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July 23, 2015: Cannabidiol in the Treatment of Epilepsy

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July 23, 2015

Cannabidiol in the Treatment of Epilepsy

The use of cannabis in medicine has garnered significant media attention. There is increasing anectodotal evidence for the use of cannabidiol (CBD), a nonpsychoactive component of cannabis in the treatment of medically refractory epilepsy. CBD acts on the cannabinoid receptors CB1/CB2, though its effect in epilepsy is likely related to its interaction with several additional channels and g-protein receptors including TRPV1 and TRPA1 with subsequent modulation of neuronal hyperexcitability1, 2. Preclinical data has demonstrated an anticonvulsant and antiepileptiform effect of CBD1, though systematic clinical studies examining its efficacy and side effects are lacking2. There are several clinical trials with anticipated enrollment beginning in early 2015 evaluating the use of CBD. These include randomized, double-blinded, placebo controlled trials investigating a 14 week course of CBD in children and young adults ages 2-18 years with medically refractory Dravet syndrome and separately, in children and adults ages 2 -55 years with medically refractory Lennox-Gastaut syndrome 1.

References

  1. Devinsky O, Cilio MR, Cross H, et al. Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia 2014; 55: 791-802.
  2. Szaflaraski JP, Bebin EM. Cannabis, cannabidiol, and epilepsy - from receptors to clinical response. Epilepsy & Behavior 2014; 41: 277-282.

Submitted by Adam Numis MD, University of California, Los Angeles.

Disclosures: Dr. Numis is a member of the Residents & Fellows Section of Neurology.

For more clinical pearls and other articles of interest to neurology trainees, visit Neurology. Listen to this week's Neurology Podcast.

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