what type of cbd oil is best for children’s seizures

Cannabis-derived drug shows promise for kids with epilepsy; GW pharma stock doubles

In 2014, I interviewed a number of moms from across the country who were fighting to get access to a form of cannabis oil that they believed would help their children’s seizures. They had an uphill battle in lobbying conservative legislatures to allow them to import the oil and in convincing their own doctors to try the experimental treatment. Many ended up going to Colorado, where there is a small community of growers, medical practitioners and researchers willing to work with them.

Their work may have finally paid off.

GW Pharmaceuticals announced Monday that the first of its four major studies of the cannabis-based drug appeared to dramatically reduce seizures in patients with Dravet syndrome, a rare and severe form of epilepsy.

“This shows that cannabinoids can produce compelling and clinical important data and represent a highly promising new class of medications, hopefully in a range of conditions,” Justin Gover, GW Pharmaceuticals’ chief executive, told Reuters.

The trial, which involved 120 patients, showed that the median reduction in convulsive seizures was 39 percent in those taking the drug, called Epidiolex, versus 13 percent in those taking a placebo. The mean age of patients was 10 years old and they had previously tried and failed an average of more than four anti-epileptic treatments.

GW is also conducting other Phase 3 studies on Dravet syndrome with 150 patients and Lennox-Gastaut Syndrome and Tuberous Sclerosis Complex.

Orrin Devinsky, a researcher with New York University Langone Medical Center’s Comprehensive Epilepsy Center who is the principal investigator, said that the data finally provides the epilepsy community “the prospect of an appropriately standardized and tested pharmaceutical formulation of cannabidiol being made available by prescription in the future.”

The company’s announcement that it will be seeking Food and Drug Administration approval for the treatment sent its shares soaring 120 percent by midday. The company has fast-track status for its application to treatment on newborns with epilepsy. Jim Cramer of “The Street” said on CNBC’s Squawk that the positive reaction may also be due to the hope that the drug could replace some addictive painkillers.

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The theory that marijuana could be used to treat seizures has been around since the 19th century, but it wasn’t until about 2012, when a Colorado mom named Paige Figi began posting stories online about her daughter’s experiences with a cannabis extract, that the idea took off. Figi’s daughter, Charlotte, had Dravet syndrome and had been suffering from more than 300 seizures each week. She used a wheelchair, could only say a few words and had gone into cardiac arrest several times.

Desperate, the family began treating her with a few drops of an extract made from a strain of marijuana that was high in CBD, which is thought to be medicinal, and low in THC, the component that creates a high. The family reported that the seizures nearly stopped.

Should Physicians Recommend Cannabinoids for Patients with Refractory Seizures?

Darcy Krueger, MD, PhD, and Katherine Holland-Bouley, MD, PhD,discuss the potential and pitfalls of using cannabidiol (CBD)-derived therapies for patients with refractory seizures. Krueger is a pediatric neurologist and director of the Tuberous Sclerosis Clinic at Cincinnati Children’s, and Holland-Bouley is a pediatric epileptologist and co-director of the medical center’s Child Neurophysiology Lab.

What types of CBD-derived therapies are available for patients with refractory seizures?

Holland-Bouley: The U.S. Food and Drug Administration recently approved a new drug called Epidiolex for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, in patients two years of age and older. This is the first FDA-approved drug created from a marijuana derivative, and the first FDA approval of a drug for the treatment of patients with Dravet syndrome.

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Epidiolex is not the same as medical marijuana. The active ingredient is 99 percent pure cannabidiol, whereas medical marijuana products contain cannabidiol and hundreds of other chemicals as well. Those chemicals can include tetrahydrocannabinol (THC), which has hallucinogenic properties. Some have advocated that products including CBD combined with THC may be more helpful than those containing CBD alone, especially in conditions associated with chronic pain, but scientific studies supporting these claims are lacking. Currently, the FDA has only approved drugs that contain purified cannabidiol and not THC.

Do CBD-derived therapies have the potential to help patients with other types of seizures?

Krueger: Early research findings are promising, and I think we will begin to see wider applications for cannabinoids. A study published in Epilepsia (Hess et al, 2016) showed that cannabidiol may be an effective and well-tolerated treatment option for patients with refractory seizures associated with tuberous sclerosis complex (TSC). This study paved the way for a full phase III randomized clinical trial, which was conducted by the same company that manufactures Epidiolex. We should see results from that study soon.

What is the downside of using medical marijuana?

Holland-Bouley: Buying medical marijuana is a little like doing business in the Wild West – customers cannot always know exactly what their product contains. And, unlike most FDA-approved drugs, medical marijuana is not covered by insurance.

Krueger: When patients do not respond to medical marijuana products or experience negative side effects, it isn’t possible to make recommendations about dosing or plant selection, because we don’t know the exact composition of these products. Every year the FDA randomly evaluates commercially available natural products that are marketed as containing CBD. In the past three years, the FDA has sent 41 warning letters to firms whose products were found to not contain the levels of CBD they claimed to contain. Being able to prescribe highly regulated, pharmaceutical-grade CBD-derived drugs will help address that problem.

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How do you counsel your patients about CBD-derived therapies?

Holland-Bouley: I tell them that CBD-derived drugs hold a lot of promise, but will not work the same for everyone. And I caution them about the variability associated with medical marijuana. Ironically, many families seem to feel more comfortable with using medical marijuana vs. pharmaceuticals, believing that because it is “natural” it will cause fewer side effects. I’m hoping that as the FDA approves more CBD-derived therapies, that perception will change.

Krueger: We still have a lot to learn about the benefits of cannabinoids for seizure control or many other conditions. But the fact is that more than 30 states have legalized medical marijuana, and a growing number of research studies are affirming the benefits of CBD-derived therapies. Patients and families look to their physicians for guidance, so it’s good to be informed and open minded about the potential of these therapies for seizure control and other symptoms when traditional therapies fail to provide relief.

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