Cannabis and other illicit drug use in epilepsy patients

Hamerle, Michael; Ghaeni, Leyli; Kowski, Alexander B.; Weißinger, Florian; Holtkamp, Martin

doi:10.1111/ene.12081

Cited by 52 publications

(52 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The predicted prevalence of medical cannabis use in epileptic patients ranges from about 4 % (77=total patient population in US medical cannabis program) to about 20 % (310=total patients at a tertiary epilepsy clinic in Germany) [252,253]. One percent of the medical marijuana users in California (~2500=total patient population) use cannabis to control seizures [254].…”

Section: Epidemiological Reports and Surveysmentioning

confidence: 99%

“…No patient reported a worsening of seizures with cannabis use [258]. The majority (84 %) of patients in a German tertiary care center reported that cannabis had no effect on their seizure control [253]. Composite data from 175 preclinical seizure models (e.g., maximal electroshock, kainic acid) or discrete experimental designs (e.g., with combined antiseizure medications).…”

Section: Epidemiological Reports and Surveysmentioning

confidence: 99%

See 1 more Smart Citation

Cannabinoids and Epilepsy

et al. 2015

View full text Add to dashboard Cite

Cannabis has been used for centuries to treat seizures. Recent anecdotal reports, accumulating animal model data, and mechanistic insights have raised interest in cannabisbased antiepileptic therapies. In this study, we review current understanding of the endocannabinoid system, characterize the pro-and anticonvulsive effects of cannabinoids [e.g., Δ9-tetrahydrocannabinol and cannabidiol (CBD)], and highlight scientific evidence from pre-clinical and clinical trials of cannabinoids in epilepsy. These studies suggest that CBD avoids the psychoactive effects of the endocannabinoid system to provide a well-tolerated, promising therapeutic for the treatment of seizures, while whole-plant cannabis can both contribute to and reduce seizures. Finally, we discuss results from a new multicenter, open-label study using CBD in a population with treatment-resistant epilepsy. In all, we seek to evaluate our current understanding of cannabinoids in epilepsy and guide future basic science and clinical studies.

show abstract

Section: Epidemiological Reports and Surveysmentioning

confidence: 99%

Section: Epidemiological Reports and Surveysmentioning

confidence: 99%

Cannabinoids and Epilepsy

et al. 2015

View full text Add to dashboard Cite

show abstract

“…A careful analysis showed that cannabis use in men (but not in women) protected against new-onset unprovoked seizures and against new-onset provoked seizures when used within 90 days of seizure presentation. Yet overall, there is insufficient epidemiological data to reach hard conclusions [154], even though cannabis may protect patients from new-onset seizures and it may help patients with established epilepsy control their seizures.…”

Section: The Cb1r-nmdar Complexmentioning

confidence: 99%

Endocannabinoid control of glutamate NMDA receptors: the therapeutic potential and consequences of dysfunction

et al. 2016

View full text Add to dashboard Cite

Glutamate is probably the most important excitatory neurotransmitter in the brain. The glutamate N-methyl-D-aspartate receptor (NMDAR) is a calcium-gated channel that coordinates with G protein-coupled receptors (GPCRs) to establish the efficiency of the synaptic transmission. Cross-regulation between these receptors requires the concerted activity of the histidine triad nucleotide-binding protein 1 (HINT1) and of the sigma receptor type 1 (σ1R). Essential brain functions like learning, memory formation and consolidation, mood and behavioral responses to exogenous stimuli depend on the activity of NMDARs. In this biological context, endocannabinoids are released to retain NMDAR activity within physiological limits. The efficacy of such control depends on HINT1/σ1R assisting in the physical coupling between cannabinoid type 1 receptors (CB1Rs) and NMDARs to dampen their activity. Subsequently, the calcium-regulated HINT1/σ1R protein tandem uncouples CB1Rs to prevent NMDAR hypofunction. Thus, early recruitment or a disproportionate cannabinoid induced response can bring about excess dampening of NMDAR activity, impeding its adequate integration with GPCR signaling. Alternatively, this control circuit can apparently be overridden in situations where bursts of NMDAR overactivity provoke convulsive syndromes. In this review we will discuss the possible relevance of the HINT1/σ1R tandem and its use by endocannabinoids to diminish NMDAR activity and their implications in psychosis/schizophrenia, as well as in NMDAR-mediated convulsive episodes.

show abstract

“…Recent studies assessed the prevalence of illicit drug use among epilepsy patients and its effects on the disease. In these studies, it was reported that frequent use of cocaine, amphetamines or heroin increases seizure risk [101]. Another study stated that heroin use is a risk factor and marijuana use a protective factor for new-onset seizures [102].…”

Section: Effects Of Cannabinoid Compounds On Epilepsy and Seizurementioning

confidence: 99%