medical marijuana for child seizures

Using medical marijuana to stop seizures in kids

Desperate for relief, parents are taking unusual steps to help children plagued with seizures. The relief, however, comes in a most unlikely form: marijuana.

As many as 30 percent of people with epilepsy — or about one million Americans — still have seizures while on Food and Drug Administration (FDA)-approved treatments. It’s left many who suffer from uncontrollable seizures — or their parents, as many of them are children — turning to medical marijuana and its derivatives in an attempt to take back control of a disease with no cure.

A seizure is an abnormal electrical storm in the brain that causes sudden alteration in consciousness, sensation and behavior that can manifest from an eye flicker to full-body convulsions. People with medication-resistant (also called intractable) epilepsy suffer from consequences of recurrent seizures, which could damage the brain and adversely impact their quality of life. This is commonly observed in children with certain types of devastating pediatric epilepsy, such as Lennox-Gastaut, Doose and Dravet syndromes.

Stories about desperate parents seeking anything to relieve their children’s seizures abound, but how much scientific evidence is there for cannabis’ effectiveness?

D. Samba Reddy, Ph.D., R.Ph., professor in the Department of Neuroscience and Experimental Therapeutics at the Texas A&M Health Science Center College of Medicine, studies novel therapies for epilepsy. He recently published an article, with co-author Victoria Golub, in the Journal of Pharmacology and Experimental Therapeutics about the current state of research into medical marijuana for treating epilepsy.

“There was a lot of media attention about how medical marijuana is good for epilepsy,” said Reddy, who is a fellow of both the American Association of Pharmaceutical Scientists (AAPS) and the American Association for the Advancement of Science (AAAS). “We became interested in finding out whether there was scientific evidence in the literature to support the claims of these people who have seen great benefits.”

There are at least 85 active components of the plant colloquially known as marijuana, but two major ones of have been the focus of study: delta 9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the psychoactive component of the plant, while CBD doesn’t cause any sort of a “high” and isn’t thought to be addictive. Preliminary studies — largely in animal models — have shown CBD might have some anti-seizure potential.

Derivatives of marijuana high in CBD (but with negligible amount of THC) might offer some benefit for intractable epilepsy. CBD-enriched products, like Epidiolex and Realm Oil, exist, but their efficacy hasn’t been proven and they exist in a sort of legal grey area. Homemade compounds exist, but since they don’t go through rigorous best practice manufacturing procedures and haven’t been approved by the FDA, it can be difficult for consumers to know exactly what they’re getting.

Although THC is known to share the actions of anandamide (from the Indian Sanskrit word “anand” for bliss or happiness), a naturally occurring compound in the brain, the exact mode of anti-seizure action of CBD is unclear. “It is critical to know how CBD controls seizures, so pharmaceutical companies can design novel synthetic compounds for epilepsy that could surpass the hurdles of mixed CBD extracts,” said Reddy, who directs an epilepsy research lab at Texas A&M. These compounds might provide the benefits without some of the risks — or the legal issues — associated with the marijuana plant.

A standard manufacturing process and clinical trials might help answer some of these questions, but conducting one isn’t easy, and there are currently only 19 clinical trials going on to test the use of cannabinoids for epilepsy. For one thing, cannabis is still listed as a Schedule I substance by the federal government, meaning gaining permission to use it in research on human participants is extremely difficult.

Still, change is occurring at the state level. Recreational marijuana use is legal for adults in four states (Alaska, Colorado, Oregon and Washington) and in 23 states and Washington, DC, medical marijuana is allowed. Texas, in a law passed during the last legislative session in 2015, legalized low-THC cannabis oils for people with intractable epilepsy while still prohibiting medical marijuana more broadly.

A new study at the University of Colorado Anschutz Medical Campus is enrolling Dravet epilepsy patients who have tried Charlotte’s Web, a specific strain of medical marijuana that is low in THC and high in CBD. The researchers will compare the genetics of those who have seen seizure activity decreased dramatically (at least 50 percent) in response to the drug versus those who did not. Although this research could yield useful information about how CBD and genetic factors interact in a Dravet population, it is not the gold standard of scientific drug trials: the randomized, placebo-controlled, double-blinded clinical trial in which patients were randomly assigned to either CBD or a placebo.

