From Cannabis to Cannabidiol to Treat Epilepsy, Where Are We?

Pellegrino Lippiello, Simona Balestrini, Antonio Leo, Antonietta Coppola, Rita Citraro, Maurizio Elia, Emilio Russo, Giovambattista De Sarro

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Several antiepileptic drugs (AEDs), about 25, are currently clinically available for the treatment of patients with epilepsy. Despite this armamentarium and the many recently introduced AEDs, no major advances have been achieved considering the number of drug resistant patients, while many benefits have been indeed obtained for other clinical outcomes (e.g. better tolerability, less interactions). Cannabinoids have long been studied for their potential therapeutical use and more recently phytocannabinoids have been considered a valuable tool for the treatment of several neurological disorders including epilepsy. Among this wide class, the most studied is cannabidiol (CBD) considering its lack of psychotropic effects and its anticonvulsant properties.

OBJECTIVE: Analyse the currently available literature on CBD also in light of other data on phytocannabinoids, reviewing data spanning from the mechanism of action, pharmacokinetic to clinical evidences.

RESULTS: Several preclinical studies have tried to understand the mechanism of action of CBD, which still remains largely not understood. CBD has shown significant anticonvulsant effects mainly in acute animal models of seizures; beneficial effects were reported also in animal models of epileptogenesis and chronic models of epilepsy, although not substantial. In contrast, data coming from some studies raise questions on the effects of other cannabinoids and above all marijuana.

CONCLUSION: There is indeed sufficient supporting data for clinical development and important antiepileptic effects and the currently ongoing clinical studies will permit the real usefulness of CBD and possibly other cannabinoids. Undoubtedly, several issues also need to be addressed in the next future (e.g. better pharmacokinetic profiling). Finally, shading light on the mechanism of action and the study of other cannabinoids might represent an advantage for future developments.

Original languageEnglish
Pages (from-to)6426-6433
Number of pages8
JournalCurrent Pharmaceutical Design
Volume22
Issue number42
DOIs
Publication statusPublished - 2016

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Cannabidiol
Cannabis
Anticonvulsants
Cannabinoids
Epilepsy
Animal Models
Pharmacokinetics
Nervous System Diseases
Seizures
Light
Therapeutics
Pharmaceutical Preparations

Keywords

  • Journal Article

Cite this

Lippiello, P., Balestrini, S., Leo, A., Coppola, A., Citraro, R., Elia, M., ... De Sarro, G. (2016). From Cannabis to Cannabidiol to Treat Epilepsy, Where Are We? Current Pharmaceutical Design, 22(42), 6426-6433. https://doi.org/10.2174/1381612822666160831122722

From Cannabis to Cannabidiol to Treat Epilepsy, Where Are We? / Lippiello, Pellegrino; Balestrini, Simona; Leo, Antonio; Coppola, Antonietta; Citraro, Rita; Elia, Maurizio; Russo, Emilio; De Sarro, Giovambattista.

In: Current Pharmaceutical Design, Vol. 22, No. 42, 2016, p. 6426-6433.

Research output: Contribution to journalArticle

Lippiello, P, Balestrini, S, Leo, A, Coppola, A, Citraro, R, Elia, M, Russo, E & De Sarro, G 2016, 'From Cannabis to Cannabidiol to Treat Epilepsy, Where Are We?' Current Pharmaceutical Design, vol. 22, no. 42, pp. 6426-6433. https://doi.org/10.2174/1381612822666160831122722
Lippiello, Pellegrino ; Balestrini, Simona ; Leo, Antonio ; Coppola, Antonietta ; Citraro, Rita ; Elia, Maurizio ; Russo, Emilio ; De Sarro, Giovambattista. / From Cannabis to Cannabidiol to Treat Epilepsy, Where Are We?. In: Current Pharmaceutical Design. 2016 ; Vol. 22, No. 42. pp. 6426-6433.
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AU - Citraro, Rita

AU - Elia, Maurizio

AU - Russo, Emilio

AU - De Sarro, Giovambattista

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N2 - BACKGROUND: Several antiepileptic drugs (AEDs), about 25, are currently clinically available for the treatment of patients with epilepsy. Despite this armamentarium and the many recently introduced AEDs, no major advances have been achieved considering the number of drug resistant patients, while many benefits have been indeed obtained for other clinical outcomes (e.g. better tolerability, less interactions). Cannabinoids have long been studied for their potential therapeutical use and more recently phytocannabinoids have been considered a valuable tool for the treatment of several neurological disorders including epilepsy. Among this wide class, the most studied is cannabidiol (CBD) considering its lack of psychotropic effects and its anticonvulsant properties.OBJECTIVE: Analyse the currently available literature on CBD also in light of other data on phytocannabinoids, reviewing data spanning from the mechanism of action, pharmacokinetic to clinical evidences.RESULTS: Several preclinical studies have tried to understand the mechanism of action of CBD, which still remains largely not understood. CBD has shown significant anticonvulsant effects mainly in acute animal models of seizures; beneficial effects were reported also in animal models of epileptogenesis and chronic models of epilepsy, although not substantial. In contrast, data coming from some studies raise questions on the effects of other cannabinoids and above all marijuana.CONCLUSION: There is indeed sufficient supporting data for clinical development and important antiepileptic effects and the currently ongoing clinical studies will permit the real usefulness of CBD and possibly other cannabinoids. Undoubtedly, several issues also need to be addressed in the next future (e.g. better pharmacokinetic profiling). Finally, shading light on the mechanism of action and the study of other cannabinoids might represent an advantage for future developments.

AB - BACKGROUND: Several antiepileptic drugs (AEDs), about 25, are currently clinically available for the treatment of patients with epilepsy. Despite this armamentarium and the many recently introduced AEDs, no major advances have been achieved considering the number of drug resistant patients, while many benefits have been indeed obtained for other clinical outcomes (e.g. better tolerability, less interactions). Cannabinoids have long been studied for their potential therapeutical use and more recently phytocannabinoids have been considered a valuable tool for the treatment of several neurological disorders including epilepsy. Among this wide class, the most studied is cannabidiol (CBD) considering its lack of psychotropic effects and its anticonvulsant properties.OBJECTIVE: Analyse the currently available literature on CBD also in light of other data on phytocannabinoids, reviewing data spanning from the mechanism of action, pharmacokinetic to clinical evidences.RESULTS: Several preclinical studies have tried to understand the mechanism of action of CBD, which still remains largely not understood. CBD has shown significant anticonvulsant effects mainly in acute animal models of seizures; beneficial effects were reported also in animal models of epileptogenesis and chronic models of epilepsy, although not substantial. In contrast, data coming from some studies raise questions on the effects of other cannabinoids and above all marijuana.CONCLUSION: There is indeed sufficient supporting data for clinical development and important antiepileptic effects and the currently ongoing clinical studies will permit the real usefulness of CBD and possibly other cannabinoids. Undoubtedly, several issues also need to be addressed in the next future (e.g. better pharmacokinetic profiling). Finally, shading light on the mechanism of action and the study of other cannabinoids might represent an advantage for future developments.

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