Thoughts from the void: Cannabis and Epilepsy

There was a time, not long ago, when epilepsy was considered a form of insanity. Even now there are numerous places in the world where a person with epilepsy is considered to be possessed by the devil. In the name of treatment, these suffering individuals were confined or beaten up to rid them of their insanity and possession by evil spirits.

'Stick around while the clown who is sick does the trick of disaster' sang Neil Young in Mr. Soul, leading me to think that he was referring to sudden seizures on stage that may have brought some of his gigs to an abrupt end. I think one of his biographies does mention epilepsy, and how gradually the seizures reduced over time. At the time of reading, I did think that his cannabis smoking probably had something to do with the reductions in seizures.

More and more studies indicate that cannabis is quite effective against many types of epilepsy, like Dravet's Syndrome, Lennox-Gastaut Syndrome and temporal lobe epilepsy (TLE). Certain types of devastating epilepsy like Dravet's and Lennox-Gastaut syndromes afflict children almost from birth. Young babies are known to go through hundreds of bouts of epilepsy in a single day, often not surviving beyond their infant years.

Slowly cannabis, mostly sourced from the black market and underground growers, was administered in the past few decades to an increasing number of epileptic young children, many of whom have been able to subsequently live near normal lives. Some of these stories have caught public attention, as in the case of Charlotte Figi, that catapulted the Stanley Brothers and their Charlotte's Web strain of cannabis to fame. To see even one baby going through the intense mental electric storms of epilepsy, and the subsequent positive changes brought about by cannabis treatment should make any sane adult ask that the plant be immediately legalized and made available everywhere, so that parents and children going through this horrific experience can benefit from the herb. Several forms of severe epilepsy, such as Dravet's Syndrome are now qualifying medical conditions for cannabis treatment in US states that have legalized medical use of cannabis. Some states like California have gone so far as to permit the administering of medical cannabis to affected children by caregivers during school hours, to enable the children to continue as much a normal life as possible.

Recently, the story of a child from UK, whose cannabis based medication was confiscated on his return from abroad, made headline news and triggered a series of protests from the public. This forced the Health Secretary to change the draconian cannabis laws a little (teeny-weeny) bit, saying that debilitating conditions, for which all other treatment methods have been exhausted, can be treated with cannabis. To wait till you go through chemical cocktails that reduce you to a vegetable, in between intense fits of epilepsy, and then if you still survive, to finally prescribe cannabis for you as a medication, sounds, to me, like a script written by an especially sick psychopath. Not only that, the medical cannabis for this patient needs to be imported from the Netherlands, since the UK has no legal cannabis, officially at least. The price of imported Dutch cannabis for this purpose is many hundred times the price you would pay if you were to walk into a coffee shop in Amsterdam and buy decent quality cannabis. This effectively makes the so called medical cannabis, legalized for severe diseases (as a last resort, mind you), excessively expensive, and practically inaccessible for most patients in the UK. Contrast this with the International Narcotics Control Board report in 2018, which states that the UK was the world's largest producer, stockholder and exporter of cannabis. For a clue as to what all this is about, we can look in the direction of the UK pharmaceutical company GW Pharmaceuticals (now renamed to Greenwich Biosciences, possibly because of the extensive attention it has been receiving in recent times). GW Pharmaceuticals, with links to the former British Prime Minister Theresa May, is making global forays with cannabis medication and has released the first US FDA approved drug Epidiolex in the US recently. According to the Guardian, "Because of European Medicines Agency recommendations, it must be taken in conjunction with Clobazam, a benzodiazepine that some parents have said can cause troubling side-effects including hallucinations and amnesia." Based on the FDA approval of Epidiolex, the FDA now bans the use of cannabidiol (CBD) in food, stating that it is a controlled drug.

Many synthetic pharmaceutical medications are themselves likely to trigger epilepsy, such as say the prolonged use of barbiturates (now replaced in many places by benzodiazepines), followed by a sudden cessation. Cocaine is said to trigger convulsions. Chemical pesticides and fertilizers too are known to trigger epilepsy.

The US, Netherlands, Canada, Germany, etc., are just a few countries with progressive cannabis laws, enabling people with severe epilepsy to medicate with cannabis. In the larger context of the entire world, many children are not surviving beyond their initial years, as they succumb to epilepsy, especially in poor countries and places with regressive cannabis laws, where the benefits of cannabis are not known. In India, in 2019, epilepsy was the third most reported neurological condition, requiring medical treatment, after stroke and migraines. There is an urgent need to legalize cannabis worldwide, to calm the electrical storms ravaging the minds and destroying the lives of numerous persons, especially infants, young children and youth. Medical bodies, physicians, health departments and leaders worldwide need to act immediately to legalize cannabis for all purposes so that a safe, affordable, accessible natural way that has worked for thousands of years is available for the treatment of epilepsy. All persons need to act selflessly to make the changes, removing global cannabis prohibition, including its home growing. The children of the poor are no less precious to their parents than the children of the elite. Cannabis' overall neuroprotective abilities, including in the treatment of brain cancers, healing brain damage due to cocaine and methamphetamine, etc., further strengthen the case for cannabis use in the treatment of epilepsy. After all, the human brain is one of the areas with the highest concentration of endo-cannabinoid receptors.

