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Medicinal cannabis has been a topic of great interest to the epilepsy community since the approval of the first FDA-approved prescription cannabidiol (CBD) in 2018. It is important to note that The FDA has not approved the cannabis plant for any medical use, just individual drugs that contain individual cannabinoids. Cannabinoids, or substances in cannabis that act on cells in the brain, include over 100 different types but two of which that have been widely studied in the research community: CBD and tetrahydrocannabinol (THC). THC is the major chemical compound found in many strains of marijuana that creates a psychoactive effect when it binds to receptors in the brain. CBD binds to different receptors and is not psychoactive. Since the FDA approval of Epidiolex®, a mostly purified plant-based cannabidiol oil used to treat seizures associated rare genetic epilepsies, there is greater efforts to understand the mechanisms behind CBD and if other cannabinoids might be useful in the treatment of seizures. Marijuana products sold in dispensaries and online are not approved or regulated by the FDA and can vary significantly in quality, safety, and effectiveness. In some cases, commercial, nonprescription cannabis products are thought to increase seizures. Today’s webinar will review the basics of cannabis biology and the differences between cannabis strains, as well as explain the medical uses of medical marijuana and the recent approvals of cannabidiol (CBD) in specific epilepsy types. Attendees will also learn about the broader uses of medical marijuana for epilepsy. This webinar is generously supported with funding by Jazz Pharmaceuticals. About the Speaker: Dr. Eric Marsh is an Associate Professor of Neurology at University of Pennsylvania Perelman School of Medicine and the Children’s Hospital of Philadelphia (CHOP), Clinical Director of Penn Orphan Disease Center, and Director of the CHOP Rett and Related disorders clinic. Dr. Marsh has particular clinical interests in developmental epilepsies, neurodevelopmental disabilities, and cortical malformations. His research has focused strongly on the impact of intraneuronal development and altered excitability on epilepsy, analyzing intracranial EEG recordings to better localize the epileptic zone and network, and performing natural history and biomarker studies. This work has primarily utilized a model of mutations in the gene ARX, but also performing basic science work with a number of other developmental genes including mouse work on Cdkl5. He has also been involved in a number of clinical trials for children with the DEEs, including Dravet, LGS, and Rett syndrome.
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In this video we dive into the facts and myths about marijuana use during pregnancy. Research to date does not support the use of marijuana during pregnancy, despite its effectiveness in providing relief for pregnancy symptoms. Subscribe to the McMaster Demystifying Medicine YouTube channel: https://www.youtube.com/c/DemystifyingMedicine This video is provided for general and educational information only. Please consult your health care provider for Information about your health. This video was made by McMaster students Priyanka Lamba, Makenzie Lamb, and Purviben Mahida in collaboration with the McMaster Demystifying Medicine Program #DemystifyingMedicine Copyright McMaster University 2020 References: Briscoe, J., & Casarett, D. (2018). Medical Marijuana Use in Older Adults. Journal of the American Geriatrics Society, 66(5), 859-863. doi:10.1111/jgs.15346 CDC. (2018, March 16). What You Need to Know About Marijuana Use and Pregnancy. Retrieved November 27, 2020, from https://www.cdc.gov/marijuana/factsheets/pregnancy.htm Commissioner, O. (n.d.). What You Should Know About Using CBD When Pregnant or Breastfeeding. Retrieved November 28, 2020, from https://www.fda.gov/consumers/consumer-updates/what-you-should-know-about-using-cannabis-including-cbd-when-pregnant-or-breastfeeding Gunn, J. K., Rosales, C. B., Center, K. E., Nuñez, A., Gibson, S. J., Christ, C., & Ehiri, J. E. (2016). Prenatal exposure to cannabis and maternal and child health outcomes: A systematic review and meta-analysis. BMJ Open, 6(4). doi:10.1136/bmjopen-2015-009986 Hildreth, D. (n.d.). What Are Topicals? Retrieved November 21, 2020, from https://ocs.ca/blogs/facts-about-cannabis-consumption/what-are-topicals Hildreth, D. (n.d.). Topical Potency. Retrieved November 21, 2020, from https://ocs.ca/blogs/facts-about-cannabis-consumption/topicals-potency Katrina, M., Gryczynski, J., Axenfeld, E., Schwartz, R.P., Terplan, M. (2017). “Pregnant Womenʼs Current and Intended Cannabis Use in Relation to Their Views Toward Legalization and Knowledge of Potential Harm.” Journal of Addiction Medicine 11(3):211–16. doi: 10.1097/ADM.0000000000000299. National Institute on Drug Abuse. (2019, December). Marijuana DrugFacts. Retrieved from https://www.drugabuse.gov/publications/drugfacts/marijuana Parmar, J. R., Forrest, B. D., & Freeman, R. A. (2016). Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs. Research in Social and Administrative Pharmacy, 12(4), 638-654. doi:https://doi.org/10.1016/j.sapharm.2015.09.002 Premium Jane. (2019, September 27). Hemp vs. Marijuana: What Is the Difference? Retrieved from https://premiumjane.com/blog/difference-between-cannabis-and-hemp/ Public Health Ontario. (2018). Brief effects of cannabis exposure during pregnancy and breastfeeding. Retrieved from https://www.publichealthontario.ca/-/media/documents/E/2018/eb-cannabis-pregnancy-breastfeeding.pdf?la=en Sarrafpour, S., Urits, I., Powell, J. et al. (2020). Considerations and Implications of Cannabidiol Use During Pregnancy. Curr Pain Headache Rep 24, 38 https://doi.org/10.1007/s11916-020-00872-w Singh, M. (2019, July 23). Medical VS Recreational Cannabis: Blog: Apollo. Retrieved from https://apollocannabis.ca/medical-vs-recreational-cannabis-in-canada/ Zumbrun, E.E., Sido, J.M., Nagarkatti, P.S. et al. (2020). Epigenetic Regulation of Immunological Alterations Following Prenatal Exposure to Marijuana Cannabinoids and its Long Term Consequences in Offspring. J Neuroimmune Pharmacol 10, 245–254 https://doi.org/10.1007/s11481-015-9586-0
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