Ask Dr. David: Alternative Non-Pharmaceutical Treatment for Seizures
February 8, 2018
What are some factors you consider when using medical cannabis to treat seizures?
Seizures are one of the most frequent medical conditions for which I have certified patients to be treated with medical cannabis. I now have many documented cases of such patients who are experiencing fewer seizures, less intense and shorter seizures or have entirely ceased having seizures. These patients have been able to wean down the medications they were taking before they started medical cannabis treatment.
A Wholistic ReLeaf Success Story: Before starting medical cannabis, one of my patients was taking three anti-seizure medications because he had been suffering from seizures for over 50 years. By taking 15mg of CBD twice daily (with no THC), he is now seizure free, has been able to stop taking one of the anti-seizure medications, and is weaning off another.
Therapeutic Challenges in Treating Seizures with Medical Cannabis
Proper dosing of medical cannabis is one of the more significant challenges we face when certifying patients with seizures. Unlike standard anti-seizure medications, there are no long-term, scientifically-backed studies I can reference when determining dosage. When evaluating a particular anti-seizure treatment, it is relatively easy to assess progress when the patient’s symptoms have been reduced or eliminated. It is much more challenging to make treatment recommendations for a patient on seizure medications whose seizures have been reduced or eliminated, but the patient wants to minimize their use of pharmacological agents due to either side effects (or concerns about future side effects with ongoing use) or take a more natural treatment approach.
Another therapeutic challenge is weaning a patient from a pharmacological agent, especially if there is more than one daily medication being used. When a patient is taking just one medication, we can slowly wean the patient by occasionally reducing the dose in small amounts and then observing for breakthrough seizures (i.e., seizures that occur despite being on medication). It is helpful to know the initial dosing approach used for that medication (i.e., the starting dose, how many times the dosage was changed and by how much), how frequently the patient is still having seizures, and what the seizure pattern was like before starting medical cannabis.
It is also challenging when patients are on more than one medication because these medications may interact with each other, usually in beneficial ways, but sometimes these interactions are negative. Therefore, changing the dose of one medication can interfere with the effectiveness or side effects of another medication. Similarly, just like medical cannabis, some medications change the rate a patient will metabolize another medication. Accurately accounting for these variables is a specialization within itself. Since I am not a neurologist, and “polypharmacy” (the simultaneous use of multiple drugs to treat a single ailment or condition) is not my area of expertise, I highly recommend that a neurologist weans the patient off of anti-seizure medications.
The severity of the underlying seizures before starting treatment (whether pharmacological or cannabis) is another challenge to reducing the amount of medication. For example, if before treatment a patient’s seizures were mild, and these mild seizures came back as a result of lowering an anti-seizure medication, the impact on the patient may not be catastrophic, but we know we need to go back up on the medication. However, if the patient’s pretreatment seizures were severe, it is critical to have thorough discussions with the patient/caregiver before determining a course of action.
The reduction or elimination of a patient’s seizures is an extremely gratifying aspect of being able to certify seizure patients to be treated with medical cannabis. I look forward to more success stories! If you are interested in medical cannabis treatment for seizures and live in Florida, give us a call today at (813) 603-4425.
Wholistic ReLeaf (formally Family Medical Cannabis Clinic) and Wholistic Pediatric and Family Care have been treating patients with medical cannabis since 2016. As the Tampa Bay area’s leading authority on medical cannabis treatment and one of the nation’s most experienced pediatricians treating with medical cannabis, Dr. David Berger is committed to first understanding his patients’ needs. He then customizes a medical cannabis treatment plan that will produce the most effective results. For more information about medical cannabis treatment in Florida, please visit our website by clicking here. Existing patients may also contact the clinic directly through their patient portal.