The following list of articles taken from various media speak about the above subject. Words in italics are the thoughts of yours truly at the time of reading the article.

'Highlights

- This study evaluating the use of cannabidiol-enriched cannabis oil in children with WS.
- The study shows that four (50%) of eight had a more than 50% seizure reduction.
- The cannabidiol-enriched cannabis oil in children with WS had a good tolerability.
- The patients were treated with a standardized plant extract of cannabis.

https://www.seizure-journal.com/article/S1059-1311(21)00321-6/fulltext

'Anecdotal reports of the benefits of cannabis and its components in the treatment of epilepsy have been reported for millennia. However, only recently randomized controlled trial data in support of cannabidiol (CBD) became available resulting in its FDA approval for the treatment of seizures and epilepsy. One of the most common and debilitating comorbidities of epilepsy is cognitive impairment. This impairment has a multifactorial etiology including network dysfunction due to seizures, negative cognitive side effects from anti-seizure medications (ASMs), and mood disturbances. Knowing the effects of a particular ASM (either positive or negative) is vital for providers to counsel patients on expected side effects, and may result in choosing a particular regimen over the other if the patient already suffers from significant cognitive deficits. Unlike most other ASMs and other well-studied cannabinoids such as delta9-tetrahydrocannabinol, CBD has been shown to have additional mechanisms of action (MOA) that result in neuroprotective, anti-inflammatory, anti-oxidant, and neurogenesis effects. These additional MOAs suggest that the use of CBD could lead to other actions including positive effects on cognition that may be independent of seizure control. This targeted review discusses the currently available data on CBD’s effects on cognition in epilepsy. First, we review the proposed mechanisms by which CBD could exert effects on cognition. Then, we present the pre-clinical/animal data investigating cognitive effects of CBD in seizure/epilepsy models. Finally, we discuss the available human data, including the studies in people with epilepsy that included cognitive evaluations pre- and on-CBD, and studies investigating if CBD has any effects on brain structure or function in areas pertinent to memory and cognitive functions.'

https://www.sciencedirect.com/science/article/abs/pii/S1525505021005771

'The administration of the proprietary cannabis tincture Nabiximols (a/k/a Sativex) is associated with a “dramatic decrease” in tic-related symptoms in a patient with Tourette Syndrome (TS), according to a case report published in the journal Tremor and Other Hyperkinetic Movements.

A pair of German researchers documented the treatment of a 25-year-old male TS patient with Nabiximols. The patient had previously reported consuming whole-plant cannabis to manage his TS symptoms. Symptoms had returned after he ceased using the plant. '

https://norml.org/news/2021/09/02/case-report-cannabis-tincture-associated-with-tic-reduction-in-tourette-syndrome-patient

'Results
Of the 330 patients who completed the original randomized trials, 315 (95%) enrolled in this open-label extension. Median treatment duration was 444 days (range = 18–1535), with a mean modal dose of 22 mg/kg/day; patients received a median of three concomitant antiseizure medications. Adverse events (AEs) occurred in 97% patients (mild, 23%; moderate, 50%; severe, 25%). Commonly reported AEs were diarrhea (43%), pyrexia (39%), decreased appetite (31%), and somnolence (28%). Twenty-eight (9%) patients discontinued due to AEs. Sixty-nine (22%) patients had liver transaminase elevations >3 × upper limit of normal; 84% were on concomitant valproic acid. In patients from GWPCARE1 Part B and GWPCARE2, the median reduction from baseline in monthly seizure frequency assessed in 12-week periods up to Week 156 was 45%–74% for convulsive seizures and 49%–84% for total seizures. Across all visit windows, =83% patients/caregivers completing a Subject/Caregiver Global Impression of Change scale reported improvement in overall condition.

Significance
We show that long-term CBD treatment had an acceptable safety profile and led to sustained, clinically meaningful reductions in seizure frequency in patients with treatment-resistant DS.'

https://onlinelibrary.wiley.com/doi/abs/10.1111/epi.17036

'Oral cannabidiol (CBD) is approved by the Food and Drug Administration (FDA) to treat patients with Dravet and Lennox-Gastaut syndromes, and tuberous sclerosis complex. The therapeutic potential of oral CBD formulations is limited by extensive first-pass hepatic metabolism. Following oral administration, the inactive metabolite blood concentration is ~40-fold higher than CBD. Inhalation bypasses the pharmacokinetic (PK) variability attributed to irregular gastrointestinal absorption and first-pass hepatic metabolism and may efficiently deliver CBD into systemic circulation. This phase 1 study compared the PK of a dry-powder inhaler (DPI) CBD formulation (10 mg; excipient containing 2.1 mg CBD) with an oral CBD solution (Epidiolex®, 50 mg) in healthy participants. Following a single dose of Epidiolex or DPI CBD (n=10 PK evaluable participants each), the maximum CBD concentration for the inhaled powder was 71-fold higher than that of Epidiolex while administering 24-fold less CBD. The mean time to reach maximum concentration was 3.8 minutes for the DPI CBD formulation compared with 122 minutes for Epidiolex. Both Epidiolex and DPI CBD were generally safe and well-tolerated. These data indicate that DPI CBD provided more rapid onset and increased bioavailability than oral CBD and support further investigations on the use of DPI CBD for acute indications.'

