Yo, what’s good? It’s your boy Dan here to give you the lowdown on Epidiolex, a dope cannabis-based medicine that’s packing some serious CBD power. It’s the first FDA-approved prescription CBD product out there, and it’s designed to help combat seizures in patients with severe forms of epilepsy. But that’s not all it can do—scientists are studying its effects on chronic pain and anxiety too.
Epidiolex is legit because it only contains one or two molecules of interest, unlike whole-plant extracts that have hundreds of different phytochemicals. The molecule of interest in this case is CBD (cannabidiol), which doesn’t get you high but has some solid medicinal properties. It’s made by GW Pharmaceuticals, the same company behind Sativex, a balanced mix of THC and CBD.
Each bottle of Epidiolex has 100ml of oral solution and a whopping 10,000mg of CBD. That’s a lot! The FDA specifically approved it for treating seizures associated with Lennox-Gastaut syndrome and Dravet syndrome, which are both neurological conditions that can affect young children. In fact, the administration has indicated that it can be used for patients as young as two years old. Over 15,000 people have used Epidiolex to help with these conditions so far.
The FDA approved Epidiolex on June 25th, 2018, which was a big deal because cannabis has been prohibited by the feds for decades. Some people think that this move just benefits big corporations who want to patent and profit from the plant, but others see it as a step forward for patients who need relief. The approval came after a bunch of controlled clinical trials showed that it could significantly reduce seizures in patients who took it. As more trials are conducted, other cannabinoid formulations might become approved and available in the future.
So how does Epidiolex work exactly? It targets a variety of receptors involved in epilepsy by harnessing the power of CBD. Unlike THC, which binds tightly to the major receptors in the endocannabinoid system (ECS), CBD has a low binding affinity to those receptors. Instead, researchers think it helps to balance out neurotransmitter firing through a number of other sites.
Before we can understand how Epidiolex combats seizures at the cellular level, we need to know how seizures happen in the first place. Normally, neurons in the brain exist in a state of balance, with excitatory and inhibitory neurotransmitters keeping them in check. During a seizure, groups of neurons in certain regions of the brain become “hypersynchronous” and excitable, sending out electrical discharges repeatedly because of either too much excitation or too little dampening.
Epidiolex affects numerous molecular targets implicated in seizures through several proposed mechanisms. For example, it binds to TRPV1 (a proposed cannabinoid receptor) to modulate seizures and increases calcium release but enters a state of desensitisation after activation by CBD. It blocks T-type calcium channels that cause an influx of calcium into neurons when activated. It also binds to some serotonin receptors whose role remains unclear but could be important for CBD’s mechanism of action. Finally, it blocks certain opioid receptors that play a role in epilepsy and directly binds to GPR55 (a site that modulates synaptic transmission).
Like any medication, Epidiolex comes with side effects such as drowsiness, decreased appetite, fatigue, malaise, rash, insomnia, infections and drug interactions. However, ongoing research looks promising for its use beyond seizures associated with Lennox-Gastaut syndrome and Dravet syndrome. Clinical trials are exploring its potential for managing chronic pain and anxiety.
That being said, Epidiolex isn’t the same as CBD oil even though they share CBD as their active ingredient. While each bottle of Epidiolex contains a highly standardised formula consisting of 10,000mg of CBD and inactive ingredients like dehydrated alcohol and sesame seed oil (to name a few), CBD oils come in many forms with varying concentrations and additional non-psychotropic cannabinoids such as CBG and CBN that create an entourage effect.
So there you have it—everything you need to know about Epidiolex and what it does. Although it might not be for everyone due to its side effects or limited FDA-approved uses at present, its potential for helping patients with epilepsy and other conditions is worth exploring further. Stay lit!