Use of Marijuana for Epilepsy Control

A brain disorder in which a person has repeated seizures (convulsions) over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. There are different types of epilepsy and seizures. Epilepsy drugs are prescribed to control seizures, and rarely surgery is necessary if medications are ineffective.

Seizure activity associated with epilepsy is many times classified as either, 'partial seizures,' or, 'generalized seizures.' Partial seizures are more common and begin in an isolated part of a person's brain. Partial seizures may be described as either simple or complex. When a simple partial seizure happens, the person retains consciousness. They might experience uncontrollable twitching, or stiffening in a limb. They may experience a tingling sensation, an odd smell without a source, or a change in consciousness. The sensations that might warn them of an impending event are called an, 'aura.'

Complex partial seizures cause impairment of a person's consciousness. During this form of seizure, a person might act aimless, confused, disturbed or emotional. The person is likely to have no memory of the event once it has ended. A simple partial seizure has the potential to progress to a complex partial seizure and then become a generalized seizure as the electrical discharge spreads to their entire brain.

About This Image: Chart showing common epilepsy medications Generalized seizures involve discharges or misfiring in all regions of a person's brain and result in impairment of consciousness. The person's behavior during generalized seizures may range from a blank stare with little to no movement referred to as, 'petit mal,' or, 'absence,' seizures to dramatic body convulsions referred to as, 'gran mal seizures.' During convulsions, the person might experience difficulties with breathing and turn blue in color. They might bite their tongue, or lose control of continence. When the person regains consciousness they do not remember what happened and tend to be very sleepy. Epilepsy is usually treated with a class of medications called, 'anticonvulsants.' Standard medications in this class include:

• Phenytion
• Primidone
• Clonazepam
• Valproic acid
• Ethosuximide
• Phenobarbital
• Carbamazepine

About This Image: Chart showing potential side-effects of epilepsy medications Newer medications may appear on the market, but there is less experience with using them. Doctors prescribe anticonvulsants according to the form of seizures a person experiences and by how well the person is able to tolerate a particular medication. A number of people have a poor response to these types of medications, even when taken in combination. Along with issues associated with effectiveness, there may be serious side-effects as a result of using anticonvulsants. While the side-effects do not always happen they may include:

• Nausea
• Sedation
• Hirsutism
• Irritability
• Impotence
• Headaches
• Depression
• Loss of hair
• Liver failure
• Weight gain
• Hyperactivity
• Unsteadiness
• Double vision
• Swollen gums
• Mood changes
• Slurred speech
• Gum dysplasia
• Poor coordination
• Sleep disturbances
• Depressed blood counts

Marijuana Use for Epilepsy

Some people who experience gran mal seizures state they can prevent seizures entirely by smoking marijuana. Other people, who experience complex partial seizures, say that marijuana also curbs the symptoms they experience and prevents loss of consciousness. Some people find that marijuana works along with other drugs they take. Still others find that marijuana works best for them when it is used without other drugs. People with epilepsy have made marijuana a part of their medical treatment.

People who use marijuana to control epilepsy need to be aware that withdrawal from any medication that controls seizures may leave them more susceptible to seizures; marijuana is not an exception. People with epilepsy are advised to use caution when using oral THC because there is not enough knowledge about the convulsive or anti-convulsive properties of the single compound.

The anticonvulsant properties of marijuana might be the oldest of its known medical benefits. Marijuana was used as a medicine for epilepsy by people in ancient societies in Africa, India, China, Rome and Greece. Written testimonies of marijuana's usefulness appeared in Western scientific journals in the 19th century.

Contradictory data concerning marijuana having both convulsive and anticonvulsive effects has been presented. Throughout the mid-1970's and early 1980's, Dr. Paul Consroe of the University of Arizona conducted several studies using both THC and CBD on animals. He discovered that while high doses of THC may trigger convulsions in animals susceptible to seizures, the administration of cannabidiol (CBD) in similar or higher doses does not cause convulsions.

The studies he performed concluded that CBD may have powerful anticonvulsant properties that counteract the muscle-exciting effects of THC when both compounds are delivered to the body in marijuana. Small studies involving cannabidiol alone; however, did not yield consistently favorable results. What this might point to is that the safest way to treat epilepsy with marijuana is to use all of its compounds together through smoking the plant instead of ingesting its separate ingredients.

Prior Studies Regarding Marijuana and Epilepsy

Even though the anticonvulsant properties of cannabis have been known since ancient times and were explored during the nineteenth century, the therapeutic use of marijuana has remained largely ignored for the past 100 years. While the medical establishment continues to show little interest, an increasing number of people with epilepsy are finding marijuana to be useful.

A report from 1975, published in the Journal of the American Medical Association, found a 24-year old person who smoked marijuana controlled seizures when combined with conventional anticonvulsive medication. The person had experienced incomplete control of his seizures on a regimen of anticonvulsant medications which included phenytoin and phenobarbital. The person complained of gran mal seizures as often as every 2 months. At the age of 22, he started smoking 2-5 marijuana cigarettes per day along with taking his regular medications. His doctors observed that his seizure activity ceased completely.

In the year 1980, a study appeared in Pharmacology. The study involved 16 people with epilepsy who experienced gran mal seizures who had not responded well to treatment with standard anticonvulsive medications. Each person was provided 200-300 milligrams of cannabidiol or a placebo along with their regular medications. Of the 8 people involved who received cannabidiol, 3 experienced complete improvement while 2 showed partial improvement. Two others show minor improvement and 1 remained unchanged. The only adverse side-effect was mild sedation. Of the 8 people who received placebos only 1 showed improvement. The other 7 people showed little to no improvement. The report concluded that cannabidiol in combination with standard anticonvulsive medications may be effective for controlling seizures associated with epilepsy in some people.

More recent tests by the United States military reported that rats protected by synthetic cannabinoids were 70% less likely to experience seizures and brain damage after exposure to nerve gas. Animal experiments provide evidence of the anticonvulsive effects of some cannabinoids. THC has potentiated the anticonvulsant activity of the drugs diazepam and phenytoin. According to a few case reports from the past few decades, some people with epilepsy continue to use marijuana to control and otherwise unmanageable seizure disorder. In contrast to THC, there is no development of tolerance to the anticonvulsive effects of CBD.

Seizures associated with epilepsy are many times controlled through medication therapy. Generally, medications can control seizure activity in around 70% of people, yet that leaves 30% of people with epilepsy without relief. In addition, traditional medications for epilepsy present side-effects. A number of people with epilepsy and other seizure disorders have found relief from medical marijuana, taken on its own or along with other medications for epilepsy. Some people with epilepsy who are unable to tolerate anti-seizure medications have been able to use marijuana with success. In addition, medical marijuana is highly effective in controlling seizures associated with epilepsy without side-effects found in traditional medications used to treat epilepsy. The side-effects related to marijuana are commonly mild and are classified as being, 'low-risk,' with, 'euphoric mood changes,' being among the most frequently experienced side-effects.

Epilepsy is often treated with benzodiazepines, barbiturates, and other powerful anti-seizure medications that find people unable to pursue the activities they wish to. Prescription anticonvulsants are not effective for approximately 20-30% of people with epilepsy. A number of people experience complications that are intolerable or even fatal from standard medications. Some people with epilepsy find that marijuana controls seizures without causing the psychological and physical depression common to pharmaceutical therapies.

Animal studies indicate that several cannabinoids not found in the synthetic THC pill have notable anticonvulsive properties. CBD, one of several medicinal compounds not available by prescription, has demonstrated the ability to control partial seizures. Marijuana is the only source of CBD and other cannabinoids that may help control seizures.