CBD has now become a brand for itself with which various companies & firms are now trying to get associated to sell their products. As the benefits list keeps on increasing, more & more people are opting for CBD medication. Being a herbal extract that can be given to people of all age groups as well as animals, CBD has surely made a safeplace for itself where it is currently untouchable. The way things have progressed, benefits have been sought at a more increased rate & after the legalisation of one medicine from CBD named “epidiolex” as the only Schedule 5 Drug by the US Federal Drug AdminIstration in June 2018, CBD medication voices have found a good backup with it.
Epidiolex is used in treatment of Dravet Syndrome & Lennox-Gastaut Syndrome two rarer developmental disorders that are particularly difficult to treat. This medication, which is a component of the marijuana plant, is approved for adults & children over the age of two due to which people ask if CBD can help in seizures?
CBD actually has its role in helping out in case of epilepsy & seizures but it is with a few things that come in addition, both good & bad. Let’s have a look.
WHAT ARE EPILEPSY & SEIZURES?
The operations of the body are maintained by the electrical activity from the brain. It is caused by complex chemical changes that occur in the nerve cells day in & day out. Brain cells either excite or inhibit (stop) other brain cells from sending messages & this is the way the operations are implemented in the brain. In a normal brain, there is a balance of cells that excite & those inhibit these messages. However, when a seizure occurs, there may be too much or too little activity, causing an imbalance between the exciting & stopping activity. The chemical changes can lead to surges of electrical activity that cause seizures. Seizures are actually not a disease in themselves. They are a symptom of many different disorders that can affect the brain. Some seizures can hardly be noticed & will come & go in a flash, while others are extremely disabling.
Epilepsy is a chronic disorder which marks recurrent episodes of unprovoked seizures. A person is diagnosed with epilepsy if two unprovoked seizures take place that had no known cause like reversible medical condition due to alcohol withdrawal or extremely low blood sugar. Seizures & epilepsy can affect too much. They might put at risk one’s safety, relationships, work, driving & social presence many more things. Public perception & treatment of people with epilepsy are often bigger problems than actual seizures. Epilepsy can also be due to a brain injury or a family tendency. Surprisingly, the cause is completely unknown.
CBD is specifically recommended for control of seizures in Lennox-Gastaut syndrome & Dravet syndrome & is not currently for treatment of other types of epilepsy. According to studies, CBD, when taken with other anticonvulsant medications, reduces the frequency & severity of seizures among people with epilepsy disorders.
- Lennox-Gastaut Syndrome (LGS)
A developmental disorder that begins in early childhood, Lennox-Gastaut syndrome is characterized by multiple seizure types along with physical & cognitive deficits. The seizures here go beyond control quite often & are treated with a different medication schedule & methodology than that of other epilepsy types. Despite different stream of medication, people with LGS often continue to suffer from persistent seizures.
Epidiolex comes in an oral solution (liquid form) & the dose is recommended based on weight. The starting dose is 2.5 mg/kg twice daily & can be gradually increased up to a dose of 20 mg/kg/day.
- Dravet Syndrome
It is a developmental disorder that begins in early childhood & is associated with multiple seizure types as well as seizures triggered by fevers. People with Dravet syndrome often have behavioral challenges and learning difficulties.
Even with treatment, people with Dravet syndrome may continue to experience persistent seizures. CBD’s regular dosage can have an impact on seizure control & quality of life for people who have Dravet Syndrome.
- Other Seizure Types
CBD stands unapproved for other types of seizures or epilepsy. This is because the time for CBD hasn’t completely come yet to reach its top form. It is still too soon to make an assessment that CBD will prove to be beneficial & tolerable for people with other seizure types apart from Lennox-Gastaut & Dravet syndrome.
Studies using CBD for seizure control are giving more attention to refractory seizure – seizures that are not easily controlled with anti-seizure treatments. For example, in a study of three patients who had seizures induced by brain tumors that could not be controlled with other anticonvulsants, CBD decreased the severity of the seizures for all three patients.
DOSAGE & WORKING
Epidiolex comes in the form of an oral solution & the dose is recommended based on the weight. The effective dose has been found to be 10 mg/kg/day & is usually divided into twice daily. This gets started at a dose of 2.5 mg/kg twice daily & is increased to the target dose after a week according to general practice. It can then be increased up to a dose of 20 mg/kg/day but only when needed It is to be noted that there is a risk of increased side effects as per reported cases when high doses are given.
Anti-seizure medications should be taken at the regularly scheduled times,without skipping or combining doses. Sometimes, children & adults with LGS or Dravet Syndrome have difficulties to take the dosage orally relating to swallowing, behavioral or cognitive problems. It may hence be a challenge to get through specially when it is children that youé dealing with.
CBD’s main working should be credited to the ECS or endocannabinoid system. Seizures are caused due to erratic electrical activity in the brain that can spread & cause uncontrolled physical movements or alterations of consciousness. Most anticonvulsants’ working mantra is based on the slowing down of excitatory nerve activity in the brain. But, LGS & Dravet syndrome may be treated with anticonvulsants that are not generally used for most types of epilepsy & often require two or more anticonvulsants.It is not completely clear why CBD can reduce some types of seizures. It is known to have a range of biochemical effects on nerve cells in the brain, and some of these biochemical interactions may have a relationship with the effect of CBD on seizures.
Though CBD has been found helpful with epidiolex in relieving epilepsy & seizures there might be side-effects like drowsiness, generalized fatigue, sleeping difficulties, weakness, decreased appetite, rashes, and diarrhea. Higher scale side-effects include liver injury & mood changes. Jaundice can be caused due to effects on the liver, abdominal pain, vomiting & dark colored urine. Depression, anxiety & suicide planning thoughts might also be there.
There are chances of CBD interacting with other anticonvulsants too. For example, it may raise the blood level of Topamax & Banzel (rufinamide) or decrease the blood level of Onfi. These interactions can affect seizure control & may result in side-effects. When used with other anticonvulsants, CBD can cause elevated liver enzyme levels which is considered a sign of liver injury.
For the good side of things, CBD does not have abuse potential & hence does not produce a ‘high’ that is typical of THC. Hence, you can be worry free that your child isn’t being drugged or can develop its addiction. This confusion is necessary to be addressed since it is possible that others may misunderstand the effects of the drug, particularly because it is new and because it is derived from the same plant that marijuana is derived from.
With the current scenario,CBD has been proved effective in certain really important ailments like arthritis but, the study is still nascent & the mileage of CBD on epilepsy & seizures is yet to be freezed on proper explanations. Though, there are positive signs & epidiolex helps in two common types of epilepsies but this isn’t the road. It is not necessary that all seizures will be due to epilepsy. Hence,a closing on seizures by CBD is still under proper studies.
But, we have seen how epidiolex can be dangerous even while treating epilepsy & is hence necessary to use it with utter caution & under expert guidance only. As somebody whose child suffers from LGS or Dravet Syndrome, you might face challenges not just in administering the dose but also because of CBD being a fairly new therapy for epilepsy. It is not yet covered in health insurance.