The Entourage Effect

Epilepsy seizures relieved by medical marijuana.

By the time Andrew* was two years old, he had been diagnosed with a rare form of epilepsy called Lennox-Gastaut syndrome, or LGS. The syndrome caused Andrew to suffer frequent seizures, where his muscles stiffened uncontrollably, as well as severe tremors.

Like many children with LGS, Andrew also experienced learning difficulties early in life. But by the time he was an adult, he was able to live somewhat independently while residing in his parent’s home.

“When I was a baby, I was delayed in learning to crawl, walk and talk, and I had trouble all through my school years,” Andrew, now 21, shares. “But I eventually made it through, and today, I have a steady job at a supermarket near our house.

“But last fall, I was really struggling. I was experiencing three to four seizures per week despite being on anti-seizure medicine. And the medicine had really uncomfortable side effects. It increased the ammonia levels in my blood, which decreased my ability to focus. As a result, I found it difficult to express myself, which was very frustrating.”

Andrew’s mother hated to see her son struggle. She has always been open to trying new treatments for her son’s epilepsy. She was excited to learn recently about breakthroughs in treating it using medical marijuana.

That knowledge triggered a search for a local provider, which is how she discovered Coastal Wellness Centers, a private medical practice that specializes in comprehensive medical cannabis treatment.

Coastal Wellness Centers is the practice of Joseph Rosado, MD. Andrew visited Dr. Rosado for a consultation appointment in late September 2019.

“When I initially saw Andrew, he was seeing multiple neurologists and taking multiple anti-epileptic medications, but they were not controlling his seizures,” Dr. Rosado reports. “He had also received a craniotomy and brain implant. The physician opened his skull and placed electrodes in his brain in an attempt to control his seizures. But nothing worked.

“When Andrew arrived at our practice in September, he had been hospitalized two days previously due to elevated ammonia levels. Those levels were elevated because he was taking high doses of the anti-epileptic medications KEPPRA® and TRILEPTAL®.

“After reviewing Andrew’s case, we recommended a medical cannabis preparation with a fifteen-to-one ratio of the active marijuana compound cannabidiol (CBD) to another active compound tetrahydrocannabinol (THC). We started him at half a milliliter twice a day.”

Backed by Research

The exact way medical cannabis works to ease the symptoms of LGS and other forms of epilepsy has not been fully defined, but its method of action is understood on a basic level.

“There are cannabinoid receptors in the body, including CB1 and CB2 receptors,” Dr. Rosado explains. “CB1 receptors are found primarily in the central nervous system, which includes the brain and spinal cord. CB2 receptors are found in the peripheral nervous system as well as the immune system cells.

“The medical marijuana works for me. It keeps my seizures and tremors controlled when nothing else helped.” – Andrew

“Most seizures are based in either the brain or the peripheral nervous system. Cannabis works on the receptors in these areas and interacts with neurotransmitters there that regulate movement. It is through those mechanisms that medical cannabis helps to control and manage seizures.”

In June 2018, the US Food and Drug Administration approved a prescription CBD drug called EPIDIOLEX® for treatment-resistant epilepsy, particularly LGS and another rare type called Dravet syndrome.

Clinical trials leading up to the drug’s approval and after show the medication is highly effective with minimal adverse effects. These study results were reported by the American Epilepsy Society and in distinguished publications, including the New England Journal of Medicine and the online journal F1000Research.

“EPIDIOLEX has been thoroughly investigated,” Dr. Rosado confirms. “Before it was approved, its effectiveness was studied in three randomized, double-blind, placebo-controlled clinical trials involving five hundred sixteen patients with Dravet or LGS.

“EPIDIOLEX, taken along with other medications, was found to be effective in reducing the frequency and severity of seizures compared with placebo. The most common adverse effects were sleepiness, sedation and lethargy, decreased appetite and poor quality sleep.”

Dr. Rosado notes that EPIDIOLEX is concentrated, purified CBD. It contains no THC. But he recommends using the entire cannabis plant and all of its cannabinoids to treat patients with epilepsy and other disorders.

“When we use all of the plant cannabinoids, we get what is called the entourage effect,” he educates. “The CBD, THC and other compounds work together like an orchestra playing a symphony. By working together, the cannabinoids affect different receptors, so the patient responds better to treatment.”

“Living Proof”

For one month, Andrew took the 15:1 ratio of CBD to THC as drops under his tongue. During that time, Dr. Rosado and Andrew discovered that one milliliter twice a day was the dosage that effectively relieved Andrew’s symptoms.

“When I returned to Coastal Wellness Centers on October 31, my seizures were controlled. They disappeared,” Andrew relates. “And I haven’t experienced any tremors since I started taking the medical marijuana.”

“At the time of that October 31 visit, Andrew was still taking the KEPPRA and TRILEPTAL, and we decided to continue those medications for three months,” Dr. Rosado notes. “But we told him to return to the office in two months, and we would begin weaning him off of one of those medications.”

Since his October appointment at Coastal Wellness Centers, Andrew has continued taking the 15:1 ratio of CBD to THC drops prescribed by Dr. Rosado. He has also maintained the one-milliliter-twice-a-day dosage, which has been effective at controlling the seizures and tremors associated with his epilepsy.

“The medical marijuana works for me,” Andrew enthuses. “It keeps my seizures and tremors controlled when nothing else helped. The anti-epileptic medicines weren’t effective, so I’m really looking forward to getting off of them. Then, I’ll get my focus back, and that will make a huge difference in my quality of life.

“I’ve lived with epilepsy and its symptoms all of my life. Dr. Rosado’s recommendations for medical marijuana relieves my symptoms of seizures and tremors, and that keeps me independent. I absolutely recommend medical marijuana and Dr. Rosado. He’s a genius when it comes to using medical marijuana to treat epilepsy. I’m living proof!”

*Patient’s name withheld at his request.
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    • Coastal Wellness Centers

      Coastal Wellness Centers is a private medical practice specializing in Comprehensive Medical Cannabis Treatment. Their patients are evaluated by state-approved certified physicians who are qualified to determine whether you, the patient, will... Read More

    • Alyn Benezette, DO

      Alyn Benezette, DO, is a board-certified clinical neurophysiologist who has been practicing for more than 25 years. He received his Doctorate of Osteopathy from Michigan State University College of Human Medicine in 1981 and later performed hi... Read More

    • Joseph Rosado, MD

      Joseph Rosado, MD, is a family medicine doctor who specializes in physical therapy and alternative addiction therapy/management. He earned his bachelor’s degree from Life College in Marietta, GA and his Doctor of Medicine degree from U... Read More

    • Kathryne Gunn, DO

      Kathryne Gunn, DO, is a medical cannabis physician who trained with Dr. Rosado. She received her undergraduate degree in psychology and health sciences from the University of Central Florida and her doctorate degree from Debusk College of Osteo... Read More