Pubdate: Mon, 01 Aug 2016
Source: Irish Times, The (Ireland)
Column: A Doctor Writes
Copyright: 2016 The Irish Times
Author: Muirius Houston


CBD Oil Reduces Seizure Activity but Without the Side Effects of Cannabis

Preparations of the leaves and resin of the cannabis plant have been 
in use for more than 2,000 years.

First introduced into western medicine in the mid-19th century, 
cannabis was prescribed in the past for a diverse range of complaints 
including anxiety, arthritis and rheumatic disorders, migraine and 
painful menstruation. A cannabis derivative, nabilone, is effective 
in treating nausea and vomiting brought on by chemotherapy treatment 
in cancer patients. The benefits of cannabis in patients with 
multiple sclerosis (MS) have been well described. It reduces muscle 
cramps and relaxes bladder and bowel sphincters. And it has been 
shown to reduce the pressure in the eyeball that leads to glaucoma.

Cannabis contains two chemical compounds of medical interest: 
tetrahydrocannabinol (THC), the psychoactive ingredient in 
marijuana/cannabis that leads to the "high" sought by recreational 
users of the drug; and cannabidiol, or CBD, a non-psychoactive 
component that has been shown to have a number of therapeutic benefits.

US experience

The US experience referred to by Vera Twomey involves a preparation 
high in CBD and low in THC. CBD oil, which is taken orally, has been 
used by patients with Dravet syndrome to anecdotal good effect; it 
has reportedly reduced seizure activity in children given the drug.

Notwithstanding the legalisation of medical cannabis use in a growing 
number of US states, at a federal level cannabis and its derivatives 
remain Schedule 1 drugs, which precludes their prescription by 
doctors who operate under a federal medical licence. So legal users 
often obtain the drug without a prescription; medics who prescribe it 
risk losing their licence to practice.

MS patients

Although cannabis remains an illegal substance under the Republic's 
Misuse of Drugs Act, a derivative, Sativex, has been approved by the 
Irish Medicines Board as a prescription-only medicine. Sativex, which 
contains both THC and CBD, is an oral spray that has been shown to 
improve symptoms in MS patients with moderate to severe spasticity.

However, before doctors here will prescribe it and other cannabis 
products, specific legislation will need to be passed. Even then, 
many doctors would want to see evidence from robust medical trials of 
its effectiveness for treatment of various conditions.

Cannabis is not without side effects: short-term memory can be 
impaired, and concentration and co-ordination are disrupted. In rare 
cases it can induce psychosis. Regular users may become apathetic and 
neglect their work and appearance. Changes in perception and sense of 
time produced by cannabis can be dangerous when driving. And of note 
for those with epilepsy, cannabis can increase the drowsiness 
associated with anti-seizure drugs.

However, if prescribing cannabis became legal here, some doctors 
would weigh up the risks versus the benefits in a case such as Ava's 
and conclude that the risk to her life of up to 16 seizures a day was 
greater than any potential sideeffects of CBD oil.
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MAP posted-by: Jay Bergstrom