Medicinal cannabis against focal epilepsies

The use of cannabis for medicinal purposes has generated growing interest in the scientific community and in patients who are looking for alternatives to better deal with various diseases. Among them, epilepsy. This chronic neurological disorder is characterized by the recurrent occurrence of seizures and other associated symptoms. Although there are conventional pharmacological treatments to control seizures, a significant percentage of patients do not respond adequately to these drugs, which has led to the search for alternative therapies.

Within this framework, a team of researchers found that cannabidiol (CBD) oil is effective in epilepsies that affect only part of the brain and are resistant to drugs. The study, which lasted six months and has been published in the academic journal Epilepsy & Behavior, evaluated the efficacy, safety, and quality of life in 44 adult patients between the ages of 18 and 60 diagnosed with focal epilepsy. .

“We did this scientific work with a population of patients with epilepsy that did not respond to conventional medication but did respond to cannabis”, highlights Silvia Kochen, director of this research project that she carried out together with Manuela Villanueva, Liliana Bayarres, Anilu Daza- Restrepo, Silvia González Martínez and Silvia Oddo, members of the Neurosciences and Complex Systems Unit (ENyS), a multidisciplinary space for research, teaching and transfer articulated between the National Council for Scientific and Technical Research (CONICET), the Arturo Jauretche National University and the high complexity hospital El Cruce-Néstor Kirchner, by Florencio Varela, in Argentina all these entities.

The study was carried out at the El Cruce hospital. The results indicate that CBD oil administered adjunctively in adult patients with drug-resistant focal epilepsy was effective, safe, and well tolerated. Of the 44 people who were part of the process, 86% halved their monthly seizures. “Unlike other drugs with which the patient has to be withdrawn from the clinical trial because it has a severe adverse effect, in this study not only did that not happen, but we also saw a positive effect on the subject’s quality of life. For example, he is more connected, his mood improves, his sleep improves, ”Kochen, scientific coordinator of Cannabis CONICET and also of the CONICET Network of Cannabis for Medicinal and Industrial Use (RACME-CONICET) told Argentina Investiga. Regarding the effects of CBD oil, the specialist emphasizes that “some substances or drugs are excellent, but many times we cannot use them because they increase anxiety or because they interfere with a good quality of sleep. So, this also positions CBD with direct efficacy in decreasing the frequency of crises, and also with other effects that are really very positive.”

The use of cannabis for medicinal purposes has generated growing interest in the scientific community and in patients who are looking for alternatives to better deal with various diseases. (Photo: CONICET / Arturo Jauretche National University / Argentina Investiga)

–One of the inclusion criteria in the sample was that they be patients with focal epilepsy. What was the reason for this selection?

–Because the most frequent form of presentation of epilepsy is what is called focal: an area of ​​the cerebral cortex where an epileptic neuronal network is located and from where the discharge originates. So the study was based on those patients with focal epilepsy who do not respond to medication. There are many publications on children and adolescents, on epileptic encephalopathies, on generalized forms of epilepsy, but there are very few on young populations and adults with forms of focal epilepsy, without any type of cognitive alteration. And so we wanted to see what the response was like in this population.

–Taking into account this research project and the favorable results of the treatment of focal epilepsy with CBD, can this drug be considered for other diseases?

–There are many open lines at the moment and an exponential growth in publications. He is working on Parkinson’s, autism, dementia, chronic pain, glaucoma, sleep disorders, anxiety disorders. To this is added that there is no lethal dose, that is, there is no report of death from the use of cannabis; there are also no serious adverse effects. It is even highly disputed whether it causes addiction, since some authors say that THC in high doses can cause it. But, on the other hand, there is research that shows that cannabis is being used as an exit drug for severe addictions.

–In line with the latter that you raise, do you consider that it is still a complication and that there is some resistance to talking about cannabis by stigmatizing it as an illegal drug?

-The question is very interesting. It happens less and less. Surveys were carried out from RACME, the CONICET cannabis network that I coordinate, also from NGOs in the Social Sciences, at the National University of Quilmes, about what they ask and there is less and less prejudice. I think one important thing is knowledge. As you have information and knowledge, you break down these taboos and prejudices and also in the demonstration of effectiveness. For example, older people who have chronic pain do very well with cannabis. So, this evidence, this construction of knowledge, which is somewhat one of my concerns to avoid saying anything, makes it also contribute. It also helps to break down all prejudices; this demonization that the plant had at the time when it was decided that it was prohibited.

