Cannabis, More Than the Euphoria: Its Therapeutic Use in Drug-Resistant Epilepsy

Author: Keri-Ann R. Buchanan-Peart, Oribhabor G I, Khokale R V
Cureus.com

Introduction & Background

Approximately 70 million people worldwide are affected by epilepsy [1]. Its prevalence ranges from 0.5% to 1% in developed countries and even higher in developing countries [2]. Despite the vast availability of antiepileptic drugs (AEDs), 30% of these people have drug-resistant forms [1,3].

The International League Against Epilepsy (ILAE) describes drug-resistant epilepsy (DRE) as the failure of adequate trials of two tolerated and appropriately chosen and used AED schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom [4]. Sustained seizure freedom occurs when the patient is seizure-free for more than one year or has sporadic seizures separated by a period three times the maximum interval between seizures before the treatment, whichever is longer [4]. About 7% to 20% of children have DRE, while 30% to 40% of adult patients remain refractory to pharmacological treatment [2]. This has a significant effect on cognitive and behavioral function and ultimately, the quality of life of these patients [5]. As a result, some of them seek alternate antiepileptic agents such as cannabis to achieve seizure freedom. Cannabis is a plant with different species; the most common being Cannabis sativa and Cannabis indica [6]. For many years, it has been used recreationally and increasingly in conditions such as multiple sclerosis, sleep disorders and epilepsy [6]. 

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