Amid growing global support for medical cannabis, an increasing number of countries and states have approved the use of a non-psychoactive cannabinoid called cannabidiol (CBD) to treat childhood epilepsy. However, a new study in the journal Drug Science, Policy and Law indicates that full-spectrum cannabis medications containing the psychoactive cannabinoid tetrahydrocannabinol (THC) may be more effective at reducing the frequency and severity of seizures.
Cannabis' potential to treat childhood epilepsy began to gain widespread attention in 2011, when a new cannabis strain called Charlotte’s Web was developed as a medication for young girl named Charlotte Figi, who suffered from a rare form of epilepsy called Dravet syndrome. Containing mostly CBD and only trace amounts of THC, this new cannabis variety put a halt to Charlotte’s relentless seizures, which had previously occurred around once every 30 minutes.
Subsequently, a number of countries authorized the use of pure CBD as a treatment for various forms of childhood epilepsy, yet many researchers argue that the entire cannabis plant – rather than just an isolated cannabinoid – is required in order to produce a therapeutic outcome. According to this theory, the plant’s medicinal properties stem from the so-called ‘entourage effect’ that arises from the interaction between the many cannabinoids and terpenes present in cannabis.
To test this theory, the authors of the new study enrolled ten UK-based patients, all of whom suffered from some form of childhood-onset epilepsy and had failed to respond to conventional medications. Currently, the British government only allows pure CBD, but not full-spectrum cannabis extracts, as a treatment for such conditions. Four of the study participants had already tried CBD, with no success.
Full-spectrum cannabis extracts were given to each participant, with some receiving a medication containing 14 percent THC and less than one percent CBD, while others were given cannabis that consisted of nine percent CBD and less than one percent THC. Total daily doses of THC ranged from 6.6 to 26.5 milligrams, while daily CBD intake varied between 200 and 550 milligrams.
Prior to treatment, participants suffered between 37.5 and 18,000 seizures a month, yet this dropped to between zero and 750 monthly seizures once these medical cannabis products were administered – a reduction of 97 percent. According to their carers, patients also experienced significant improvements in cognitive ability, emotional regulation, panic attacks and sleep, while no negative side effects were reported.
In the UK, legislation that came into force in November 2018 allows clinicians to prescribe non-approved cannabis products where they see fit, yet the study authors report that only 20 such prescriptions have been awarded in the past two years. Meanwhile, a national survey conducted by the Centre for Medical Cannabis revealed that around 72,000 epilepsy sufferers in the UK are currently self-medicating with black-market cannabis.
Based on this data, the study authors call on the authorities to expand access to full-spectrum cannabis medications through the National Health Service.
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