https://jpharmsci.org/article/S0022-3549(21)00413-5/fulltext

'“Generally, higher quality of life, lower psychiatric symptom scores and improved sleep were observed among people using an artisanal CBD product based on both cross-sectional and longitudinal comparisons,” the study says. “Artisanal CBD Users reported significantly better epilepsy medication tolerability, a lower odds of prescription medication use and traditional anticonvulsant use, and reduced healthcare utilization compared with Controls.”

“These findings are consistent with research indicating that practitioners recommending CBD in clinical care for epilepsy report integrating the use of CBD both as a means to improve patient quality of life and as well as for seizure reduction,” the researchers noted.'

https://www.marijuanamoment.net/epilepsy-patients-who-use-artisanal-cbd-have-higher-quality-of-life-study-finds/

'Median percent reductions from baseline ranged 48%–71% for drop seizures and 48%–68% for total seizures through 156 weeks. Across all 12-week visit windows, 87% or more of patients/caregivers reported improvement in the patient's overall condition on the Subject/Caregiver Global Impression of Change scale.

Significance
Long-term add-on CBD treatment had a similar safety profile as in the original RCTs. Sustained reductions in drop and total seizure frequency were observed for up to 156 weeks, demonstrating long-term benefits of CBD treatment for patients with LGS [Lennox–Gastaut syndrome].'

https://onlinelibrary.wiley.com/doi/abs/10.1111/epi.17000

'Results
This review identified 12 cost-utility analyses conducted across a variety of diseases including multiple sclerosis (MS) (N = 8), pediatric drug-resistant epilepsies (N = 2), and chronic pain (N = 2). The incremental cost-effectiveness ratio varied widely from cost saving to more than US $451?800 per quality-adjusted life-year depending on the setting, perspectives, types of medicinal cannabis, and indications. Nabiximols is a cost-effective intervention for MS spasticity in multiple European settings. Cannabidiol was found to be a cost-effective for Dravet syndrome in a Canadian setting whereas a cost-utility analysis conducted in a US setting deemed cannabidiol to be not cost-effective for Lennox-Gastaut syndrome. Overall study quality was good, with publications meeting 70% to 100% (median 83%) of the Consolidated Health Economic Evaluation Reporting Standards checklist criteria.

Conclusions
Medicinal cannabis-based products may be cost-effective treatment options for MS spasticity, Dravet syndrome, and neuropathic pain, although the literature is nascent. Well-designed clinical trials and health economic evaluations are needed to generate adequate clinical and cost-effectiveness evidence to assist in resource allocation.'

https://www.sciencedirect.com/science/article/abs/pii/S1098301521015229

'Researchers reported that the efficacy of Epidiolex improved the longer subjects took it. They reported: “[The] percentage of children achieving [a] =50 percent seizure frequency reduction was 44 percent at month 1, and 41 percent at year 1, and [a] 61 percent reduction at year 2, while adult responder rates were 34 percent at month 1, 53 percent at year 1, and 71 percent at year 2.”

Authors concluded, “Our study provides further evidence of sustained seizure frequency and severity reduction over two years of treatment with highly purified CBD in TRE [treatment-resistant epilepsy].”'

https://norml.org/news/2021/04/08/study-efficacy-of-cannabis-derived-epilepsy-drug-sustained-long-term

'Evidence from the adjusted model revealed a significant mean reduction in seizure frequency compared to baseline in children and adults at all time points (1 month and 1 and 2 years).

Percentage of children achieving =50% seizure frequency reduction was 44% at month 1, and 41% at year 1, and 61% reduction at year 2, while adult responder rates were 34% at month 1, 53% at year 1, and 71% at year 2 (all P < 0.0001). CSSS showed a sustained reduction from baseline to all 3 time points. Children displayed 52% seizure reduction at month 1, a 51% reduction at year 1, and 75% reduction at year 2. Seizure reductions in adults were 60%, 81%, and 85%, respectively (all P < 0.0001). While there were no significant differences between seizure frequency reduction between children and adults at all time points, there was a significant difference in seizure severity reduction at year 1, with adults reporting greater improvement in seizure severity (P < 0.001).'

https://www.sciencedirect.com/science/article/abs/pii/S1525505021000962

'"Giving sickle cell patients a more direct pathway into the medical cannabis program will permit them a non-opioid option to manage their pain,” said Commissioner of Health Jan Malcolm.

