Cannabidiol y epilepsia: avances en su investigación como opción terapéutica
Resumen
El cannabidiol (CBD), uno de los principales componentes de la planta Cannabis sativa, tiene propiedades farmacológicas con potencial terapéutico, por lo que ha sido objeto de estudio en los últimos años. Al momento, sólo ha sido aprobado legalmente para el tratamiento de las convulsiones farmacorresistentes en pacientes pediátricos. Los avances realizados en la investigación de las acciones terapéuticas del CBD en epilepsia, se han sustentado principalmente en el empleo de modelos animales. Con estos modelos animales se han evaluado un amplio rango de dosis, con diversas vías y esquemas de administración. A nivel clínico, se han evaluado las interacciones farmacocinéticas/farmacodinámicas entre el CBD y otros fármacos antiepilépticos, a fin de establecer su utilidad como coadyuvante, realizando ajustes de dosis y valorando la presencia de efectos adversos (como la inducción enzimática en el hígado). Además, el CBD es una molécula que interactúa con múltiples blancos moleculares y que además posee propiedades antioxidantes y antiinflamatorias intrínsecas. Esta información nos ha demostrado que los efectos anticonvulsivantes del CBD aún no han sido explorados a detalle en el tratamiento de la epilepsia farmacorresistente, donde las opciones terapéuticas son limitadas. Tampoco se han evaluado los mecanismos moleculares involucrados en sus efectos anticonvulsivos, donde la administración intracerebral del CBD podría facilitar esta tarea. Con el desarrollo de esta revisión, esperamos que el lector tenga una visión general del estado actual del CBD como una molécula con potencial terapéutico para el tratamiento no solo de la epilepsia sino también de la epilepsia farmacorresistente.
Abstract
Cannabidiol (CBD), one of the main components of the Cannabis sativa plant, has pharmacological properties with therapeutic potential, which is why it has been the subject of study in recent years. At present, it has only been legally approved for the treatment of drug resistant seizures in pediatric patients. The advances made in the research of the therapeutic actions of CBD in epilepsy have been based mainly on the use of animal models. With these animal models, a wide range of doses have been evaluated, with various routes and administration schedules. At the clinical level, the pharmacokinetic/pharmacodynamic interactions between CBD and other antiepileptic drugs have been evaluated, in order to establish its usefulness as an adjuvant, making dose adjustments and assessing the presence of adverse effects (such as enzymatic induction in the liver). In addition, CBD is a molecule that interacts with multiple molecular targets and also has intrinsic antioxidant and anti-inflammatory properties. This information has shown us that the anticonvulsant effects of CBD have not yet been explored in detail in the treatment of drug resistant epilepsy, where therapeutic options are limited. The molecular mechanisms involved in its anticonvulsant effects have not been evaluated either, where intracerebral administration of CBD could facilitate this task. With the development of this review, we hope that the reader will have an overview of the current status of CBD as a molecule with therapeutic potential for the treatment not only of epilepsy but also of drug resistant epilepsy.
Keywords: cannabidiol; epilepsy; drug resistant epilepsy; seizures; antiepileptic drugs.
Palabras clave
Referencias
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DOI: https://doi.org/10.25009/eb.v16i40.2636
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