A group of Australian clinical experts have developed consensus advice about medical cannabis recommendations for patients living with epilepsy. Epileptologists, clinical pharmacists, pharmacologists, and cannabis researchers compiled data to help clinicians decide how and when to recommend cannabis products. The advice was published in the British Journal of Clinical Pharmacology in an effort to establish guidelines for supporting patient-doctor discussions about cannabinoid treatments, dosing, potential drug interactions, and seizure management efficacy.
Many epilepsy patients are interested in trying medical cannabis for different reasons. Some patients find that traditional Anti- Epileptic Drugs (AEDs) such as keppra, clobazam and lamotrigine do not effectively control seizures, or they cause severe side effects such as depression, lethargy, increased heart rate, and mood swings.
The consensus advice provides a critical foundation for establishing the most effective treatment plans. Treatments should take into consideration age, weight, seizure frequency, and other health factors in order to identify the most effective CBD:THC ratios for an individual. Studies have shown that high CBD and low THC products reduce seizure activity and increase seizure threshold, so many clinicians recommend starting with small doses of high cannabidiol (CBD), low tetrahydrocannabinol (THC) for children with severe, intractable forms of epilepsy like Dravet Syndrome and Lennox-Gastaut Syndrome. In studies comparing seizure control efficacy of full spectrum cannabis oil and Epidiolex (a purified CBD isolate FDA-approved for intractable childhood epilepsy), full spectrum oil proved to be more effective in reducing seizures.
This consensus advice will be updated as more research studies on cannabis-based epilepsy treatments are conducted. Senior study author Jennifer Martin explains the importance of these guidelines for the epilepsy community: “In the absence of a registration dossier, scientific experiments and case reports are helpful to provide some guidance to optimized dosing.” The consensus advice will play a critical role in advancing medical care and quality of life for many epilepsy patients.