Are you curious about the efficacy of cannabis tincture vs oil in treating pediatric epilepsy?
About 5% of children experience a seizure in their early years. Only 0.5% of children have epilepsy, a condition that causes repeated, unprovoked seizures.¹
Having a seizure doesn’t necessarily mean that someone has this condition. The patient needs to experience a minimum of two unprovoked seizures at least a day apart to receive an epilepsy diagnosis.
Health professionals don’t always know the cause of this disorder. In some cases, it may be a genetic predisposition. In other instances, the cause of paediatric epilepsy could be a brain abnormality.
As a health practitioner, you may have patients that don’t respond well to conventional treatment. Understanding the efficacy comparison between tincture and oil can help you provide an alternative or collaborative therapy.
Understanding cannabis tincture and oil
Cannabis tincture and cannabis oil are both extracts from the cannabis plant. While they may seem similar, they have notable differences.
Cannabis tincture
One main difference between tincture and oil is the method of extraction. To make a tincture, you must soak the cannabis in alcohol and slowly heat the mixture. Once the alcohol infuses with CBD, it must be boiled or diluted.
Cannabis oil
Cannabis oil is extracted from hemp or cannabis plants using supercritical CO2. This method subjects carbon dioxide to a pressure of around 1071 psi and a temperature of 31.1°C, giving it gas and liquid properties.
The CO2 then becomes the solvent. It’s non-toxic, so it’s safer, but the process may take longer. It can also cost more, as it uses expensive equipment.
After removing the plant matter, only the cannabis oil remains. Manufacturers typically combine it with a carrier oil, like coconut oil, hemp seed oil, or olive oil, to enhance its absorption rate.
Potency and administration of tincture vs oil
Oils and tinctures can have different potency levels, and some are more concentrated than others.
Cannabis oil is typically a pure form of CBD, while a tincture may have traces of THC and other compounds. One advantage of oil is that manufacturers can easily filter specific compounds after the extraction process.
The alcohol base of cannabis tinctures may affect the taste. It makes it slightly harsher compared to oil. Each individual’s taste will vary, which impacts their choice.
A tincture is easier to administer and absorbs faster when done sublingually. The user also experiences the effects in a shorter period of time. On the other hand, the body takes longer to absorb the oil.
Users can administer both these extracts topically or add them to food or drinks.
Current research on cannabis tincture vs oil in paediatric epilepsy
The effectiveness of cannabis extracts in paediatric epilepsy requires more research in Australia.
Existing studies show that CBD has been quite effective in reducing seizures in paediatric patients with epilepsy.² Tinctures appear to benefit the user more by administering doses more accurately.
Other research shows the effectiveness of cannabis extracts, even with traces of THC. The results indicate a 50% reduction in the frequency of seizures. The same applies to pure CBD.³
The positive side effects include increased alertness and improved sleep. The adverse effects include:
- Vomiting
- Fatigue
- Diarrhoea
- Upper respiratory tract infection
- Decreased appetite
The efficacy of cannabis tincture or cannabis oil in some patients may not apply to all, but it’s said to be more beneficial than antiepileptic meds.
These varying results require the supervision of a medical practitioner. Monitoring the effects of pediatric medical cannabis therapies is vital.
Factors influencing efficacy
The ratio of THC to CBD has an impact on treating epileptic seizures. It may help reduce seizures by 50%, or even alleviate them completely.
Higher levels of CBD in cannabis tincture and cannabis oil are safer for paediatric epilepsy. Some patients may experience sensitivity to the alcohol base or the oil.
The method of extraction can influence the efficacy of these cannabis extracts. It can impact the bioavailability and the rate of absorption. The individual’s health and compliance with the treatment impacts the efficacy as well.
Each person has a different physiological makeup. It impacts how the body absorbs substances that enter their body. The dosage also plays an important role.
When comparing cannabis tincture vs oil, the former has a faster rate of absorption. It offers more effective and speedier results compared to oil.
A dose of 20 mg/kg/day of CBD may assist in alleviating seizures. A recommended starting point for CBD treatment is 5 mg/kg/day, gradually increased to 20 mg/kg/day.⁴
Starting low and going slow is the best way to administer a new treatment. Gradually increasing the dosage should occur under the supervision of a healthcare professional. If any adverse effects outweigh the efficacy, treatment may have to stop.
Patient perspectives and case studies
A survey conducted in Thailand with parents of paediatric epileptic patients showed that CBD-enriched cannabis oil greatly reduced seizures. However, the results didn’t indicate anyone that became seizure free.⁵
A 17-year-old patient experienced great relief from seizures. This change came after living with Dravet syndrome since he was 12. The cannabis oil effects were almost immediate.
Another Dravet syndrome patient who experienced success with cannabis oil is Charlotte Figi. The treatment brought her relief after experiencing approximately 300 grand mal seizures per week. “Charlotte’s Web” is a cannabis oil named after her as a result of her success.
