Abstract
Although cannabis has been known for ages as an “alternative medicine” to provide relief from seizures, pain, anxiety, and inflammation, there had always been a limited scientific review to prove and establish its use in clinics. Early studies carried out by Carlini's group in Brazil suggested that cannabidiol (CBD), a non-psychotropic phytocannabinoid present in Cannabis sativa, has anticonvulsant properties in animal models and reduced seizure frequency in limited human trials. Over the past few years, the potential use of cannabis extract in refractory epilepsy, including childhood epilepsies such as Dravet's syndrome and Lennox-Gastaut Syndrome, has opened a new era of treating epileptic patients. Thus, a considerable number of pre-clinical and clinical studies have provided strong evidence that phytocannabinoids has anticonvulsant properties, as well as being promising in the treatment of different neuropsychiatric disorders, such as depression, anxiety, post-traumatic stress disorder (PTSD), addiction, neurodegenerative disorders and autism spectrum disorder (ASD). Given the advances of cannabinoids, especially CBD, in the treatment of epilepsy, would the same expectation regarding the treatment of other neuropsychiatric disorders be possible? The present review highlights some contributions from Brazilian researchers and other studies reported elsewhere on the history, pre-clinical and clinical data underlying the use of cannabinoids for the already widespread treatment of refractory epilepsies and the possibility of use in the treatment of some neuropsychiatric disorders.
Highlights
Cannabis sativa, a plant popularly known for giving rise to marijuana, has in its composition more than 140 compounds called phytocannabinoids
The two phytocannabinoids most researched for the treatment of epilepsies are delta-9-tetrahydrocannabinol (THC— main psychoactive compound) and especially cannabidiol (CBD—main non-psychoactive compound), which are useful in preventing seizures and reducing mortality, with low toxicity and high tolerability [11, 17,18,19,20]
The path to the safe and effective use of cannabinoids in treating epilepsy seems to be unraveled by science; the question: would the same expectation regarding the treatment of other neuropsychiatric disorders be possible? To shed light on this issue, this review, in addition to emphasizing the use of CBD in the treatment of epilepsy, examines the possibility of using this compound as an alternative to the treatment of some neuropsychiatric disorders
Summary
A plant popularly known for giving rise to marijuana, has in its composition more than 140 compounds called phytocannabinoids. Different researchers have confirmed the pioneering studies of Carlini et al since the 1970s, that is, that CBD can be a safe and effective therapeutic alternative for the treatment of epilepsy, a condition that affects millions of people across the world [11, 36,37,38,39,40]. This contribution made an extensive article published recently (2020) in The NY Times about CBD, which considers Carlini as the “discoverer” of the use of this compound in epilepsy [41]. There is much more evidence from studies in animals than in humans, in addition to few randomized controlled trials [28, 42], many clinical observations have suggested cannabinoids, not just CBD, as a new treatment for refractory epilepsies (for better visualization of the contribution of Carlini et al, see Figure 1)
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