“I read about hemp oil for preventing seizures in children and adults with autism. Is there research to support this?”
Today’s “Got Questions?” response is from developmental pediatrician Daniel Coury, medical director of Autism Speaks Autism Treatment Network (AS-ATN). Dr. Coury is the chief of developmental-behavioral pediatrics at Nationwide Children’s Hospital, in Columbus, Ohio.
With the legalization of medical marijuana in several U.S. states, questions have begun to arise regarding its use and that of related products with the same active ingredients. Hemp oil is one of these related products and has long been legal in the U.S.
Hemp and marijuana both belong to the Cannabis plant genus. Hemp differs in that it has very little tetra hydro cannabinol, or THC, and higher amounts of cannabidiol, or CBD. High amounts of THC are associated with marijuana’s well-known euphoria. CBD is not. Proponents of hemp oil treatment say that users don’t feel stoned.
What conditions can hemp and marijuana help? What side effects do they have? Is hemp a potential treatment for autism or the seizures experienced by many individuals with autism? These are important questions. However, we still have little research to inform our answers.
Marijuana used for medical purposes has been studied as a treatment for nausea and anorexia in chemotherapy patients. To a more-limited extent, it’s also been studied as a treatment for glaucoma. Medical research has shown its effectiveness for these conditions. As a result, we have a pharmaceutical-grade form of the active ingredient THC that we can prescribe for these purposes.
More recently, some experts have suggested evaluating THC for treatment of epilepsy. This may be what has prompted recent interest in hemp oil, which in fact is low in THC.
Of course, there are many important steps between the suggestion that a chemical might be helpful in treating something as serious as seizures and a recommendation that it be used outside of a research setting. Typically, the development of medications begins with animal studies that provide preliminary information on safety and possible effectiveness. Before a new medicine can be used in humans, the FDA generally requires safety testing in adult, juvenile and pregnant animals. If the compound looks promising and safe in animals, it moves on to clinical trials in humans. Again, the goal is to determine safety and efficacy, along with dosing recommendations.
Where are we with hemp, marijuana or their active ingredients? At this time, there are nearly 400 clinical studies with marijuana listed in ClinicalTrials.gov. But none are looking at the treatment of epilepsy or autism. Still, there have been some case reports of children being treated with marijuana or its active components for epilepsy that did not respond to standard medical treatments. Encouragingly, some responded well to medical marijuana. They experienced fewer seizures.
What about CBD?
Recently, researchers used an online survey to get information from 19 parents who were using a CBD-enriched strain of marijuana to treat children with severe epilepsy disorders. The parents frequented a Facebook page on the subject. Sixteen reported that their children had improved on the treatment. There’s some evidence from animal studies to support this observation. These studies have shown that a compound similar to CBD has anticonvulsant properties in mice and rats.
There’s also an experimental medicine containing CBD currently being studied for treatment of epilepsy associated with Dravet syndrome and Lennox-Gastaut syndrome. Both are extremely rare conditions associated with treatment-resistant epilepsy and severe developmental delay. At this time, the treatment is not available outside FDA-supervised studies. You can read more about these studies and opportunities for participation here.
So, should you try hemp oil to reduce seizures in a child or adult with autism?
Clearly, we lack the safety and efficacy studies to guide such a decision. So it’s important to regard hemp oil as an experimental medication. On the cautionary side, studies of marijuana users have associated cannabis with brain abnormalities in adolescents. And clearly, it affects thinking abilities. We don’t know, with certainty, whether these effects would likewise be true of hemp oil, which contains different levels of marijuana’s active ingredients.
In my opinion – and that of most medical experts – such unknowns and their associated risks may be acceptable in someone with no other effective choices. But they may not be worth the risk in someone whose epilepsy can be well-managed with proven treatments.
I hope this information proves helpful. Please continue to reach out with your questions.
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