Another observational study, conducted with parents, showed the efficacy of cannabis extracts as an “add on.” This treatment is used in conjunction with other epilepsy therapies.⁶
Further evidence indicates that the effects of cannabis oil enhance antiepileptic drugs.⁷
Studies that were recently conducted highlighted certain challenges regarding the formulation of cannabinoids, which contributes to limited efficacy. These include low solubility, poor bioavailability, and rapid metabolism.
Neuropediatricians should educate parents about what to expect from CBD. Its interactions and potential side effects are also vital in knowing what to expect. Unrealistic expectations can affect the efficacy of cannabis tincture and cannabis oil.
It’s hard to assess the challenges and successes of cannabis tincture and cannabis oil. More research can help clarify these therapies.
Safety considerations
The benefits of tincture and oil depend on the type of cannabis used.
Cannabis tincture may contain elevated levels of THC, which can create a psychoactive reaction and cause anxiety, paranoia, or impair the patient’s cognition. While CBD doesn’t deliver a high, it can cause drowsiness, dizziness, or changes in appetite.
Administration of cannabis tincture and cannabis oil should start with low dosages and gradual increments.
Cannabis oil is a popular form of medicinal cannabis in Australia. It usually contains no more than 0.3% THC.
The Therapeutic Good Administration regulates medicinal cannabis products in Australia. Only registered health practitioners can apply to prescribe this form of therapy.
As a health practitioner, patients should inform you of all current medications. You should assess their progress every 12 weeks and monitor their response to the treatment.
When purchasing any cannabis products, ensure that they’re properly labelled.
Recommendations for paediatricians
Paediatric epilepsy patients should consult an epilepsy specialist for treatment. The consultation should cover the possible risks and benefits.⁸
Participating in clinical trials is another topic for discussion. These help the caregivers and families to make informed decisions.
As a paediatrician, you should closely monitor the patient’s treatment plan. Collaborate with paediatric neurologists when considering cannabis as part of therapy.
You should remain informed about the legal status of medicinal cannabis in your area. Complying with the law is vital when prescribing cannabis products.
Give the parents all the therapeutic options available before suggesting cannabis. This treatment can also take place in conjunction with other therapy.
Commonwealth approval may be necessary depending on the type of cannabis product prescribed.
Making the right choice as a paediatrician
When comparing cannabis tinctures vs oil, many regard them as the same thing. While there are a few similarities, there are also differences.
Cannabis tincture extraction uses alcohol, while cannabis oil uses CO2 extraction and various oils as its carrier. Both extracts have evidence of reducing seizures from paediatric epilepsy.
The efficacy comparison of the two products depends on the ratio of compounds. Cannabis therapy in Australia for paediatric patients is steadily growing. More research can help clarify safety and efficacy.
This form of therapy is best done under the supervision of a paediatrician. Medical practitioners and patients should determine an appropriate treatment plan together.
Remaining well informed about the effectiveness of cannabis tincture vs oil is vital. As a professional, it helps you make the best decisions for your paediatric patient. It also ensures they benefit fully from any treatment.
Sign up for a course with PlantEd to improve your medical cannabis knowledge. You can also keep abreast of the latest development in the cannabis industry with our newsletter.
References
- Neurology : About epilepsy. (2020). Rch.org.au. https://www.rch.org.au/neurology/patient_information/about_epilepsy/
- CBD for Seizures- Use, Effectiveness, Side Effects, and More. (2021, May 10). Neurology Center for Epilepsy & Seizures. https://www.neurocenternj.com/blog/cbd-for-seizures-use-effectiveness-side-effects-and-more/
- Espinosa-Jovel, C. (2021). Cannabinoids in epilepsy: clinical efficacy and pharmacological considerations. Neurología (English Edition), 38(1). https://doi.org/10.1016/j.nrleng.2020.02.012
- Goods T. Guidance for the use of medicinal cannabis in the treatment of epilepsy in paediatric and young adult patients in Australia [Internet]. Therapeutic Goods Administration (TGA). 2023 [cited 2024 Apr 10]. Available from: https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-treatment-epilepsy-paediatric-and-young-adult-patients-australia#caveats
- Ngampoopun M, Nabangchang C, Suwanpakdee P. Survey of local cannabidiol use in parents of children with epilepsy in Thailand: the prevalence, perceptions, and knowledge. Journal of Cannabis Research. 2022 Jul 26;4(1).
- Aguirre-Velázquez CG. Report from a Survey of Parents Regarding the Use of Cannabidiol (Medicinal cannabis) in Mexican Children with Refractory Epilepsy. Neurology Research International. 2017;2017:1–5.
- Morano A, Fanella M, Albini M, Cifelli P, Palma E, Giallonardo AT, et al. Cannabinoids in the Treatment of Epilepsy: Current Status and Future Prospects. Neuropsychiatric Disease and Treatment. 2020 Feb;Volume 16:381–96.
- Medicinal cannabis in the treatment of epilepsy [Internet]. 2022. Available from: https://epilepsyfoundation.org.au/wp-content/uploads/2022/06/Medicinal-Cannabis-Position-Statement-June-2022.pdf