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Marijuana for Epilepsy: Weighing the Evidence Charlotte's Web, Notes, Studies

Marijuana for Epilepsy: Weighing the Evidence, Epilepsy Notes, Andrew N. Wilner, MD, March 25, 2014

Considering Marijuana

In 2011 (more than 2.5 years ago) in "Marijuana: A Viable Epilepsy Therapy?" I reviewed the possibility of marijuana (Cannabis sativa) for the treatment of epilepsy. That article concluded, "More research is needed before patients should consider marijuana for seizure relief, particularly because this represents criminal activity under US federal law and may be accompanied by adverse medical (and legal) events."

What Hasn't Changed Since 2011?

What hasn't changed is the desperation of people with uncontrolled seizures and their families. Heather Jackson, the mother of Zaki, one of the children who responded to Charlotte's web, stated in a Huffington Post video interview, "If you wanted to take my money, I would give it to you. I wanted to save my boy."[13] Such vulnerable families need to be protected from scams, false promises, and dangerous drugs.

Conclusions

Despite the recent journalistic hype, my 2011 conclusions about "medical marijuana" have not changed. Marijuana is still a schedule I drug. It is not FDA-approved for the treatment of epilepsy or any other neurologic condition. Its medical (and recreational) use is still illegal under federal law. There are no controlled trials demonstrating that marijuana is "safe" or "effective" for the treatment of epilepsy. On the other hand, there is evidence that marijuana may be harmful, particularly in the developing brain after regular use. Synthetic cannabinoids appear even more toxic.

However, for many people with epilepsy, seizures cannot be controlled with FDA-approved medications. Other treatment options, such as the vagus nerve stimulator, responsive neurostimulation, or the ketogenic diet, may not work or may not be appropriate choices. For patients who have exhausted conventional therapies, medical marijuana, for which there is anecdotal evidence of seizure control, could be considered as an unproven, "compassionate use" alternative. Any such use of marijuana should be carefully monitored by a physician. A better alternative for children with intractable epilepsy would be enrollment in the new Epidiolex clinical trial.

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