Cannabinoids and Epilepsy.
Cannabis has been used for centuries to treat seizures. Recent anecdotal reports, accumulating animal model data, and mechanistic insights have raised interest in cannabis-based antiepileptic therapies. In this study, we review current understanding of the endocannabinoid system, characterize the pro- and anticonvulsive effects of cannabinoids [e.g., Δ9-tetrahydrocannabinol and cannabidiol (CBD)], and highlight scientific evidence from pre-clinical and clinical trials of cannabinoids in epilepsy. These studies suggest that CBD avoids the psychoactive effects of the endocannabinoid system to provide a well-tolerated, promising therapeutic for the treatment of seizures, while whole-plant cannabis can both contribute to and reduce seizures. Finally, we discuss results from a new multicenter, open-label study using CBD in a population with treatment-resistant epilepsy. In all, we seek to evaluate our current understanding of cannabinoids in epilepsy and guide future basic science and clinical studies.
Department of Neuroscience and Physiology, Neuroscience Institute, NYU Langone Medical Center, New York, NY, 10016, USA.
Evan C
EC
Rosenberg
Department of Neuroscience and Physiology, Neuroscience Institute, NYU Langone Medical Center, New York, NY, 10016, USA.
Richard W
RW
Tsien
School of Pharmacy, The University of Reading, Whiteknights, Reading, RG6 6AP, UK.
Benjamin J
BJ
Whalley
Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, New York, NY, 10016, UK. od4@nyu.edu.
Orrin
O
Devinsky
D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use*; D002186:Cannabinoids / Q000627:therapeutic use*; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans
D000927:Anticonvulsants; D002186:Cannabinoids
Epilepsy; THC; cannabidiol; cannabinoids; cannabis; seizures