Minnesota’s medical cannabis program already has Tourette’s syndrome as one of its qualifying medical conditions. Vocal or motor tic disorder is distinct from Tourette’s syndrome in that patients experience only vocal or motor tics, where people with Tourette’s experience both vocal and motor tics.

Evidence from Tourette’s patients who participate in the program shows that medical cannabis can effectively treat tics. “This change will allow people who have either vocal or motor tics to participate in Minnesota’s medical cannabis program,” she said.'

https://www.health.state.mn.us/news/pressrel/2020/cannabis120120.html

'Cannabinoids have been found to be effective in controlling seizures and the highly purified form of cannabinoid derived for Cannabis sativa. Cannabidiol (CBD) is now approved for Lennox–Gastaut syndrome (LGS) and Dravet syndrome. CBD was used in a 9-year-old boy with LGS (unknown etiology) with very good results. The electroencephalography (EEG) response was very dramatic with near normalization of EEG background and complete control of seizures. The effect of CBD on EEG with such an improvement has not been described previously. Also, this adds to evidence that early intervention in LGS with CBD might be more helpful and improve outcomes.'

https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0040-1714329

'GW Pharmaceuticals’ plant-derived CBD drug Epidyolex received approval from Australia’s Therapeutic Goods Administration (TGA) to be used in treating seizures related to Lennox-Gastaut syndrome and Dravet syndrome for patients 2 and older.

The approval is the third major global regulatory approval for Epidyolex, GW said in a news release.

“The TGA approval is further proof that cannabis-based medicines can successfully go through extensive randomized placebo-controlled trials and a rigorous evaluation process to reach patients who need them,” GW Chief Operating Officer Chris Tovey said in a statement.'

https://mjbizdaily.com/gw-pharmaceuticals-cannabis-drug-gets-regulatory-ok-in-australia/

'Cannabidiol (CBD) is a major phytocannabinoid in Cannabis sativa. CBD is being increasingly reported as a clinical treatment for neurological diseases. Febrile seizure is one of the most common diseases in children with limited therapeutic options. We investigated possible therapeutic effects of CBD on febrile seizures and the underlying mechanism. Use of a hyperthermia-induced seizures model revealed that CBD significantly prolonged seizure latency and reduced the severity of thermally-induced seizures. Hippocampal neuronal excitability was significantly decreased by CBD. Further, CBD significantly reduced the a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) mediated evoked excitatory postsynaptic currents (eEPSCs) and the amplitude and frequency of miniature EPSCs (mEPSCs). Furthermore, CBD significantly accelerated deactivation in GluA1 and GluA2 subunits.'

https://www.sciencedirect.com/science/article/abs/pii/S1043661820314365

'Hughes said of his son’s improvement since taking cannabis: “Charlie is happier, more alert, far more vocal, constantly babbling and takes an interest in his toys. He can feed himself and loves nothing more than some rough and tumble with me. He’s come alive again.

“No one knows definitively what effect all those anti-epileptic drugs in combination with each other have on the development of the brain. If he wasn’t asleep or completely zonked out, he was just seizing. Cannabis has massively improved his general wellbeing.”

With regards to cannabis-based medicines available on the NHS for epilepsy, Nice recommends just Epidyolex for two rare syndromes of the condition. Because of European Medicines Agency recommendations, it must be taken in conjunction with Clobazam, a benzodiazepine that some parents have said can cause troubling side-effects including hallucinations and amnesia.'

https://www.theguardian.com/society/2020/aug/16/parents-of-toddler-with-severe-epilepsy-seek-legal-review-of-cannabis-oil-guidelines

'Results
There were no statistically significant changes in cognitive function, as measured by the NIHTB-CB, in those participants who were able to complete such testing, but there was a nonsignificant trend toward improvement in some cognitive domains. For participants who were unable to complete formal standardized cognitive testing because of the magnitude of their cognitive impairment, their functional adaptive skills, as measured by the ABAS-II, were unchanged after a one-year trial of CBD.

Significance
Our findings suggest that CBD, as an add-on drug for TRE in a pediatric sample, does not appear to cause adverse effects (AEs) involving cognition or adaptive function over one year of treatment. '

https://www.epilepsybehavior.com/article/S1525-5050(20)30478-9/fulltext

'The new FDA approval, granted July 31 to GW’s U.S. subsidiary, Greenwich Biosciences, means the drug can now be used in the United States to treat seizures associated with tuberous sclerosis complex (TSC), a genetic disease believed to affect one in 6,000 people.

