging from explosive diarrhea to heart attack to death, now imagine using a drug that has the same side effects and also does not work to control the seizures. These children, whom try the cannabidiol (CBD) and it does not work and the pharmaceutical drugs also do not
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work continue to have 10's to 100's of seizures a day or a week and have no quality of life leave their parents feeling lost, alone, and still searching for a cure or just something to help their child and give them the life they deserve. (time.com/pot-kids/)
More studies need to be performed to help people understand the effect of cannabidiol (CBD) has on children with debilitating seizures. Cannabidiol (CBD) is worth trying when pharmaceuticals have been tried and failed for that child. If more people were open minded and did not look at this as an illegal drug and more as an option of medication, it could be more world wide and help more people both children and adults.
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Work Cited
CDC. "Epilepsy Fast Facts"
Kwon, Diana. "Can Cannabis Treat Epileptic Seizures?"
Pickert, Kate. "Pot Kids".
Strauss, Mark. "Will Marijuana for Sick Kids Get Government to Rethink Weed?"
Weir, Kristen. "Marijuana and the Developing Brain". American Psychological Association.
"Marijuana derivative reduces seizures in people with treatment resistant epilepsy". Science News
"Realm of Caring".
