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September 17, 2015: Cannabis in epilepsy

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September 17, 2015

Cannabis in epilepsy

Cannabis has long been used to manage medical conditions such as inflammatory conditions, pain, gout, menstrual disorders, and epilepsy. More recently, it has gained a resurgence of interest with its potential use in “medical marijuana” and management of refractory epilepsies. There are two main components of Cannabis, tetrohydrocannabinol (THC) and cannabidiol (CBD). CBD is felt to have nonpsychotropic properties as it does not bind to the CB1 and CB2 receptors, as THC does. In fact, CBD can counteract the psychotropic effects of THC in some preparations. In vivo and in vitro studies have demonstrated improved seizure control with preparations of CBD, although specific formulations, dosing and routes of administration were not consistent amongst studies. Current preparations of “medical marijuana” aim to have a high CBD: THC ratio, limiting the psychotropic effects of the substance.

References

  1. Devinsky O, Cilio MR, Cross H et al. Cannabidiol: Pharmacology and potential therapeutic rolein epilepsy and other neuropsychiatric disorders. Epilepsia 2014. 55: 791-802.

Submitted by James Addington, M.D. Resident Physician, Department of Neurology, University of Virginia.

Disclosures: Dr. Addington 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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