The frequent use of cannabis among people with hard-to-treat epilepsy was found to be linked to greater illness severity and other related health burdens, according to a new study.
Patients with epilepsy may use cannabis due to perceived therapeutic benefits. However, an analysis of cannabis use among people with drug-resistant epilepsy found that frequent users were admitted to an epilepsy monitoring unit sooner following diagnosis than nonusers, according to the Sept. 28 peer-reviewed study published in the Epilepsia journal.
Time taken from onset of epilepsy to epilepsy monitoring unit admission was five years for frequent cannabis users compared to more than 18 years for nonusers.
Frequent users were also found to have a higher prevalence and frequency of focal to bilateral tonic–clonic seizures (FBTCS). These are seizures that begin in a limited area on one side of the brain, eventually spreading to both sides. FBTCS are a major mortality determinant among epilepsy patients and are associated with sudden, unexpected death. Among frequent cannabis users, over 90 percent had the condition compared to nonusers’ 57 percent.
Moreover, researchers discovered that patients with frequent cannabis use had increased antiseizure medication requirements.
“These findings underscore the importance of systematically assessing cannabis exposure in clinical practice,” the study authors said.
In the study, researchers assessed data from 64 drug-resistant epilepsy patients admitted to an epilepsy monitoring unit, including 22 individuals who used cannabis at least 20 days a month, and 42 nonusers.
Drug-resistant epilepsy is identified when seizures continue to occur even after the person is given two appropriate seizure medications.
Patients who used cannabis frequently were found to have been “discharged on a greater number of antiseizure medications,” even though the number of medications were similar during admission, according to the study.
In a Sept. 28 statement, Washington University School of Medicine in St. Louis, whose researchers were part of the study, said that while the analysis cannot establish that cannabis usage worsens epilepsy, there is a concerning association at play.
Dr. Aaron Struck, senior author of the study, said that the findings indicate that the issue of cannabis use should be raised directly with patients.
“There isn’t definitive data that cannabis use worsens epilepsy,” Struck said. “But if someone is using cannabis to help with anxiety or sleep, I’d prefer to treat those problems with drugs we understand rather than something largely unregulated whose impact on the brain we don’t really know.”
The study reported no conflict of interest among its authors. No outside funding was received for the work.
According to a position statement from the American Academy of Neurology (AAN), the organization acknowledges interest among patients and physicians regarding the use of cannabis, and that the plant may be useful when it comes to treating neurological disorders.
However, AAN does not support the use of cannabis products as medications for neurological disorders, citing the lack of sufficient peer-reviewed research determining the safety and efficacy of such use, the organization said. Epilepsy is a neurological disorder.
As an example of a product that has proven to be sufficiently safe for treating some epilepsy patients, AAN cited the Food and Drug Administration-approved Epidiolex. The medication contains a purified form of cannabidiol, an active compound found in cannabis, and is used to treat seizures associated with certain epilepsy conditions.
The recent study on cannabis use in epilepsy patients comes as cannabis use disorder (CUD) among American adults is rising, according to an Aug. 19 study published in the JAMA Psychiatry journal.
An analysis of 186,823 adult participants in a survey found that past-year CUD prevalence among men aged 18 and above rose from 7.3 percent to 9.3 percent between 2021 and 2024, paralleling overall cannabis use jumping from 22.2 percent to 25.7 percent during this period. A similar trend was observed among women as well.
According to the study, the findings “repudiate conventional assumptions that cannabis carries a low addiction risk and that most young adults with CUD have mild symptoms.”