The FDA approved Epidiolex to treat TSC patients 1 year old and up and also expanded the age range for the use of Epidiolex to treat seizures caused by Lennox-Gastaut and Dravet syndromes, lowering the minimum age from 2 years old to 1, GW Pharma said.'

https://mjbizdaily.com/fda-approves-gw-pharmaceutical-cannabis-drug-epidiolex-for-new-indication/

'Our systematic review was conducted according to the PRISMA guidelines and aimed to summarize the literature regarding the use of cannabinoids in ASD. After searching in Web of KnowledgeTM, PsycINFO, and Embase, we included ten studies (eight papers and two abstracts). Four ongoing trials were retrieved in ClinicalTrials.gov. Findings are promising, as cannabinoids appeared to improve problem behaviors, sleep, hyperactivity, and communication deficits, with limited cardiac and metabolic side effects. Interestingly, they generally allowed to reduce the number of prescribed medications and decreased the frequency of seizures in epileptic patients. Mechanisms of action could be linked to the excitatory/inhibitory imbalance found in people with ASD'

https://www.preprints.org/manuscript/202007.0373/v1

'Cannabidiol (CBD) is an illegal drug with no redeeming value. It is also a useful prescription medicine for epilepsy, with considerable potential for treating numerous other conditions. And it is a natural dietary supplement or ‘nutraceutical’ with countless evangelists in the health and wellness community. Although contradictory, all three statements are true from different perspectives, and clinical researchers are frustrated.'
https://www.nature.com/articles/d41586-019-02524-5

'The oral administration of cannabis-based products is associated with improvements in autistic patients with self-injurious behaviors and co-morbid epilepsy, according to data published in the journal Seminars in Pediatric Neurology.

A pair of investigators affiliated with the Tufts University School of Medicine described their clinical experience working with children and young adults with ASD (autism spectrum disorder) who had consumed either cannabis or hemp-based products. Among subjects with ASD-associated aggression, 60 percent reported improvements following treatment. Among subjects diagnosed with both ASD and epilepsy, 91 percent reported some improvement in seizure control.'
https://norml.org/news/2020/07/16/study-cannabis-based-products-may-ease-symptoms-in-autistic-patients

'Across social media, people are sending their support to the Figi family and sharing anecdotes about how Charlotte’s battle against Dravet syndrome—and the success she demonstrated in treating it with the cannabis compound—changed hearts and minds. Her impact has been felt across state legislatures and in Congress, where her story was often told as a clear example of why laws prohibiting access to cannabidiol needed to change.'
https://www.marijuanamoment.net/lawmakers-mourn-loss-of-charlotte-figi-whose-story-inspired-national-cbd-movement-and-helped-change-policies/

'Charlotte Figi was more than an individual, she was an entire movement wrapped up into a sweet girl with a big smile and an even bigger heart.'
https://edition.cnn.com/2020/04/08/health/sanjay-gupta-weed-charlotte-figi-tribute/index.html

'As a proof of concept, we compare the long-term efficacy of a single administration of the microdepots to a single administration of Cannabis extract in a pentylenetetrazol-induced convulsion model. One week following administration, the microdepots reduce the incidence of tonic-clonic seizures by 40%, increase the survival rate by 50%, and the latency to first tonic-clonic seizures by 170%. These results suggest that a long-term full-spectrum Cannabis delivery system may provide new form of Cannabis administration and treatments'
https://pubs.acs.org/doi/10.1021/acsami.0c04435

'Results
The incremental cost per QALY gained with the use of adjunctive cannabinoid oil, from the health care system perspective, was $32,399 compared with clobazam and valproate. Stiripentol was dominated by cannabinoid oil, producing fewer QALYs at higher costs. At a willingness-to-pay threshold of $50,000, cannabinoid oil was the optimal treatment in 76% of replications. From a societal perspective, cannabinoid oil dominated stiripentol and clobazam/valproate. The interpretation of the results was insensitive to model and input assumptions.

Conclusion
Compared with clobazam/valproate, adjunctive cannabinoid oil may be a cost-effective treatment for Dravet syndrome, if a decision maker is willing to pay at least $32,399 for each QALY gained. The opportunity costs of continuing to fund stiripentol, but not cannabinoid oil, should be considered'
https://link.springer.com/article/10.1007/s40273-020-00923-5

'Conclusions
The present study, although with some limitations, shows a good safety profile of medical cannabis in children and young patients with drug-resistant epilepsy and encourages the possibility of further studies with oral cannabis-based drugs. The correlations between THC-CBD plasma concentrations and their administered dosages underline the need of a therapeutic drug monitoring for cannabinoids therapy.'
https://www.sciencedirect.com/science/article/abs/pii/S0965229919316012?via%3Dihub

'Results
The majority (73 %) of the responding epilepsy patients wished to receive plant-derived CBD; 5 % preferred synthetic CBD. Reasons for this choice were botanic origin, lack of chemistry, and the assumption of fewer and less dangerous side effects. Eighty-two percent of the patients estimated the monthly costs of CBD treatment to be below €500. Using the willingness-to-pay approach to assess the commitment of patients, 68 % could imagine buying the drug themselves. Fifty-three percent of these would be willing to pay up to €100, 40 % €100 to €200, and another 7 % €200 to €500 per month'
https://www.seizure-journal.com/article/S1059-1311(20)30175-8/pdf

