Epilepsy

Even though it has become big news over the past several years, the idea that cannabis could help reduce the frequency of seizures has been around since the 1970s. Indeed, alongside glaucoma, cancer and multiple sclerosis (MS), epilepsy was one of the first conditions where cannabinoid-based treatments were thought to potentially have anti-seizure effects. The initial researchers were correct, and there is now a considerable body of evidence suggesting that cannabidiol (CBD) can help reduce the frequency of seizures in people suffering from Dravet syndrome or Lennox-Gastaut syndrome. We now have the Scheule V, CBD-based Epidiolex available on prescription.

If you read through all the conditions on this site, you will notice that there is one similar thing that binds them all: inflammation. Epilepsy is no different in this regard, where there are lesions found in the nervous system, and there is impaired regulation of the immune system in the injured neuronal tissue.

There are several reasons why CBD helps for some kinds of epilepsy. These include:

  • CBD desensitizes the TRPV1 receptor (aka the vanilloid receptor, responsible for detecting pain and heat), thereby reducing neuronal excitability
  • CBD acts as an anti-inflammatory as “cannabinoids downregulate cytokine and chemokine production and, in some models, upregulate T-regulatory cells (Tregs) as a mechanism to suppress inflammatory responses.”
  • High concentrations of CBD block calcium ion channels and antagonizes CB1 and CB2 receptors, lending to CBD’s anti-convulsant properties.
  • An effect on adenosine reuptake and antagonism of G protein-coupled receptor 55 (GPR55) have been recently suggested to play an important role in CBD anti-seizure activity.
  • Cytochrome P450 (CYP450), CYP2C9, CYP3A, CYP2C19, and CYP2D6 are all enzymes that are responsible for the metabolism of many anti-epileptic drugs (AEDs), such as Clobazam. Many of those with epilepsy have mutations in the genes that code for these enzymes, meaning that the anti-epileptic drugs (AEDs) they are being given are not effective, and even harmful. Side-effects include addiction, drowziness, fatigue, tremors, headache. vomiting, being in a “fog” and, in cases of overdose, death. CBD could help reduce or replace the need for such drugs.
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