As for experts like Reddy, who is a Texas board-certified pharmacist, most are taking a cautious wait-and-see approach.

The American Epilepsy Society (AES) has released a statement on the use of medical marijuana in the treatment of epilepsy stating that due to the lack of data, no conclusion can be drawn at present.

The Epilepsy Foundation doesn’t specifically discourage cannabis use, but urges anyone exploring treatment for epilepsy to work with their treating physician to make the best decisions for their own care and to follow applicable laws.

“Despite all of the controversy about medical marijuana as a potential therapy for epilepsy,” Reddy said, “most people agree that what we need is greater rigorous scientific study into cannabinoids to prove or disprove their safety and efficacy.”

Desperate for relief, parents are taking unusual steps to help children plagued with seizures. The relief, however, comes in a most unlikely form: marijuana.

Marijuana Can Help Children with Seizures, Cancer Nausea

Researchers said medical marijuana is effective in treating some conditions in children, but they urge caution on using the drug in young patients.

Should kids and adolescents ever use medical marijuana?

Administering the drug to younger patients remains somewhat contentious, but it also appears effective in treating a limited number of symptoms.

According to a new study published today in the journal Pediatrics, medical marijuana is effective in treating seizures and chemotherapy-induced nausea in young patients.

Researchers conducted a meta-analysis, looking at 22 relevant studies on the use of medical cannabis on children and adolescents to reach this conclusion.

Of the many chemical components found in marijuana, researchers determined that tetrahydrocannabinol (THC), the most abundant cannabinoid found in the plant, improved nausea and vomiting for young chemotherapy patients.

Cannabidiol (CBD) another cannabinoid present in marijuana was determined to have an effect on seizures.

Some advocates have hailed these results as further proof of the effectiveness of medical marijuana, particularly in cases where children haven’t responded to other traditional treatments.

“The real-world results of these programs indicate that cannabinoids can play a role in pediatric care, particularly in the treatment of life-threatening seizures, and that they can do so in a manner that is sometimes safer and more effective than conventional treatments,” Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws (NORML), told Healthline.

While treatment for the above conditions using medical marijuana seems promising, the review concludes there’s little evidence to support its effectiveness in treating a wide range of other conditions in young people.

Researchers wrote that they didn’t find sufficient support for the benefits of medical marijuana on neuropathic pain, posttraumatic stress disorder, or Tourette’s syndrome in young patients.

Other health organizations have previously issued warnings on the use of medical marijuana (and recreational marijuana) in children and adolescents due to the risks it represents.

The American Academy of Pediatrics (AAP) previously warned parents about these dangers, which they say include weakened motor skill control and memory function, as well as mental health issues, including depression.

“Our research supports the AAP’s concerns that cannabis can be harmful to children’s brains,” said Dr. Shane Shucheng Wong of Harvard’s department of psychiatry and a lead study author. “Studies of children and adolescents who use recreational cannabis, particularly frequent use of high potency cannabis over longer periods of time, suggest negative effects on learning, memory, attention, and problem-solving ability.”

As such, appropriate dosing of medical marijuana is of the utmost importance for younger patients.

Currently there are only two synthesized cannabinoids that are approved by the Food and Drug Administration (FDA) as medications: dronabinol and nabilone.

Both are used to treat nausea and vomiting in children and adults.

AAP guidelines recognize the use of these two approved drugs in order to treat those conditions.

“The academy’s guidelines also recognizes cannabis may be an option for debilitating conditions, which includes seizures from epilepsy conditions,” said Wong.

The study authors warn that the use of the drugs in pediatric cases must be judicious because of the potential of psychoactive effects.

Naturally-derived cannabis — the actual components of the plant, including flowers and leaves — that are typically smoked or vaporized can have wildly varying chemical components and potency depending on the strain.

The same is true for marijuana concentrates and edible products.

The varying potency and chemical makeup of these products can make consistent, appropriate dosing more challenging in young patients.

To ensure oversight and appropriate usage, all states with medical marijuana programs require consent forms from a legal guardian and a physician to give kids access to medical marijuana.

Some states require the guardian to control dosage and frequency of use, but others do not.

As another safeguard, some states require two physicians to sign off on a minor using medical marijuana.

Researchers said medical marijuana is effective in treating some conditions in children, but they urge caution on using the drug in young patients.