Sean Mallen
As marijuana marches towards legalization in Canada, researchers are
digging ever deeper into its potential therapeutic benefits. For people
suffering from epilepsy it could mean reaching back to the wisdom of the
ancients to deliver a modern form of relief.
For thousands of
years, cannabis has been known to have anticonvulsant properties. It
was used in both ancient China and India, and then much later during
Victorian times in Europe.
In the 20th Century, researchers
started to narrow down the source of the benefits, extracting a chemical
from marijuana called cannabidiol (CBD), which unlike THC will not make
you high, but which has shown promise in reducing seizures.
But
in the 1980s, research virtually stopped. Some wonder whether it was a
casualty of the Reagan Administration's War on Drugs. Researchers
wishing to conduct studies of cannabis were frustrated by legal
obstacles to access.
A neuroscientist in San Francisco named
Catherine Jacobson pushed hard to break down the barriers. Dr. Jacobson
also happened to be the mother of a boy who suffered terribly from
drug-resistant epilepsy. Having heard about cannabidiol, she took
matters into her own hand--working in her garage to develop an extract,
which she administered to her son and which gave him relief.
In a blog, she wrote passionately about her frustrations:
"As a mother, I am furious that the federal government has discouraged
research into these potentially life-saving therapies for years by
restricting clinical research. As a scientist, I decry the federal
government for interfering with scientific freedom."
Dr. Jacobson was one of many parents and patient advocates who campaigned for cannabidiol studies.
But
now the legal landscape is shifting. As more jurisdictions legalize
marijuana use, CBD is drawing more attention as a possible therapy for
forms of epilepsy that resist other drug treatments.
Leading an
important study is Dr. Mac Burnham, Co-Director of EpLink - The
Epilepsy Research Program of the Ontario Brain Institute.
'What we propose to do really needs to be done," he said in an interview.
"There
is a compound out there that could improve the lives of some
people--and not being used because doctors don't have enough information
on effective dosing and safety to prescribe it."
Other recent
studies have started to build the case for CBD. GW Pharmaceuticals, a
British drug company, did a clinical trial with children suffering from
Dravet Syndrome--a rare condition that not only causes seizures, but
developmental disabilities. The study found that children treated with a
CBD-based drug saw a media reduction of about 39 per cent in the
convulsive seizures they suffered every month, compared with a 13 per
cent reduction among those receiving a placebo. Those are significant
results.
Dr. Burnham says the GW study may lead to the production
of a drug that may be expensive and potentially only be helpful for a
very select group--children suffering from rare forms of epilepsy.
His
research project takes a broader focus--the roughly one-third of people
with epilepsy for whom medications are ineffective in completely
stopping seizures. He is launching a clinical study that will examine
the use of CBD on adults. All the recent trials have been with children.
It will be a controlled, double blind trial. All participants
will continue with their current medication.
Half the group will be
also given cannabidiol while the other half will get a placebo. Neither
the doctors not the patients will know who is getting what.
Dr.
Burnham is interested in discovering whether a simple extract of CBD can
be effective, which is important because it would be much cheaper than a
synthetic drug developed by a pharmaceutical company. He also wants to
determine a therapeutic dosage because he is hearing from neurologists
that they do not want to use CBD, fearing that they do not know enough
about it and needing reassurance that it is safe.
His team plans
to use low dosages, then gradually escalate them to about 1400
milligrams - looking at whether a dose within this range can safely
reduce seizures. CBD will be administered in the form of an oil.
"We
don't expect it to be a magic bullet that could end seizures but could
be as good as any of the anticonvulsives that have been released in the
last 20 years," he said.
The project will be run out of Toronto
Western Hospital and the London Health Sciences Centre. It is planned
to begin in 2017, with results to be published about two years later.
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