Children With Epilepsy Have Fewer Seizures When Given Whole-plant Cannabis, Study Finds
Children with rare epilepsies experience fewer seizures when treated with whole-plant cannabis products, according to a recent trial.
Published in BMJ Paediatrics Open, the study involved 10 children who lived with a range of epilepsies, including Dravet’s syndrome, Doose syndrome, and West syndrome.
None of the children had responded well to conventional anti-epileptic drugs or the purified CBD medication Epidiolex in the past. Yet whole-plant cannabis – which includes CBD, THC, and other cannabinoids – reduced the rate of the children’s seizures by 86 percent, on average, in the trial.
The authors are now calling for further studies into the benefits of whole-plant cannabis medicines.
The full cannabis experience
It’s thought that around a third of epilepsy patients don’t respond to conventional anti-epileptic medications.
Cannabis-derived products have been suggested as alternative treatments, leading to the US Food and Drug Administration (FDA) and other national drug regulators to approve the CBD medication Epidiolex for the treatment of seizures associated with Dravet syndrome and Lennox-Gastaut syndrome.
But campaigners have argued that this CBD-focus limits the potential of cannabis-based medicines, as certain studies have found that other cannabinoids – such as cannabigerolic acid (CBGA) and cannabidivarinic acid (CBDVA) – can help reduce seizures, too.
So, to test the benefits of these cannabinoids and others, the researchers from Imperial College London and the independent research group Drug Science recruited 10 children with rare, refractory epilepsies. All were aged from between 1 and 13 (average age: 6.2) and most had been treated with at least 7 conventional anti-epilepsy drugs to no avail.
The children received whole-plant extracts either through private prescriptions (average cost of £874 a month) or the UK’s National Health Service (NHS). The families of the children were then asked to record the number of seizures their child experienced while on the medication from January 2021 to May 2021.
Once these data were analyzed, the researchers found that, on average, the monthly seizure rate for all 10 patients fell by 86 percent.
One child went from 2,800 seizures per month to 560; another went down from 600 seizures a month to none at all.
Parents and carers also reported significant improvements in the well-being of their children, including better sleep, eating, general behavior, and cognition. Only a few unwanted side effects, such as tiredness, were reported.
While the authors recognize the study’s limitations – there was no placebo control, for one, and the data from the parents and carers couldn’t be verified – they say that their findings still demonstrate the medical benefits of whole-plant cannabis products for the treatment of epilepsies.
“Moreover, our data suggest that whole-plant medical cannabis products are superior to isolated CBD products in the patients examined,” the authors wrote in their paper.
“We believe that our data on whole-plant medical cannabis in childhood-onset severe treatment-resistant epilepsy provides evidence to support its introduction into the NHS within current NICE [National Institute for Health and Care Excellence] prescribing guidelines,” the authors continued.
Cannabis and epilepsy
Reacting to the study, Jonathon Arnold, an assistant professor at the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney, remarked that the research, “suggests there is a population of patients who respond well to whole plant cannabis but not other conventional medications, including purified CBD.”
“We have recently reported that various molecules found in cannabis beyond CBD have anticonvulsant properties in preclinical models. It may be that these other components contribute to the anti-seizure effects observed in whole plant cannabis,” Arnold, who wasn’t involved in the study, said in a statement.
“Of course, a major limitation of this study is that it is only a retrospective case series and is not a [placebo] controlled study. It does, though, suggest a randomised placebo-controlled trial testing a whole plant cannabis product in intractable childhood epilepsy patients is warranted.”
While few randomized controlled trials have been carried out to assess how whole-plant cannabis products affect epileptic seizures, several have been conducted to test the effects of CBD.
Published last year in Acta Neurologica Scandinavica, a review of four randomized controlled trials found that add-on CBD effectively reduced seizure frequency in patients with Lennox-Gastaut syndrome and Dravet syndrome, irrespective of concurrent use of the anti-epileptic medication clobazam.
Another study, published this August in Epilepsy & Behavior, found that people with epilepsy who used commercial CBD products had a higher quality of life and less anxiety compared to their peers who didn’t use CBD.
However, many clinicians and researchers around the world remain concerned about the adverse events linked to many CBD and medical cannabis medications.
A recent paper from the Hebrew University of Jerusalem concluded that, while medical cannabis showed good promise in the treatment of seizures, high doses of CBD were still related to decreased appetites in children, fatigue, and feelings of apathy.
“Children aren’t small adults, medical cannabis affects kids differently, and doctors need to pay close attention to those differences,” Professor Ilan Matok, an author of the study, said in a statement at the time. “The goal of our meta-analysis is to shed light on this area and provide doctors and parents with a more informed view of the potential of cannabis to help or harm their young patients.”