About 1% of children in the U.S. have epilepsy; if untreated, seizures can lead to cognitive limitations, depression, and even death. More than 20 antiepileptic drugs (AEDs) are on the market for epilepsy, yet 30% of people with epilepsy continue to have seizures. Worse, the side effects of many of these drugs can seriously compromise the central nervous system and quality of life. Non-psychoactive marijuana extracts, including British-made Epidiolex, cause fewer side effects and are generally well-tolerated. That means kids with epilepsy can take marijuana derivatives for epilepsy without experiencing the sensation of being “high”.
Cannabidiol (CBD) and cannabidivarin (CBDV) are two of the most researched chemical compounds in marijuana purported to reduce severity and frequency of epileptic seizures. Unlike tetrahydrocannabinol (THC), these compounds don’t have psychoactive properties; in other words, you can’t get high from CBD or CBDV. Evidence from animal studies, anecdotal reports dating back thousands of years, and a handful of preclinical and clinical studies on humans support their effectiveness. So far, over 12 states have legalized the use of marijuana and its derivatives to treat certain medical conditions, including epilepsy, and 9 more are considering the measure. Parents are particularly hopeful about cannabis extracts to treat childhood forms of epilepsy that don’t respond well to existing AEDs; these include Dravet syndrome, a rare but brutal and intractable form of epilepsy that begins in infancy, and Lennox-Gastaut syndrome, a psychologically and developmentally debilitating childhood-onset form of epilepsy that consists of multiple types of seizures.
However, experts agree that rigorous placebo-controlled studies on humans are too slim to draw definitive conclusions. Neurologist and epilepsy specialist Dr. Daniel Friedman, who performed a major human clinical trial for treating seizures using cannabinoids at the NYU Comprehensive Epilepsy Center, says, “Right now, the evidence for the utility of cannabinoids, and particularly cannabidiol, for the treatment of severe epilepsy is intriguing, but the definitive proof is not there yet.” Friedman adds that our knowledge of the short- and long-term side effects of CBD or CBDV on the developing brain of a child, as with other anticonvulsants, is largely unknown. Most data regarding the safety of cannabinoids come from studies of recreational use of cannabis; Friedman reports short-term side effects include impaired memory, judgment, and motor performance, while long-term side effects consist of impairment of cognitive function and motivation levels and an increased risk of psychotic disorders, as well as addiction, which occurs in 9% of long-term cannabis users.
More information should emerge from ongoing animal and human trials. In 2015, the U.S. Food and Drug Administration (FDA) approved clinical trials testing Epidiolex’s efficacy at 10 epilepsy treatment centers in the U.S. and others around the world. Further, FDA has permitted compassionate-use waivers for epileptic children who have not responded to existing therapies. About 2 out of 5 of those patients report about a 50% reduction in frequency of major seizures, and some became seizure-free.