A small UK study has found epileptic children treated with whole plant medicinal cannabis products displayed an 86 percent average reduction in seizure frequency. The researchers behind this series of case reports call for direct clinical trials to test whether whole plant cannabis oils are more effective at treating epilepsy than products solely containing cannabidiol (CBD).
In 2018 a CBD formulation called Epidiolex was approved by the US Food and Drug Administration (FDA) to treat severe forms of childhood-onset epilepsy. It was the first cannabis-derived medicine to be approved for any medical use in the United States.
For well over a century scientists have recognized cannabis to be an effective anticonvulsant, and more recent research has suggested CBD to be primarily responsible for those therapeutic benefits. But Epidiolex, and other CBD-focused products, haven’t always been effective in everyone and some researchers have speculated the therapeutic outcomes of cannabis to be influenced by the synergistic effect of hundreds of different distinctive compounds found in the plant.
This new research, published in the journal BMJ Pediatrics Open, reports on 10 case studies of children using whole plant cannabis extracts to treat severe epilepsy. Overall, the study found the children reported an 86 percent drop in seizure frequency using a variety of whole plant products.
It is important to note these findings are observational and retrospective. This study was not a controlled trial with a placebo group but instead it covers 10 separate case studies, all of which have unique case histories.
Two of the children in the study, for example, previously tried Epidiolex to control their seizures with no success. And a number of different whole plant cannabis extracts were utilized by the children in the study, all with varying CBD and THC concentrations.
The researchers also note there is little data on the chemical makeup of these whole plant products beyond THC and CBD concentrations. So it is unclear exactly what combination of other cannabis compounds could be playing a role in the therapeutic outcomes.
It is only recently that researchers have begun to investigate the myriad of unique chemicals in cannabis, from lesser known cannabinoids such as CBGA, to a unique class of compounds known as terpenes. The new study calls for more research into the therapeutic effects of these little known compounds.
The study also addresses the controversial topic of administering THC to children in a therapeutic context. The researchers note any potential deleterious effects in children from whole plant cannabis products must be weighed against the known adverse effects from many anti-epileptic drugs (AEDs).
“… adverse effects from AEDs are the leading cause of treatment discontinuation and after seizure frequency, the major determinant of impaired health-related quality of life in people suffering with epilepsy,” the researchers write. “Adverse events are commonly reported with AEDs with one such study reporting 1139 adverse drug reactions in 124 young people using anti-epileptic drugs while another study reported that behavioural problems and somnolence were the most common adverse drug reactions and that AED polytherapy significantly increase the likelihood of children developing such reactions.”
Jonathon Arnold, a cannabinoid researcher from the University of Sydney, says these new findings are promising. He notes his preclinical research has identified several molecules in cannabis with anticonvulsant properties and a clinical trial to explore whole plant cannabis products in intractable childhood epilepsy patients is certainly warranted.
“It may be that whole plant cannabis is effective in not only reducing seizures but assisting in behavioral and cognitive impairments,” says Arnold, who did not work on this new study. “That medicinal cannabis reduced the number of conventional anti-seizure medications used is promising but more data is needed."
The new study was published in the journal BMJ Pediatrics Open.
Source: BMJ
