Neurology specialist encouraged by new option for epilepsy medication

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COLUMBIA - Following the approval of a new cannabis-based treatment, a neurologist who specializes in pediatric epilepsy said having a new medication is encouraging.

The FDA approved the first drug made with marijuana components and the first medication specifically made to treat Dravet syndrome. It's called Epidiolex.

Komul Ashraf, with Neurology Incorporated, said Lennox-Gastaut and Dravet syndrome are severe forms of epilepsy in young children that can cause ongoing seizures, harming their development.

"I'm very encouraged that the epilepsy world now has another medication to add to its arsenal of medications we can try for these children and their families that suffer from these difficult-to-treat epilepsy syndromes," Ashraf said.

She said the two disorders start in very young patients who often must try many different medications and still often have anywhere from ten to 20 seizures a day.

"Up until now, we've had medications that help with treating epilepsy disorders and epilepsy syndromes. They work, but it's very difficult, especially in more severe type of epilepsies like Lennox-Gastaut and Dravet syndrome, to completely make a patient seizure free. So there are medications, they just don't work completely," Ashraf said.

She said some doctors could choose not to prescribe Epidiolex even though it's gotten FDA approval.

"There's always risk and benefit that we have to consider and so we treat each patient individually and its not just a cookbook knee-jerk response for every patient, but the goal for every medication and treating a patient is that they get the best effectiveness, they become as seizure free as possible with the lowest amount of side effects," Ashraf said.

She said she can understand the difficulties children with epilepsy and their caregivers face. 

"Overall, my feeling is, I'm a mom. I'm a mom of two and if my kid was having seizures that were very very difficult to control, I would be okay with giving them medication that would hopefully help them be seizure free because, as a kid going through it and their parents or family members caring for them, it must be very difficult to see their kid have seizures repeatedly. 

Epidiolex and is made with cannabidiol (CBD), which differs from tetrahydrocannabinol (THC), which causes the high typically associated with marijuana.

The FDA reported it did "three randomized, double-blind, placebo-controlled" clinical trial of 516 patients.

"Epidiolex, taken along with other medications, was shown to be effective in reducing the frequency of seizures when compared with placebo," the report said.

Side effects included, "sleepiness, sedation and lethargy; elevated liver enzymes; decreased appetite; diarrhea; rash; fatigue, malaise and weakness; insomnia, sleep disorder and poor quality sleep; and infections."

The FDA said it will continue to support rigorous scientific research on the potential medical use of marijuana-derived products, but will take action when it sees the illegal marketing of products with CBD using serious, unproven medical claims.