'Parents sought medical cannabis as a treatment because of a perceived unmet need stemming from the failure of antiepileptic drugs to control their children's seizures. Medical cannabis was viewed as an acceptable treatment, especially compared with adding additional antiepileptic drugs. After learning about medical cannabis from the media, friends and family, or other parents, participants sought authorization for medical use. However, most encountered resistance from their child's neurologist to discuss and/or authorize medical cannabis, and many parents experienced difficulty in obtaining authorization from a member of the child's existing care team, leading them to seek authorization from a cannabis clinic. Participants described spending up to $2000 per month on medical cannabis, and most were frustrated that it was not eligible for reimbursement through public or private insurance programs.'
https://www.epilepsybehavior.com/article/S1525-5050(20)30299-7/pdf

'Josh will sift through the propaganda, fear and greed encompassing medical marijuana. Recently featured on CNN, Josh and his brothers developed a non-psychotropic strain of marijuana which is drastically reducing seizures for many pediatric epilepsy patients in Colorado. With millions facing life-threatening illnesses, Josh outlines the hurdles needed to effect social change and maps a path toward helping those who desperately need revolutionary medicine.'
https://www.youtube.com/watch?v=ciQ4ErmhO7g

'Medical marijuana isn’t devil weed or the cure for everything. Find out what it really is, and what it can really do. Dr.Alan Shackelford shows us.'
https://www.youtube.com/watch?v=wVlIZkbdwF4

This brought tears to my eyes..

'Hugh Hempel is a technology industry veteran turned health care entrepreneur. In this moving talk he discusses how medicinal cannabis has enriched the lives of his ailing 11 year-old daughters. This talk will challenge your views of medical marijuana.'
https://www.youtube.com/watch?v=3N8QMeIsX2c

'The evidence supports the use of cannabinoids, especially cannabidiol, in similar forms of refractory epilepsy including Dravet and Lennox-Gastaut syndromes. Evidence for cannabinoids specifically in CDD is limited but growing, with multiple anecdotal reports and an open-label trial showing cannabidiol to be associated with a significant reduction in seizure activity. This review provides the first comprehensive overview of the potential role for cannabis based preparations in the treatment of CDD and provides justification for further clinical and observational research.'
https://www.sciencedirect.com/science/article/pii/S0920121118306107

'The present study illustrates that CBD is a well-tolerated and effective antiseizure agent and illustrates a potential disease-modifying effect of CBD on both reducing seizure burden and associated comorbidities well-after the onset of symptomatic seizures in a model of TLE (temporal lobe epilepsy).'
http://centaur.reading.ac.uk/80937/

'A two-year-old girl with severe epilepsy is believed to have become the first child in the UK to be prescribed medical cannabis.

For Jorja Emerson the treatment is "the difference between her living and dying", according to her father.'
https://www.itv.com/news/2018-12-04/two-year-old-girl-first-child-to-be-prescribed-medical-cannabis-in-uk/

'Despite considerable community interest in the use of CBD for paediatric epilepsy, there has been little evidence for its use apart from anecdotal reports, until the last year. Three randomized, placebo-controlled, double-blind trials in Dravet syndrome and Lennox–Gastaut syndrome found that CBD produced a 38% to 41% median reduction in all seizures compared to 13% to 19% on placebo. Similarly, CBD resulted in a 39% to 46% responder rate (50% convulsive or drop-seizure reduction) compared to 14% to 27% on placebo.'
https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.14087

http://www.sciencemag.org/news/2017/05/cannabis-knocks-back-epilepsy-new-clinical-trial

An expert panel on Thursday unanimously recommended that the Food and Drug Administration approve a new medicine for two rare and devastating forms of epilepsy, paving the way for the authorization of what would be the country’s first medication made from marijuana.
https://www.scientificamerican.com/article/panel-recommends-fda-approval-of-epilepsy-drug-derived-from-marijuana/

'By enhancing GABAergic inhibition of DGCs, CBD may reduce the likelihood of seizures occurring. However, when excitatory transmission increases during thermal induction and seizure occurrence is inevitable, CBD reduction in DGC excitability may dampen the severity of the seizure and shorten its duration. These dual actions of CBD make it a promising antiepileptic strategy in an otherwise medically resistant disorder. Coupled with its relatively low side-effect profile compared with other antiepileptic drugs, the emerging data supporting efficacy of CBD in treatment-resistant epilepsies holds great promise for improved therapy of these devastating diseases.'
http://www.pnas.org/content/114/42/11229

'Corresponding author and academic director of the Lambert Initiative, Professor Iain McGregor, said: "Although the iillicit extracts we analyzed contained low doses of CBD, three in four were reported as 'effective', indicating the importance of researching the cannabis plant in its entirety for the treatment of epilepsy.'
https://www.news-medical.net/news/20180705/Research-sheds-light-on-composition-of-cannabis-used-to-treat-children-with-epilepsy.aspx

'Pediatric epilepsy has a major impact on the quality of life for patients and their families. Interest in the use of cannabis as a treatment for pediatric epilepsy and, in particular, for treatment-resistant epilepsy has grown over the last decade, driven in part by media reports of children whose treatment-resistant epilepsy has responded to cannabis after the failure of conventional treatments. This living systematic review will provide a comprehensive summary of the current evidence for the use of cannabis for the treatment of pediatric epilepsy and will incorporate new evidence as it becomes available. The results will be of use to decision-makers, including parents of affected children, clinicians, and policy makers.'
https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0761-2

'Recent research has suggested that THC-containing cannabis oil might be superior to CBD-only preparations in reducing seizures, but there has been concern about how kids would tolerate such a treatment.

