Cannabinoids in epilepsy: clinical efficacy and pharmacological considerations

Neurologia (Engl Ed). 2023 Jan-Feb;38(1):47-53. doi: 10.1016/j.nrleng.2020.02.012. Epub 2021 Nov 22.

Abstract

Introduction: Advances in the development of drugs with novel mechanisms of action have not been sufficient to significantly reduce the percentage of patients presenting drug-resistant epilepsy. This lack of satisfactory clinical results has led to the search for more effective treatment alternatives with new mechanisms of action.

Development: The aim of this study is to examine epidemiological aspects of the use of cannabis-based products for the treatment of epilepsy, with particular emphasis on the main mechanisms of action, indications for use, clinical efficacy, and safety. We conducted a narrative review of articles gathered from the PubMed, EMBASE, and Google Scholar databases and from the reference sections of relevant publications.

Conclusions: In recent years there has been growing interest in the use of cannabis-based products for the treatment of a wide range of diseases, including epilepsy. The cannabis plant is currently known to contain more than 100 terpenophenolic compounds, known as cannabinoids. The 2 most abundant are delta-9-tetrahydrocannabinol and cannabidiol. Studies of preclinical models of epilepsy have shown that these cannabinoids have anticonvulsant properties, and 100% purified cannabidiol and cannabidiol-enriched cannabis extracts are now being used to treat epilepsy in humans. Several open-label studies and randomised controlled clinical trials have demonstrated the efficacy and safety of these products.

Keywords: Cannabidiol; Cannabinoides; Cannabinoids; Cannabis; Epilepsia; Epilepsy; Marihuana; Marijuana; Tetrahidrocannabinol; Tetrahydrocannabinol.

Publication types

  • Review

MeSH terms

  • Anticonvulsants / therapeutic use
  • Cannabidiol* / pharmacology
  • Cannabidiol* / therapeutic use
  • Cannabinoids* / pharmacology
  • Cannabinoids* / therapeutic use
  • Cannabis*
  • Epilepsy* / drug therapy
  • Hallucinogens* / therapeutic use
  • Humans
  • Treatment Outcome

Substances

  • Cannabinoids
  • Cannabidiol
  • Anticonvulsants
  • Hallucinogens