Cannabinoids (THC and CBD) as Controllers of Drug-resistant Epilepsy Syndromes

Epilepsy is one of the most common neurological disorders, which is spreading more and more every day. Almost one third of epileptic patients suffer from drug-resistant onesets that are known with refractory seizures, leading to decrease in quality of life that will cause inevitable psychological consequences. According to the population-based national study survey of epilepsy, Iran has the highest prevalence of long life epilepsy that is 2-3 more than the overall worldwide estimation. It has been estimated that 1300000 Iranian people struggle with epilepsy and 400000 of them are diagnosed with drug-resistant syndromes. So nowadays, comprehensive research has been done to find a treatment for drug-resistant epilepsy. Cannabis sativa as a new hope has been used for epilepsy, pain and anorexia from deep past. This plant has more than 80 canabinoids that among them Δ9-tetra hydrocanabidiol (THC) and canabidiol (CBD) have a high share. From 19th century, the role of THC on treatment of drug-resistant epilepsy has been investigated and from 2 years ago CBD as a new idea has attracted scholar s attention for medical usage especially for drug-resistant syndromes. In many studies, positive effects of phitocanabidiols have been reported; using animal modeling of epilepsy, seizures, epileptogenesis and neuroprotection, however, usage of CBD is preferable due to plethora psychic side effects of THC. CBD is the most frequent molecule used for drug-resistant epilepsy like Lenox-Gastaut and Dravet treatment whereas the mechanism is not understood clearly. Method: A comprehensive study on cannabinoid s effect on epilepsy has been done, using search engines like Google Scholar and PubMed. Our strategy to find most relevant papers was using key words like Epilepsy, Cannabinoids and seizure, cannabis, THC without any limitation on year and language. Cannabis sativa belongs to Urticales order and Cannabaceae family (Ahmed et al., 2008) cannabis has been known as hemp, marihuana, marijuana, Indianhemp, indestrialhemo in Europe. In English, marijuana refers to that kind of Cannabis which is cultivated for drug manufacturing and hemp is used to produce fiber (Sengloung et al., 2009). Cannabis grow in western and middle parts of Asia like Russia, China, India, Pakistan, Iran specially marginal parts of Himalaya toward India. This plant grows in arid lands mostly (Anwar et al., 2006). Cannabis is known as a herb with miscellaneous potentials that it is utilized as a source of drug, fiber, food and oil around the world (Small et al., 2002Piluzza et al., 2013). More than 480 different metabolites in Cannabis have been reported and most of these secondary metabolites like flavonoids, stilbenoids, terpenoids, alkaloids, and chemicals with Nitrogen, lignans and phenolic amids are found in cannabis tissues (Flores-Sanchez et al., 2008). Cannabinoids are unique materials which are found only in Cannabis Sativa which are terpenophenolic molecules with 21 carbons. More than 70 cannabinoids have been detected in cannabis that the main 10 among them are CBG, CBC, 9 Δ - THC, and 8 Δ - THC, CBL, CBE, CBN, CBD, CBNT and CBT while the rest are classified as sundries. (Flores-Sanchez et al., 2008, Cascini et al., 2013). 0.3% of these molecules or less is found in root, seed and stalk, less than 1% in below leaves and 2-3% in the top leaves of female plants (Carpentier et al., 2012). Among Canbinoids, mentioned above, CBD and THC are the most important due to medical usage such as killing pain, appetite increase, migraine, seizure, decreasing nausea between cancerous patients who are under chemotherapy, epilepsy, MS, anti-cancer and so on (Chandra et al., 2010; Sirikantaramas et al., 2004; Van Bakel et al., 2011). Regarding a certain group of epileptic people (almost one third of whole) who suffer from treatment-resistant epilepsy, no proper remedy has been found (Devinsky et al., 2016) these patients have to experience anaemia as a side effect. Conclusion: Regarding prior arts, studies and experiments mentioned previously, effect of Cannabis as a medication with infinitesimal side effects has been proved. So, Cannabis cultivation and oil extraction in order to combat with a wide range of disease, most importantly treatment-resistant epilepsy has been necessitated. To aim this goal, Scholar s effort to provide the best condition for Cannabis cultivation is in demand to reach the highest amount of oil as a material for drug manufacturing to have a share in decreasing of death from epilepsy.

کلیدواژه ها:

Canabidiols ، Cannabis ، seizure ، epilepsy