Research concerning the optimal use of CBD oil for the management of epilepsy evolves day by day; from analysis of cell lines, to clinical trials with minor patients. New discoveries renew the hope of both patients and relatives to manage this disorder, especially in pediatric cases.
The annual incidence in the Spanish territory has 12,400 - 22,000 new cases, being minor children (children of 6 - 14 years) the largest affected population. It is also estimated that around 8% - 33% of cases of epilepsy can not be controlled under treatment. In other words, in Spain an approximate 100,000 individuals need to resort to alternative treatments to be able to control the seizures and symptoms that this disorder entails. In children, epileptic seizures occur at an early age, after a first attack, the chances of a second one has a probability of 40-52%. In case a second attack occurs, these probabilities increase up to 73% within the next 4 years.
Unfortunately, this disorder seems to be very resistant to conventional treatments such as antiepileptic drugs and high doses of steroids. These can produce adverse effects even worse than the seizures themselves. This is why, despite years of research and development on these drugs, family members and those affected with this disorder resort to alternative options, including CBD.
The first descriptions of the symptomatology of epilepsy as a disorder date back around 400 BC. documented by the father of medicine, Hippocrates. This disorder is caused by a sudden electrical activity in the brain, which in turn is reflected in an abnormal activation of the neurons involved. Resulting in what is known as Epileptic Seizures.
This disorder seems to be very resistant to conventional treatments and even ketogenic diets (high in fat, low in carbohydrates).
Drugs categorized as antiepileptic drugs are designed to reduce electrical activity within the brain, which tends to produce a cascade of adverse effects and toxicity, which may be as or even worse than the discomfort caused by the same seizures.
Among the common side effects of medications such as Carbamazepine, Lamotrigine and Oxcarbazepine we find:
Despite years of research and development on these drugs, family members and those affected by this disorder resort to slightly less conventional options.
Since 2008, the number of publications related to cannabinoid extractions, CBD oil, has increased considerably, nowadays with more than 1205 publications on scientific bases such as PubMed. Among the investigations with human patients we find examples such as Porter and Jacobson. In this study, the evolution in time after dose of CBD oil in a group of 19 children (ages between 2 and 16), resistant to conventional treatments with antiepileptic drugs, is documented, it is also documented that these individuals were treated with about 12 different types of drugs, prior to the start of the study.
It was found that more than 50% of the individuals presented drastic reductions in the number of seizures after the dose of CBD oil and without the presence of typical adverse effects mentioned above. Even more interesting, was the dosage provided, a daily dose of 0.5 mg / kg up to 28.6 mg / kg is reported. During the progressive follow-up, parents and relatives report that patients were relieved from seizures after 4 months of uninterrupted daily use. Other cases mention up to 80% reduction in the frequency of attacks. It should be noted that these improvements also influenced other aspects of patients' daily life such as: improvement in mood, better sleep and increased alert signals.
Parallel studies in healthy patients, reported having implemented doses as high as 600mg in the use of CBD oil, this dosage showed to be very well tolerated and without producing psychotic symptoms in individuals enrolled.
New hypotheses based on clinical evidence suggest that the pharmacological effects of this group of cannabinoids could be explained thanks to its mechanism of action on the Cannabinoid Receptors: CB1 and CB2. To emphasize these receptors, it has been suggested that the structural difference between the molecules, CBD and THC, are the ones that make the difference in the moment of stimulation and activation of these.
As we see in the following image:
The structural conformation of both cannabinoids is quite similar. However, when analyzed in a three-dimensional space:
It is appreciated that THC has a relatively flat conformation in space, while CBD has angles in the configuration of its rings. What has led researchers to hypothesize that this conformation is the one that explains why CBD has little affinity for the CB1 receptor and, therefore, does not produce psychotropic effects when it is coupled to it, but it does produce the therapeutic effects.
On the one hand, the promise coming from the use of this cannabinoid is significant, there are many parameters that must be studied with greater scientific rigidity and on the other hand, patients, family members and doctors must be educated about the properties, as well as the limitations of the use of CBD oil.
Unfortunately, this progress is not accelerated enough to help the large number of children and adults who suffer from this disorder. This leads parents and relatives to take less conventional outlets in order to avoid irreversible adverse effects and the management of symptoms. Studies on efficacy and safety at high doses can take years to come to light, so you tend to see CBD as a possible compassionate medication.
In conclusion, there is an increasing number of interest in the use of CBD oil and other forms of cannabinoids within the clinical studies area. It is expected that these tests will be strengthened with the corresponding rigor in the near future due to the potential antiepileptic effect of this molecule.
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