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Cannabidiol and epilepsy in Brazil: a current review
Carlos André Oshiro1, Luiz Henrique Martins Castro1
1Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo, SP, Brazil.
Arquivos De Neuro-Psiquiatria
|August 17, 2022
Summary
Cannabidiol (CBD) shows promise for epilepsy treatment, with proven efficacy and safety. However, clear guidelines and regulatory frameworks are needed for wider access and improved quality of life for epilepsy patients in Brazil.
Area of Science:
- Pharmacology
- Neurology
- Regulatory Science
Background:
- Cannabidiol (CBD) is an emerging therapeutic for epilepsy.
- While effective and safe, knowledge gaps and regulatory hurdles limit its use.
- Specific guidelines for different epilepsy types are lacking.
Purpose of the Study:
- Review pharmacological and clinical aspects of CBD in epilepsy.
- Detail the regulatory landscape for CBD in Brazil.
- Propose a practical therapeutic guide for CBD use in Brazil.
Main Methods:
- Non-systematic literature review up to February 2022.
- Inclusion of authors' clinical experience.
- Focus on current concepts of CBD and epilepsy.
Main Results:
- CBD is approved for Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex.
- CBD is generally well-tolerated with a better-understood adverse event profile and drug interactions.
- In Brazil, CBD is regulated differently from medication, accessible via prescription and import, but not covered by the national health system.
Conclusions:
- CBD represents a significant advancement in epilepsy treatment.
- Further research and public health initiatives are crucial for equitable access.
- Improving access to CBD can enhance the quality of life for individuals with epilepsy in Brazil.
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:13Seizures: Classification
Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for their...
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for their...
01:14Antiepileptic Drugs: Glutamate Antagonists
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
01:21Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...