(Photo of Dr. Mac Burnham-Courtesy Ontario Brain Institute)
As marijuana marches towards legalization in Canada, researchers are digging ever deeper into its potential therapeutic benefits. For people suffering from epilepsy it could mean reaching back to the wisdom of the ancients to deliver a modern form of relief.
For thousands of years, cannabis has been known to have anticonvulsant properties. It was used in both ancient China and India, and then much later during Victorian times in Europe.
In the 20th Century, researchers started to narrow down the source of the benefits, extracting a chemical from marijuana called cannabidiol (CBD), which unlike THC will not make you high, but which has shown promise in reducing seizures.
But in the 1980s, research virtually stopped. Some wonder whether it was a casualty of the Reagan Administration's War on Drugs. Researchers wishing to conduct studies of cannabis were frustrated by legal obstacles to access.
A neuroscientist in San Francisco named Catherine Jacobson pushed hard to break down the barriers. Dr. Jacobson also happened to be the mother of a boy who suffered terribly from drug-resistant epilepsy. Having heard about cannabidiol, she took matters into her own hand--working in her garage to develop an extract, which she administered to her son and which gave him relief.
In a blog, she wrote passionately about her frustrations:
"As a mother, I am furious that the federal government has discouraged research into these potentially life-saving therapies for years by restricting clinical research. As a scientist, I decry the federal government for interfering with scientific freedom."
Dr. Jacobson was one of many parents and patient advocates who campaigned for cannabidiol studies.
But now the legal landscape is shifting. As more jurisdictions legalize marijuana use, CBD is drawing more attention as a possible therapy for forms of epilepsy that resist other drug treatments.
Leading an important study is Dr. Mac Burnham, Co-Director of EpLink - The Epilepsy Research Program of the Ontario Brain Institute.
'What we propose to do really needs to be done," he said in an interview.
"There is a compound out there that could improve the lives of some people--and not being used because doctors don't have enough information on effective dosing and safety to prescribe it."
Other recent studies have started to build the case for CBD. GW Pharmaceuticals, a British drug company, did a clinical trial with children suffering from Dravet Syndrome--a rare condition that not only causes seizures, but developmental disabilities. The study found that children treated with a CBD-based drug saw a media reduction of about 39 per cent in the convulsive seizures they suffered every month, compared with a 13 per cent reduction among those receiving a placebo. Those are significant results.
Dr. Burnham says the GW study may lead to the production of a drug that may be expensive and potentially only be helpful for a very select group--children suffering from rare forms of epilepsy.
His research project takes a broader focus--the roughly one-third of people with epilepsy for whom medications are ineffective in completely stopping seizures. He is launching a clinical study that will examine the use of CBD on adults. All the recent trials have been with children.
It will be a controlled, double blind trial. All participants will continue with their current medication. Half the group will be also given cannabidiol while the other half will get a placebo. Neither the doctors not the patients will know who is getting what.
Dr. Burnham is interested in discovering whether a simple extract of CBD can be effective, which is important because it would be much cheaper than a synthetic drug developed by a pharmaceutical company. He also wants to determine a therapeutic dosage because he is hearing from neurologists that they do not want to use CBD, fearing that they do not know enough about it and needing reassurance that it is safe.
His team plans to use low dosages, then gradually escalate them to about 1400 milligrams - looking at whether a dose within this range can safely reduce seizures. CBD will be administered in the form of an oil.
"We don't expect it to be a magic bullet that could end seizures but could be as good as any of the anticonvulsives that have been released in the last 20 years," he said.
The project will be run out of Toronto Western Hospital and the London Health Sciences Centre. It is planned to begin in 2017, with results to be published about two years later.
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