Cannabinoids in patients with epilepsy

Wieslaw Oczkowski, MD, is a professor emeritus in the Department of Medicine at McMaster University and director of the Regional Stroke Network for the Central South Ontario Region.

What is the current place of cannabidiol and other cannabinoids in the treatment of epilepsy? How often are over-the-counter (OTC) cannabinoid preparations used by patients with epilepsy in North America? How does it affect the clinical management of epilepsy?

The use of cannabinoids/marijuana in managing epilepsy is still not completely defined. It’s better understood in the pediatric population for individuals with very refractory epilepsy syndromes. It would seem, from not necessarily perfect clinical trials, that in the younger, pediatric population the addition of a cannabinoid may decrease the frequency of seizures.

In the adult population that’s not clearly understood. It requires further randomized trials to see if in fact they’re effective: if they have [fewer] side effects as opposed to good effects, and how effective they are.