Cannabis Use in Epilepsy and Anorexia- Two "N-of-One" Trials (P6.039)

Abstract

Objective:Two cases demonstrate the safety and efficacy of Cannabis use to treat epilepsy and anorexia. Background: This report uses the "N-of-One" methodology to assess the safety and efficacy of chronic cannabis use. Both cases involve periods off treatment with significant return of symptoms (seizures and weight loss) with hospital records consistent with the hypothesis of the therapeutic effects of cannabis. Design/Methods: N-of-One trial design over 20 to 40 years of exposure to cannabis. Results: A 38 year-old male with post-traumatic Nocturnal Frontal Lobe Epilepsy used cannabis for 20 years. When he was unable to access cannabis, recurrent serious seizures requiring ICU care occurred. Following hospitalization, return to use of a buccal cannabis oil preparation (Charlotte's Web) restored his seizure-free state. A 50 year old male developed an eating disorder in the third grade. After 2 years on the anabolic steroid (oxandrolone), his weight and appetite improved but the steroid was discontinued due to serious side effects (headaches and liver function abnormalities). In his late teens, he began cannabis use (inhaled) and maintained normal weight. Two episodes (at age 40 and 50) when he was off cannabis resulted in weight losses of 22 pounds (30 days following cannabis) and 12 pounds (10 days following cannabis). Hospital records associated with these episodes failed to discover a diagnosis beyond primary anorexia. Conclusions: These patients illustrate the potential therapeutic use of cannabis in seizure disorders or anorexia. The route of administration (inhaled or buccal) avoids the first-pass effect associated with pill formulations and presents higher levels of cannabinoids such as cannabidiol (CBD) to the endocannabinoid system in the frontal and insular cortex. Study Supported by:

Disclosure: Dr. Petro has nothing to disclose.