This study found that most of the children saw a significant drop in their seizures after taking the drug for several weeks, with none of their caregivers reporting the kids developed any hallucinatory effects'
https://www.ctvnews.ca/health/cannabis-oil-with-thc-may-help-treat-kids-with-severe-epilepsy-1.4035970

'Heather Benton moved her family to Colorado to legally get the THCa patches she believed were helping reduce her daughter Addyson's 100-times-a-day seizures. They came back after Ohio's medical marijuana program was announced more than two years ago. But they’re still waiting.'
https://www.wcpo.com/news/local-news/hamilton-county/cincinnati/ohio-missing-starting-date-for-selling-medicinal-marijuana

'Eleven of the participants are under age 19. The patients who saw the greatest improvement suffer from two of the hardest-to-treat forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, Kratochvil said. People with the potentially fatal disorders can experience many severe seizures every day.'
https://www.omaha.com/livewellnebraska/health/majority-of-epilepsy-patients-in-unmc-cannabidiol-trial-have-seen/article_bb88ae31-ca59-57be-897f-0ced4ea30da5.html

'Currently, only Texans diagnosed with "intractable epilepsy" are allowed to use cannabis that contains low levels of the psychoactive ingredient tetrahydrocannabinol, or THC. Menéndez's bill would dramatically expand this law by legalizing medical marijuana for Texans with certain other debilitating conditions, including cancer, glaucoma, HIV, Alzheimer's, PTSD, autism or chronic pain, nausea and muscle spasms'
https://www.dallasnews.com/news/texas-legislature/2019/01/03/texas-marijuana-advocates-get-fired-decriminalize-pot-2019

'Voters approved a constitutional amendment in November allowing medical marijuana in Missouri.

The measure allows patients with cancer, HIV, epilepsy and other conditions access to marijuana. It also permits use by veterans suffering from post-traumatic stress disorder.'
https://mjbizdaily.com/missouri-to-start-taking-medical-marijuana-business-application-fees-jan-5/

The 21 qualifying conditions for medical marijuana in Ohio includes epilepsy or another brain-seizure disorder

'The Enquirer set out to determine how many Ohioans could be eligible for medical marijuana under the 21 qualifying conditions from the Ohio Department of Health, the U.S. Centers for Disease Control and Prevention and private nonprofits that raise money for medical research. For many diseases, the numbers of patients are estimates, since the government does not track patient counts for every ailment. The conclusion: About 3.5 million Ohioans deal with at least one of the qualifying conditions. Ohio's population is 11.66 million'
https://www.cincinnati.com/story/news/2018/07/18/3-10-ohioans-eligible-medical-marijuana-card/784017002/

Minnesota's list of qualifying conditions for medical marijuana includes seizures

Pennsylvania's list of medical conditions qualifying for medical marijuana includes epilepsy and intractable seizures.

'In particular, I would really love to see anxiety, depression and ADHD added,” Spaar said.'
https://triblive.com/state/pennsylvania/14367032-74/pennsylvania-to-consider-more-conditions-that-should-qualify-for-medical-marijuana

'In the US, 28 states plus Washington DC have legalised medical marijuana in some form. An analysis has shown that compared with other states, those regions spent less money on prescriptions through Medicaid – the healthcare programme for people on low incomes – for five conditions sometimes treated with cannabis between 2007 and 2014. These conditions were pain, depression, nausea, psychosis and seizures.'

'When we reviewed its medical uses in 1993 after examining many patients and case histories, we were able to list the following: nausea and vomiting in cancer chemotherapy, the weight loss syndrome of AIDS, glaucoma, epilepsy, muscle spasms and chronic pain in multiple sclerosis, quadriplegia and other spastic disorders, migraine, severe pruritus, depression, and other mood disorders. Since then we have identified more than a dozen others, including asthma, insomnia, dystonia, scleroderma, Crohn’s disease, diabetic gastroparesis, and terminal illness. The list is not exhaustive.'
http://rxmarijuana.com/old_medicine.htm

'Recently, it (marijuana) has been successfully utilized as an adjunctive treatment for malignant brain tumors, Parkinson's disease (PD), Alzheimer's disease (AD), multiple sclerosis (MS), neuropathic pain, and the childhood seizure disorders, Lennox-Gastaut and Dravet syndromes. In this review, we provide animal/human research data on the current clinical/neurological uses for CBD alone or with Delta9-THC, emphasizing its neuroprotective, antiinflammatory, and immunomodulatory benefits when applied to various clinical situations.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938896/

