CBD for Epilepsy – A Breakthrough Treatment? 

By  Dr. Mike Hansen

CBD for Epilepsy – Long before the CBD first came to millions of people’s attention worldwide due to the story of a little girl from Colorado who was suffering the most debilitating form of Epilepsy, called Dravet’s Syndrome. Charlotte Figi had her first seizure at 3 months and by the time she was 5 she was suffering 300 mal seizures a week. Her heart stopped several times; her parents at one point had signed off on medically-induced coma to give Charlotte’s little body a break and a “do not resuscitate order” in case anything went wrong. They were considering hospice care. Their daughter had ceased to talk; the only sounds they heard from her were her frequent falls and her crying.

Then CBD saved Charlotte’s life. Her father, Matt, a former Green Beret who’d been forced to leave the military due to his daughter’s condition, researched his daughter’s condition doggedly. He ran across a video of a boy in California with Dravet’s Syndrome who’d been treated successfully with a form of marijuana that was CBD heavy—a 30:1 CBD to THC ratio. He found growers in Colorado who had a similar strain, and a doctor who agreed to help convert the marijuana flower to oil and administer it to Charlotte.

The result was as striking as it was immediate. 

“When she didn’t have those three, four seizures that first hour, that was the first sign,” her mother, Paige told CNN. “And I thought well, ‘Let’s go another hour, this has got to be a fluke.”

The seizures stopped for another hour. And for the following seven days. Her seizures, over time, did not entirely disappear; they happened two to three times per month, mostly as she slept. Her doctor found the correct dosage: three to four milligrams of oil per pound of the girl’s body weight stopped the seizures.

“I literally see Charlotte’s brain making connections that haven’t been made in years,” her father, Matt, told CNN. “My thought now is, why were we the ones that had to go out and find this cure? This natural cure? How come a doctor didn’t know about this? How come they didn’t make me aware of this?”

CNN’s Dr. Sanjay Gupta made a documentary about Charlotte called Weed that reached an international audience in the tens of millions. Today Charlotte is 11 years old and 99.9 percent seizure-free. She is known as the girl who revolutionized the cannabis industry. Her story played a key role in destigmatizing CBD.

A handful of studies existed prior to Charlotte’s experience. In 1980, a small study in Brazil in which adult subjects took only 3 mg daily of CBD cured four of eight epilepsy patients of “convulsive crises” entirely, and reduced seizures among three others. In the late 1990s, scientists at the National Institutes of Health discovered that CBD held immense medical promise. In test tubes, CBD shielded neurons from oxidative stress, a damaging process common in many neurological disorders, including epilepsy.

Since Charlotte’s story brought attention to CBD’s use in treating epilepsy, science has fully caught up, documenting what her parents came to discover through extreme trial—CBD is remarkably effective at treating severe forms of childhood epilepsy.

A groundbreaking 2017 study published in the New England Journal of Medicine firmly established CBD’s effectiveness. The double-blind, placebo-control study tested 120 children and teenagers who suffered from Dravet’s Syndrome and drastically reduced their seizures

“This study clearly establishes cannabidiol as an effective anti-seizure drug for this disorder and this age group,” principal investigator Orrin Devinsky, director of the Comprehensive Epilepsy Center at New York University Langone Medical Center, told Scientific American. “It certainly deserves to be studied in other types of epilepsy. 

The form of CBD used in that study, a highly purified cannabidiol “oral solution” called Epidiolex, became the first CBD treatment approved by the FDA. In June 2018, Epidiolex became available by prescription in the United States to treat seizures associated with Dravet syndrome or Lennox-Gastaut syndrome (LGS) in patients aged 2 years or older.

Multiple studies have been remarkably consistent in their findings: low doses of CBD usually reduce seizures at least by half in children suffering from epilepsy. Most recently, in April of this year, a team of researchers at the American Academy of Neurology’s annual meeting announced another forthcoming major study with almost identical results.

“The children in this study had already tried an average of four epilepsy drugs with no success and at the time we’re taking an average of three additional drugs, so to have this measure of success with cannabidiol is a major victory,” said Dr. Ian Miller from the Nicklaus Children’s Hospital in Miami.

CBD for Epilepsy

What CBD is able to do for those suffering from epilepsy is becoming clearer with every subsequent study. How CBD is doing this, however, has many scientists beginning to believe that its therapeutic uses will be even more wide-ranging. This because CBD appears to interact with multiple systems within the human body, increasing our own cannabinoids,  stimulating the GABA receptors which calm the nervous system, and binding with serotonin receptors —  the very molecular structures targeted by the more conventional class of drugs, Select Serotonin Reuptake Inhibitors, generally used to treat depressive and anxiety disorders.

As the New York Times Magazine reported just this week in a cover story in its annual health issue, CBD has 65 cellular targets in the human body and thus “may provide a kind of full-body massage at the molecular level.”

Neuroscientist Yasmin Hurd told the Times that this “biochemical promiscuity” is one reason CBD seems so medically promising—rather than targeting one pathway or receptor, CBD seems to work more system-wide.  “The brain is about a symphony,” she said, noting that CBD appears to have the ability to “bring the entire symphony into harmony.”

Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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