Cannabidiol in the Treatment of Epilepsy

Wrede, Randi von; Helmstaedter, Christoph; Surges, Rainer

doi:10.1007/s40261-021-01003-y

Cited by 37 publications

(31 citation statements)

References 72 publications

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“…CBD, in particular, is of particular interest as it has it circumvents the psychotropic effects resulting from the activation of CB 1 R [150]. CBD has demonstrated efficacy as an adjunct treatment option in the clinical management of Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) as, in multiple studies, it has reduced the frequency of epileptic seizures [149,[151][152][153][154][155].…”

Section: Epilepsymentioning

confidence: 99%

The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases

Lowe

Toyang²,

Steele

et al. 2021

IJMS

126

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The Endocannabinoid System (ECS) is primarily responsible for maintaining homeostasis, a balance in internal environment (temperature, mood, and immune system) and energy input and output in living, biological systems. In addition to regulating physiological processes, the ECS directly influences anxiety, feeding behaviour/appetite, emotional behaviour, depression, nervous functions, neurogenesis, neuroprotection, reward, cognition, learning, memory, pain sensation, fertility, pregnancy, and pre-and post-natal development. The ECS is also involved in several pathophysiological diseases such as cancer, cardiovascular diseases, and neurodegenerative diseases. In recent years, genetic and pharmacological manipulation of the ECS has gained significant interest in medicine, research, and drug discovery and development. The distribution of the components of the ECS system throughout the body, and the physiological/pathophysiological role of the ECS-signalling pathways in many diseases, all offer promising opportunities for the development of novel cannabinergic, cannabimimetic, and cannabinoid-based therapeutic drugs that genetically or pharmacologically modulate the ECS via inhibition of metabolic pathways and/or agonism or antagonism of the receptors of the ECS. This modulation results in the differential expression/activity of the components of the ECS that may be beneficial in the treatment of a number of diseases. This manuscript in-depth review will investigate the potential of the ECS in the treatment of various diseases, and to put forth the suggestion that many of these secondary metabolites of Cannabis sativa L. (hereafter referred to as “C. sativa L.” or “medical cannabis”), may also have potential as lead compounds in the development of cannabinoid-based pharmaceuticals for a variety of diseases.

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Section: Epilepsymentioning

confidence: 99%

The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases

Lowe

Toyang²,

Steele

et al. 2021

IJMS

126

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“…There are no studies about GS and cannabinol. However, in other epilepsy syndromes of childhood, such as Dravet's syndrome and Lennox Gastau, cannabinol reduced the frequency of seizures by 37.2% in Lennox Gastau and 38.9 in Dravet's syndrome [20].…”

Section: Condition Clinical Manifestations Genetics Epidemiologymentioning

confidence: 94%

Refractory Seizure in a Patient With Griscelli Syndrome: A Unique Case With One Mutation and a Novel Deletion

Ortíz

Ruxmohan

Alzamora

et al. 2021

Cureus

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Griscelli syndrome (GS) is a rare syndrome characterized by hypopigmentation, immunodeficiency, and neurological features. The genes Ras-related protein (RAB27A) and Myosin-Va (MYO5A) are involved in this condition's pathogenesis.We present a GS type 1 (GS1) case with developmental delay, hypotonia, and refractory seizures despite multiple medications, which included clobazam, cannabinol, zonisamide, and a ketogenic diet. Lacosamide and levetiracetam were added to the treatment regimen, which decreased the seizures' frequency from 10 per day to five per day. The patient had an MYO5A mutation and, remarkably, a deletion on 18p11.32p11.31. The deletion was previously reported in a patient with refractory seizures and developmental delay. We reviewed all cases of GS that presented with seizures. We reviewed other cases of GS and seizures described in the literature and explored possible seizure mechanisms in GS. Seizure in GS1 seems to be related directly to the MYO5A mutation.The neurological manifestations in GS2 seem to be caused indirectly by the accelerated phase of Hemophagocytic syndrome (HPS), which is characteristic of GS2. By having the MYO5A gene mutation combined with the 18p11.32p11.31 deletion, the prognosis and severity of the patient's condition are poor. This is the first report of GS1 with a deletion in 18p11.32p11.31.

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“…Finally, apart from the above-mentioned epilepsy syndromes, CBD was administered in several other epileptic syndromes, such as CDKL5 deficiency disorder, Sturge-Weber syndrome, Doose syndrome, Aicardi syndrome, febrile infection-related epilepsy syndrome, and infantile spasm (206). Two systematic reviews have included 19 and 30 non-randomized studies respectively, comprising openlabel interventional studies, case studies, retrospective chart reviews and self-report surveys (211,212).…”

Section: O P Y R I G H T E D R a S P Amentioning

confidence: 99%

Cannabidiol and the central nervous system: translating into clinics

Saviano¹,

Raucci²,

Tallarico³

et al. 2021

Pharm Adv

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Cannabis plants contain more than a hundred cannabinoids of which we have only limited knowledge about their effects and exact mechanisms of action. Cannabidiol (CBD) represents one of the most studied; it was discovered at the beginning of the last century while only recently has attracted greater attention. CBD mechanism of action is still unclear and debated; in the plant only the (-) enantiomer can be found and it seems that only the (+) enantiomer is able to bind to the cannabinoid receptors although evidence of a modulation of the endocannabinoid system exists. Furthermore, several other mechanisms have been proposed which may be differently relevant for different disease spanning from ion channels to immune responses and modulation of inflammation. It is a highly lipophilic drug with a peculiar pharmacokinetic which has led to the use and proposal of different formulations and routes of administration; of note, CBD has a complex interaction with cytochromes and is at high risk of drug-drug interaction with many drugs. Nowadays, CBD has been studied for potential efficacy in several pathologies and central nervous system (CNS) diseases are the most promising with clinical studies already in the started and some formulations with CBD already authorized for the treatment of spasticity in multiple sclerosis and seizures in some specific epileptic syndromes such as Lennox-Gastaut or Dravet. This review article is summarizing the relevant studies and perspectives of CBD use in the most relevant areas of CNS disorders also including a detailed description of its proposed mechanism(s) of action, pharmacokinetic characteristics and safety profile.

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Cannabidiol in the Treatment of Epilepsy

Cited by 37 publications

References 72 publications

The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases

The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases

Refractory Seizure in a Patient With Griscelli Syndrome: A Unique Case With One Mutation and a Novel Deletion

Cannabidiol and the central nervous system: translating into clinics

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