'Under a law passed in 2015 and tweaked twice since then, Louisiana is allowing therapeutic cannabis to treat a long list of diseases and disorders, such as cancer, a severe form of cerebral palsy, seizure disorders, epilepsy and muscular dystrophy. Earlier this year, lawmakers added glaucoma, severe muscle spasms, intractable pain, post-traumatic stress disorder and Parkinson’s disease.'
https://apnews.com/89637c7abda94107a41f70c6ab1c044f

'Under the new rules, those suffering chronic pain, severe epilepsy or nausea as a result of chemotherapy could be prescribed the drug by specialist doctors, this newspaper understands.'
https://www.telegraph.co.uk/politics/2018/10/06/medical-cannabis-available-prescription-within-month/

'In conclusion, the experimental and clinical use of CBD, a compound that does not produce the typical subjective effects of marijuana induced by delta9-THC, has clearly shown anxiolytic, antiepileptic, and antipsychotic properties, among other effects. Since the 1970s, a number of scientific articles showing the potential therapeutic effects of CBD in different animal models of neuropsychiatric disorders and some clinical trials have been published. Recent investigations on the new effects of CBD and its synthetic analogs and on the comprehension of the mechanisms of action of this compounds as well as a better understanding of the endocannabinoid system have emerged.'
https://www.frontiersin.org/articles/10.3389/fimmu.2018.02009/full

'GW Pharmaceuticals plc (Nasdaq: GWPH, AIM: “GWP,” GW,” “the Company” or “the Group”), a biopharmaceutical company focused on discovering, developing and commercializing novel therapeutics from its proprietary cannabinoid product platform, announces positive top-line results of the second randomized, double-blind, placebo-controlled Phase 3 clinical trial of EPIDIOLEX® (cannabidiol or CBD) CV in the treatment of seizures associated with Dravet syndrome, a rare and severe form of childhood-onset epilepsy.'
http://ir.gwpharm.com/news-releases/news-release-details/gw-pharmaceuticals-announces-second-positive-phase-3-pivotal-0

'GW Pharmaceuticals is setting out to sell $300 million worth of U.S. depository shares. The London-based company’s announcement comes on the heels of the U.S. Drug Enforcement Administration’s move to take some cannabidiol products off the most restrictive class of controlled substances.

That change will allow Epidiolex – a CBD drug manufactured by GW Pharmaceuticals to treat rare types of epilepsy – to be distributed through traditional pharmaceutical channels via doctors’ prescriptions rather than medical marijuana dispensaries.'
https://mjbizdaily.com/cbd-drugmaker-gw-pharmaceuticals-poised-to-raise-300-million-with-stock-offering/

'More than 17 countries permit the medicinal use of cannabis, but the UK is not one of them. Cases of children with severe epilepsy who have seen benefit with cannabinoid derivatives from the cannabis plant but cannot access the medication have reignited the debate over medicinal cannabis.'
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31611-8/fulltext

'"Nembies": after the phrase, "to take the edge off," Burroughs first draft glossary continued; "Sometimes injected intravenously. If you miss the vein you will surely get an abcess. Barbiturates are more dangerous than junk because a user of barbiturates - eight or more capsules per day - gets the horrors when he is cut off barbiturates, and he is subject to epileptic fits with frequent head injury from flopping around on concrete floors. He is most likely to find himself cut off in a place where the floors are concrete." - Junky, William S Burroughs, 1977, originally published in 1953

'There is a strong biological rationale regarding how cannabis-derived medications could affect tic severity. Anecdotal case reports and series have noted that many patients report that their tics improve after using cannabis. However, only two small randomized, placebo-controlled trials of delta9-tetrahydrocannabinol have been published; these suggested possible benefits of cannabis-derived agents for the treatment of tics. Trials examining other agents active on the cannabinoid system for tic disorders are currently ongoing. Cannabinoid-based treatments are a promising avenue of new research for medications that may help the Tourette syndrome population. However, given the limited research available, the overall efficacy and safety of cannabinoid-based treatments is largely unknown. Further trials are needed to examine dosing, active ingredients, and optimal mode of administration of cannabis-derived compounds, assuming initial trials suggest efficacy. '
https://link.springer.com/article/10.1007%2Fs40263-019-00627-1

'“The evidence described in the present systematic review indicates that CBD is a promising adjunct therapy for the treatment of cocaine dependence due to its effect on cocaine consumption, brain reward, anxiety, related contextual memories, neuroadaptations and hepatic protection as well as its anticonvulsant effect and safety,” the study authors concluded.

“The clinical administration of CBD leads to a reduction in the self-administration of cocaine and, consequently, the amount of the drug consumed. Moreover, the reward induced by cocaine is blunted by CBD treatment.”'
https://www.marijuanamoment.net/cbd-is-a-promising-therapy-in-treating-cocaine-misuse-meta-study-finds/