Scientists highlight potential of cannabis in epilepsy, pain, cancer and more

A new paper highlights the potential of cannabis in the treatment of epilepsy, pain, cancer and more – but stresses the need for more reliable evidence.

Researchers at the Medical University of Vienna have published a review highlighting the vast therapeutic potential of the medicinal use of cannabis, in the leading journal Science. 

Their paper highlights the use of cannabinoids for indications such as treatment-resistant epilepsy and neuropathic pain, as well as in neurological diseases associated with ageing, such as Alzheimer’s, Parkinson’s, and Huntington’s diseases.

It also suggests that cannabinoids, particularly THC, may promote cancer cell death.

The clinical effects of cannabis-based medicines are mostly due to activation of endogenous cannabinoid CB1 and CB2 receptors. 

Analgesic, antiepileptic, antipsychotic, sedative and neuroprotective effects have been ascribed to CBD, through both anecdotal observations and international clinical trial. 

Currently, CBD is approved in some countries for the treatment of refractory epilepsy and spastic paralysis. 

In Austria, the CBD-containing drug Sativex is approved for the treatment of multiple sclerosis and spasms and Epidiolex is approved for the treatment of certain genetic forms of epilepsy. Dronabinol is also given as an adjunctive medication for chronic pain and in the treatment of cancer.

Neurobiologist and lead author of the paper, Tibor Harkany, even stresses the potential use of cannabinoids as a first-line treatment for epilepsy, as they would have a favourable influence on disease progression.

She concludes that the “expanding knowledge of the endocannabinoid system is lifting phytocannabinoids from fringe utilisation to potentially safe and effective medicines in adults”.

However, as in the UK, in Austria there is still insufficient data to develop safe cannabinoid-based medicines and researchers have suggested that “cannabis must be brought into evidence-based medicine”. 

Harkany commented: “We know that cannabis could be used for many diseases, and, to some extent, we also know how it works. But the fact that there are so many products on the market also gives the impression that it helps with everything and nothing. But, in fact, cannabis is not a miracle plant; it has very specific uses and we urgently need a number of scientific, evidence-based clinical trials on this subject.”

Psychiatrist Siegfried Kasper, emeritus head of MedUni Vienna’s Department of Psychiatry and Psychotherapy, added: “It is very important for both the university sector and pharmaceutical companies to initiate basic and translational studies to give us a better understanding of the specific effects of cannabinoids. There would be a great future if we could standardise the forms of application of cannabis constituents and then conduct research with standardised extracts in specially designed clinical trials.”

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