Cannabinoids in the treatment of epilepsy – an updated review

Abstract

Introduction. It is estimated that 30% of people with epilepsy continue to have seizures despite treatment. The approval of many new antiseizure drugs during the past two decades has not substantially reduced the proportion of patients with medically refractory disease. Patients need new treatments. Many families choose to try alternative therapy options. An abundance of preclinical evidence and anecdotal human data support the use of cannabinoids in the treatment of epilepsy. Aim. The present review paper aims to present the current state of knowledge regarding the effectiveness and safety of cannabinoids in the treatment of epilepsy. Material and methods. This review covers the most relevant and recent papers identified using the PubMed database. Results and discussion. Cannabidiol has shown anticonvulsant activity in many acute animal models of seizures. Recently three well controlled randomized trails focused on the potential usefulness of cannabinoids in the treatment of epilepsy have been published. Based on these publications, the US Food and Drug Administration approved in 2018 a purified, plant-derived cannabinoid for the treatment of seizures in patients with Dravet syndrome and Lennox-Gastaut syndrome. Conclusion. An abundance of preclinical evidence and anecdotal human data support the use of cannabinoids in the treatment of epilepsy. Recently purified, plant-derived cannabinoid was approved for the treatment of seizures in patients with Dravet syndrome and Lennox-Gastaut. Additional data are needed to determine the long-term efficacy and safety of cannabidiol for severe epilepsy syndromes