Epidyolex stands out as the sole cannabis-based medication approved for epilepsy treatment through the NHS, but UK private medical cannabis clinics can prescribe a much larger range of cannabis-based medications. This medicine, derived from cannabis, has garnered global interest, particularly for its effectiveness against two specific childhood epilepsy types: Dravet Syndrome and Lennox-Gastaut Syndrome.
Studies focus on a non-psychoactive type of cannabis, which has shown promise in reducing seizure frequency. Health authorities, including the FDA in the US and the EMA in Europe, are currently reviewing these studies. However, these treatments are not yet widely available and are restricted to research settings.
Key Takeaways
- Epidyolex is the only cannabis-based medicine approved for epilepsy through the NHS in the UK.
- Private medical cannabis clinics have the right to offer patients a much wider range of cannabis-based options.
- NICE recommends Epidyolex for adults and children aged 2 or over with Dravet and Lennox-Gastaut syndromes.
- Research demand exists for CBD medicines targeting other severe, treatment-resistant epilepsies.
- NHS prescription of Epidyolex is under strict conditions and specific patient groups.
- NICE has not recommended THC-based cannabis medicines for epilepsy, leading to specialist prescriptions on a case-by-case basis.
Understanding Epilepsy and Its Traditional Treatments
Epilepsy, marked by recurring seizures, affects many globally. Annually, 50.4 out of every 100,000 individuals experience epilepsy, with higher rates in low to medium-income areas. Traditional treatments include antiepileptic drugs and surgeries, but about a third of patients find these methods ineffective.
Given the limitations of conventional treatments, alternative options like cannabidiol (CBD) are being explored. Although early tests with small participant numbers were not promising, larger recent studies have shown significant seizure reduction with CBD2.
Whole-plant medical cannabis has notably benefited children with treatment-resistant epilepsy, often reducing the need for other antiepileptic drugs3.
Cannabis’s potential for epilepsy treatment is supported by a long history and various laboratory and animal studies. Cannabidiol helps control seizures by acting on specific molecules, making it a promising adjunct to traditional epilepsy treatments4.
The Science Behind Cannabis and Epilepsy
Cannabis has been used to treat epilepsy for thousands of years. Modern research focuses on CBD and THC, with CBD showing a strong ability to reduce seizures. Studies have demonstrated its efficacy in controlling seizures both in vitro and in vivo, particularly temporal lobe and partial seizures.
Evidence also suggests CBD can mitigate seizures caused by cocaine in mice and protect brain cells in epileptic rats. These findings underscore CBD’s potential as a key epilepsy treatment component. Programs like the Epilepsy Therapy Screening Program (ETSP) are further investigating CBD’s seizure-controlling properties.
Researchers are delving into the endocannabinoid system to understand how CBD reduces seizure risk. Additionally, CBD’s immunosuppressive effects could have broader medical applications4.
Clinical Trials and Research on Cannabis Epilepsy Treatment
Clinical trials highlight CBD’s effectiveness in managing seizures. Great Ormond Street Hospital (GOSH) studies on children with Dravet and Lennox-Gastaut Syndromes showed CBD could reduce seizures by nearly 40% compared to a placebo.
In these trials, CBD also significantly decreased ‘drop attacks’ in Lennox-Gastaut Syndrome children. These carefully controlled studies, using a specific CBD medication, led to FDA approval and EMA review for future use in Europe.
Epidyolex represents a significant advance in the UK’s cannabis-based epilepsy care. However, its use is tightly regulated, available only to participants in the studies5.
Types of Cannabis-Based Medications for Seizures
In the UK, cannabis is approved for specific epilepsy types like Dravet and Lennox-Gastaut syndromes. Epidyolex, a special cannabis medicine, is available free to patients in England, Northern Ireland, Wales, and on a closely monitored basis in Scotland, provided other treatments have failed.
Despite regulatory support, access to cannabis for epilepsy remains limited. Epidyolex, which contains no THC, is favoured due to the lack of evidence supporting THC’s safety and efficacy in treating seizures. However, ongoing research may expand future treatment options5.
However, private medical cannabis clinics here in the UK have a wider range of cannabis-based medications available for seizures. These clinics require a referral from your GP and charge consultation fees, but they offer access to different types of medicinal cannabis that may not be available through the NHS.
Private Medical Cannabis Clinics: Expanding Treatment Options
While the NHS primarily prescribes Epidyolex, private medical cannabis clinics in the UK can legally offer a broader range of cannabis-based medications. These clinics provide access to various formulations and strains tailored to individual patient needs, which are unavailable through the NHS.
Private clinics can prescribe cannabis medicines that include both CBD and THC, offering patients options that might be more effective for their specific conditions. This flexibility allows for personalised treatment plans, potentially improving outcomes for those who do not respond well to standard NHS-prescribed medications.
These clinics also facilitate access to innovative treatments, including whole-plant extracts and specific cannabis oil blends. The cost of treatment in private clinics can be high, but for many patients, the expanded options and personalised care are worth the investment.
Safety and Side Effects of Cannabis-Based Medications
Epidyolex, a pure CBD medicine approved in the UK, is recommended when other treatments fall short. It is effective for both children and adults with specific epilepsy types but comes with side effects, including tiredness, loss of appetite, diarrhoea, fever, and nausea, affecting more than 1 in 10 users.
The long-term safety of THC-containing medicines for young brains remains uncertain, necessitating further studies. Unapproved cannabis oils with CBD and THC are rarely used and not recommended due to inconsistent quality and potential interactions with epilepsy drugs1.
What Experts Say About Using Cannabis for Epilepsy Control
Experts call for comprehensive research on cannabis for epilepsy, focusing on both CBD and THC treatments. While some countries allow medical cannabis, the NHS demands strong evidence. Studies have shown CBD’s potential to stop seizures, but more research is needed.
NICE recommends Epidyolex, a pure CBD medicine, for some treatment-resistant epilepsy types, providing it for free via the NHS. Experts like Epilepsy Action advocate for expedited studies to identify more beneficiaries and simplify access to cannabis treatments.
CBD remains the primary focus, but THC-containing combinations could also be beneficial. A 2012 study found CBD could prevent certain seizures in animals, indicating potential4.
Conclusion
Research into cannabis for epilepsy, particularly cannabidiol (CBD), shows promise. Beginning with 1843 studies on Indian hemp, current research continues to reveal CBD’s seizure-reducing capabilities. The interaction with the endocannabinoid system offers additional hope for cannabinoids in epilepsy treatment4.
Clinical trials have shown significant seizure reduction with CBD extracts, though side effects were common. The UK’s stringent regulations limit CBD use, necessitating further studies to confirm long-term safety and effectiveness7.
CBD’s potential to protect nerves in conditions like epilepsy, Parkinson’s, and Alzheimer’s highlights the promise of cannabis treatments, pending further testing. While short-term safety appears favourable, long-term effects require more research8.
n summary, the journey to establishing cannabis as a viable epilepsy treatment continues, driven by CBD’s potential. Advanced clinical trials and robust research are crucial for unlocking new treatment avenues, meeting safety concerns, and expanding cannabis use for epilepsy.
Source Links
- https://www.epilepsy.org.uk/info/treatment/medical-cannabis-based-treatments
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235654/
- https://bmjpaedsopen.bmj.com/content/5/1/e001234
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/
- https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/epilepsy/use-cannabis-based-medicinal-products-treat-epilepsy/
- https://www.epilepsy.org.uk/involved/campaigns/cannabis
- https://www.scientificamerican.com/article/can-cannabis-treat-epileptic-seizures/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6514832/