–Does the approval of the medical cannabis and hemp law also have an impact?

–We are all waiting for the implementation to be completed through the National Cannabis Agency. One concern we have is that it is taking too long. The other concern is that when it is regulated, we do not repeat the mistakes of other countries, where it was limited to a few and then all the work that is carried out throughout the country, at the federal level is not taken into account: public and private companies, small NGOs, small cooperatives. The idea is that when it is regulated, the arms really open very broadly, so that this is not delimited, limited, to a few.

–Are there experiences in other developing countries that can be taken as an example?

–There are many experiences to take and there are also many experiences not to take. You have to try not to make the same mistakes. For example, last year I was in California, where cannabis is totally legal, the same applies to alcohol: you have to be of legal age. But it turns out that, although it is full of shops where you can buy something that has 80% THC, that is, there is no cap, no limitation, it is very expensive, it is extremely expensive. And since it is not advertised as a health product, it is accessible to those with good purchasing power. And the rest can not access. So, being in Oakland, which is across from San Francisco and is the historical place where the whole cannabis movement began, I was received by a company that was historical and that at that time was an NGO, with a more hippie vibe, but they sold it because the spirit that it had, a spirit of solidarity, accessible to anyone, is now an almost lustful initiative because acquiring any of these products is very expensive. I can also give the example of Uruguay, where there are cannabis clubs that cannot sell health products. But in pharmacies there is only one registered product that is very expensive. So what do people do? They turn to the black market: buy health products that they have in the cannabis club. I am giving these examples because it seems to me that it is the great challenge that we have. In Argentina we are able to do things very well with an accessible and quality proposal.

–There are NGOs, cooperatives and companies dedicated to the cultivation, production and marketing of cannabis that, to do so, must be registered in the National Registry of Seed Commerce and Control (RNCyFS) under the National Seed Institute (INASE). One of these companies is Whale Leaf Farm, located in Puerto Madryn. CONICET granted him the license to commercialize two varieties of seeds: Pachamama, which has genetics high in cannabidiol (CBD) and Malvina, with genetics in tetrahydrocannabinol (THC). Is this also part of that great challenge that you pose?

–The research and development of these seeds depends on the Patagonian National Center (CENPAT), which is a CONICET research and development center, and the Cannabis CONICET company, which depends on the ENyS. The commercialization of these seeds is done through the company Whale Leaf Farm, which can also cultivate. Then, a larger scale can be made: the scale that reproduction generates for you only for research and development is not the same as if you are going to commercialize it. This means sovereignty, quality; It means that when you go to grow, to produce, you know the genetics of the plant you are using. So if I recognize what kind of pain a patient has, we can choose the plant that has a seed with THCCBD in ratios more THC than CBD, even for an epilepsy patient, use CBD. I put it as an example. And it also has to do with an economy because it is much cheaper to buy national seeds than if we have to import them. This impacts the entire production chain. And beyond these licenses, from the Cannabis CONICET company we also do quality controls on the seeds of small, medium, and large producers. And also, through the experimental cultivation fields that UNAJ has, which is assembled with our research lines and the Agricultural Sciences career of the University. The proposal consists of continuing to improve the genetics of the plant to find new and better forms that have a direct impact on health, food and also at an industrial level.

–What other applications do you think cannabis and, particularly, hemp can have, thinking of other sectors such as the industrial, productive field, for example?

-In this path that I am traveling I found out that it was (Manuel) Belgrano who brought hemp to our country. And we found that in 1937 there were already records of all the places in the country, province by province, where hemp was grown. In fact, there is more and more evidence that when it is prohibited and circumscribed within the prohibited drugs (the United States does it more or less around the 1930s) it is because hemp fiber competed very strongly with the plastic that just appeared. At that time, plastic products were crap and there was no awareness about pollution. That is why it is believed that it was banned because if not, it does not make any sense. In fact, at this time, for example, the Lego company reported that its next dolls are going to be made with hemp fiber. They are not going to use plastic anymore. Also its use as biodiesel. That is why the potentiality that it really has is infinite. (Source: Julio Longa / Andrea Romero / Damián Ierace / Arturo Jauretche National University / Argentina Investiga)