FROM THE EDITORS

Cannabidiol and medical marijuana for the treatment of epilepsy Epilepsia, 55(6):781–782, 2014 doi: 10.1111/epi.12647

Gary Mathern, Epilepsia Co-Editor in Chief

Astrid Nehlig, Epilepsia Co-Editor in Chief

Rarely in recent memory has there been such interest and public discussion about the potential use marijuana and one of its active substances cannabidiol (CBD) in the treatment of various neurologic conditions such as chronic pain and multiple sclerosis. This has been especially true for patients with refractory seizures and catastrophic epilepsies such as Dravet’s syndrome. Although much of the discussion has occurred in the United States, where several states have semilegalized use of medicinally grown marijuana (leading some families to move to those states for access), patients and their families throughout the world have asked physicians if this is a treatment they should consider. To properly assess the use of CBD and other compounds it is critical to know about the safety and efficacy of medical marijuana, which to the editors seemed an important topic for the readers of Epilepsia. This subject was brought to our attention by Orrin Devinsky early last fall, and we thank him for helping in developing this series for Epilepsia. In this edition of Epilepsia, we present a series of articles on the potential use of CBD and medical marijuana for

Michael Sperling, Epilepsia Associate Editor

epilepsy. We start with this editorial to introduce the topic. Followed are two papers in our Controversy in Epilepsy series. The first by Maa et al. provide arguments from consumers and others that CBD and medical marijuana should be available for the treatment of people with epilepsy. This is followed by a rebuttal by Cilo et al. on the limited knowledge we have on the safety and utility of these compounds for those with seizures. The authors were able to review the content of each other’s work and the papers were peerreviewed. Next, Devinsky and colleagues have authored an Invited Review on this topic. Finally, the Editors of Epilepsia would like your feedback on the subject of CBD and medical marijuana for the treatment of epilepsy. Please go to the website on the next page and complete the questionnaire. We will publish the findings a few months after these articles are published. If there is a topic or idea that you think has broad interest for the readers of Epilepsia, please contact us at [email protected] epilepsia.com.

Wiley Periodicals, Inc. © 2014 International League Against Epilepsy

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To complete the questionnaire, please go the following website: http://surveys.verticalresponse.com/ a/show/1539433/4235ab9776/0 The poll includes some of the following questions:

Based on the information from the position papers do you believe:

1. There are sufficient SAFETY data to allow for open nonprescription use of medical marijuana in treating epilepsy 2. There are sufficient SAFETY data for use of medical marijuana in treating epilepsy, but only with prescription and under medical supervision 3. The SAFETY data are insufficient and medical marijuana should not be used for treating epilepsy without more studies

Based on the information from the position papers do you believe:

1. There are sufficient data showing EFFICACY to allow for open nonprescription use of medical marijuana in treating epilepsy 2. There are sufficient EFFICACY data for use of medical marijuana in treating epilepsy, but only with prescription and under medical supervision 3. The EFFICACY data are insufficient and medical marijuana should not be used for treating epilepsy without more studies

What is your opinion about having pharmacologic grade compounds containing CBD available for use in epilepsy patients?

1. Yes, such compounds should be available 2. No, such compounds are not needed as growers can provide the compounds

Would you advise patients with severe, catastrophic epilepsy who have not responded to approved therapy to try medical marijuana?

1. Yes 2. No

The Poll will remain open until September 1, 2014 at 5pm Pacific Standard Time (Greenwich -8 hours). Gary Mathern Co-Editor in Chief, Epilepsia Astrid Nehlig Co-Editor in Chief, Epilepsia Michael Sperling Associate Editor, Epilepsia

Epilepsia, 55(6):781–782, 2014 doi: 10.1111/epi.12647

Cannabidiol and medical marijuana for the treatment of epilepsy.

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