Cannabidiol as a Treatment for Seizures, Convulsions and Epilepsy

Abstract

The pharmacological and medicinal properties of Cannabis sativa in the production of euphoria and the treatment of pain, nausea, anorexia, glaucoma, muscle spasticity, seizures, convulsions, epilepsy and many other indications have been the subject of considerable interest for thousands of year. While Δ⁹-THC is the chemical constituent in cannabis most commonly associated with these actions, other phytocannabinoids have also been shown to possess significant pharmacological activity and therapeutic potential. Cannabidiol (CBD) is one such compound that produces a variety of pharmacological effects of potential clinical importance, while at the same time being practically devoid of the psychoactivity and abuse liability associated with Δ⁹-THC. Despite its lack of psychoactivity, CBD and CBD-containing cannabis extracts are controlled as Schedule 1 substances by the United States Drug Enforcement Administration. However, the accumulating evidence showing that CBD formulations can provide therapeutic benefit in treating debilitating diseases has prompted actions by both the Drug Enforcement Administration and the Food and Drug Administration to facilitate continued preclinical and clinical research. Some of the most promising clinical applications for CBD-based therapeutics are in neuronal hyperexcitability, seizures, convulsions and epilepsy. An increasing amount of preclinical and clinical evidence supports the use of CBD for these indications; however, the safety and efficacy of CBD dose formulations in infants, adolescents and other patient populations remain to be firmly established. In addition, the mechanisms of action responsible for CBD’s clinical effects remain to be fully elucidated, it inhibits cytochrome P450s and it has drug interaction liabilities. There is also speculation that extracts of cannabis produce a synergistic entourage effect that improves efficacy over CBD alone. Thus, there remains a clear need for further studies of the structure-activity relationships and mechanisms of action of CBD-based formulations to ensure that the therapeutic indices of dosage formulations are clearly understood and optimized for patient populations.

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