Abstract
Cannabis has been considered as a therapeutic strategy to control intractable epilepsy. Several cannabis components, especially cannabidiol (CBD), induce antiseizure effects. However, additional information is necessary to identify the types of epilepsies that can be controlled by these components and the mechanisms involved in these effects. This review presents a summary of the discussion carried out during the 2nd Latin American Workshop on Neurobiology of Epilepsy entitled “Cannabinoid and epilepsy: myths and realities.” This event was carried out during the 10th Latin American Epilepsy Congress in San José de Costa Rica (September 28, 2018). The review focuses to discuss the use of CBD as a new therapeutic strategy to control drug‐resistant epilepsy. It also indicates the necessity to consider the evaluation of unconventional targets such as P‐glycoprotein, to explain the effects of CBD in drug‐resistant epilepsy.
Highlights
Epilepsy is a neurological disease characterized by the presence of spontaneous and recurrent seizures.[1]
In the modern era of highly effective and specific therapies targeted to treat different disorders, efforts have to focus to identify the real composition of the used extracts of phytocannabinoids
Concerning CBD, it is evident that it induces therapeutic effects that can be applied to control drug-resistant epilepsy
Summary
Epilepsy is a neurological disease characterized by the presence of spontaneous and recurrent seizures.[1]. The use of cannabis extracts has been of great interest in the control of drug-resistant epilepsy, mainly in children with severe (catastrophic) epileptic syndromes, that is, neurological syndromes associated with seizures difficult to control and cognitive dysfunction such as Dravet (pathogenic variants in the sodium channel gene SCN1A) or Lennox-Gastaut syndromes. Other studies indicate that the effectiveness of phytocannabinoids as antiseizure therapy is contradictory.[15,16] Based on the information described above, the National Academy of Science, Engineering and Medicine of the USA indicates that at present, the evidence to support the use of cannabinoids in epilepsy is insufficient.[17]. The effects of cannabis on specific types of epilepsy are unknown Concerning this issue, few studies exist about the effects of cannabis extracts in temporal lobe epilepsy, the most common drug-resistant epileptic syndrome in adults (see below). European Cannabis sativa contains more cannabidiol (CBD) than THC, whereas Asian Cannabis indica has more THC than CBD.[23]
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