CBD for Seizures
Many people with epilepsy, a chronic condition in which they suffer from recurring seizures, use anticonvulsant drugs to reduce the frequency and severity of their seizures.
But when those seizures are not well controlled by these medicines, some patients find cannabidiol, or CBD, to be a helpful additional treatment.
So what do experts say about CBD for seizures? Read on for a full breakdown of CBD’s role in epilepsy treatments.
About CBD for Seizures
CBD treats epilepsy.
In recent years, doctors, patients, and researchers have found evidence to support decades old indications that CBD, taken in combination with anticonvulsant drugs, can reduce both the severity and frequency of epileptic seizures.
Just the Facts
CBD has a strong likelihood of improving outcomes for treatment-resistant forms of epilepsy.
Epilepsy is a disorder in which people suffer from chronic seizures, or abnormal electrical discharges in the brain. It’s the fourth most common brain disorder in the U.S.
Seizures are commonly thought of as full-body convulsions, but they can also appear as sudden losses of consciousness or muscle control.
Most epilepsy patients use anticonvulsant medicines for treatment, but those with forms of epilepsy that are resistant to drugs often seek alternative treatments.
How CBD Could Help With Epilepsy
CBD — a non-intoxicating compound that has been shown to have various medicinal benefits — has been used to treat patients with severe forms of epilepsy like Lennox-Gastaut syndrome and Dravet syndrome.
In clinical trials, participants typically took CBD in addition to their antiepileptic treatment plans and found the results to be promising.
While researchers have demonstrated a certain level of effectiveness in using CBD in epilepsy treatments, it’s not yet clear exactly how CBD interacts with seizure activity. However, there are several theories about how CBD works against seizures through different neurological methods.
One theory is that in the brains of epilepsy patients, which are preconditioned to have abnormal increases in electrical activity, CBD has been shown to reduce calcium transmission between certain channels, which may play a part in lowering electrical overexcitement.
Other theories focus on CBD’s ability to inhibit the uptake of adenosine, a substance that affects electrical transmission between synapses in the brain, and CBD’s ability to reduce the release of glutamine in the GPR55 receptor. Glutamine is the most prevalent neurotransmitter, and GPR55 is related to the more prominent cannabinoid receptor CB1R, which has been shown to play a role in regulating electrical activity in the brain.
Because CB1R is activated more firmly by THC than CBD, CBD is not understood to play a direct role in that cannabinoid receptor’s potential to reduce seizures.
However, the combination of CBD and THC, as found in full spectrum CBD (as opposed to ~100% pure CBD isolate), has been shown to improve how cannabis is used to activate CB1R in epilepsy treatments.
On its own, THC can have adverse effects on patients, from nausea to unwanted psychoactive stimulation. But adding CBD into a THC-based regimen can mitigate these side effects and lead to a more comfortable treatment option.
Epidiolex for Seizures
In June 2018, the FDA approved a CBD isolate drug, Epidiolex, for use in treating drug-resistant forms of epilepsy.
A 2017 trial conducted on Epidiolex showed promising evidence for its treatment of Dravet syndrome, a severe form of epilepsy that can begin affecting patients as young as a few months old. In the study, patients saw a decrease in the average number of monthly seizures by about half (from 12 to 6).
While Epidiolex will hopefully help patients, some who have already tried CBD isolate treatments and seen little results are seeking out full spectrum CBD treatments that include higher quantities of THC than hemp-based products do.
However, more research needs to be done on the relationship between THC and CBD in epilepsy treatments. One study found that patients who moved to Colorado for “marijuana-based” full spectrum CBD reported higher reductions in seizures than patients who received the same treatments but were already living in Colorado beforehand.
We’ve summarized a few of the most recent studies that are relevant to using CBD for seizures. Click to expand the studies listed below.
Some patients in both trials experienced side effects from the CBD. These ranged from moderate effects like sleepiness and tiredness, to more adverse ones such as vomiting, diarrhea, and abnormal liver functions. None of the reactions were life-threatening.
This study was double-blind and placebo-controlled, which is an important and tricky aspect of CBD research. Because cannabis is still federally classified as a Schedule I drug, in the same Schedule as cocaine and heroin, it’s not easy for CBD studies to obtain approval. And this poses an obstacle for more thorough research to be conducted on its medical benefits.
The U.S. government has previously cited the lack of “well-controlled studies” to support their decision to keep cannabis on the Schedule I list, but it’s used that same argument to prevent researchers from performing the “well-controlled studies” needed to better understand the effects of CBD.
As more states legalize cannabis for medical and recreational use, there is hope that the federal government will also adjust its official stance on cannabis. In fact, with the FDA’s approval of Epidiolex, it already has.
In 2017, researchers found that full spectrum CBD could be a more potent treatment option than CBD isolate.
Their paper looked at patients receiving a certain dose of full spectrum CBD and compared them to patients receiving a dose of CBD isolate that was three times higher. In the end, both groups reported a similar reduction in their seizures, and the researchers concluded that full spectrum CBD was three times as potent as CBD isolate.
Fabricio Pamplona, one of the researchers who conducted the meta-analysis, told me over email that this did NOT suggest taking higher doses of full spectrum CBD would reduce epileptic seizures even more, but rather that full spectrum CBD “is over three times as cost effective for the patient, because you need a lower dose.”
Pamplona also said these results support evidence of the “entourage effect” in epilepsy treatments, adding that “although the exact composition of synergic compounds could not be inferred from this paper…it does suggest that there is some positive interaction between CBD and the complex matrix of phytocompounds in the Cannabis plant.”
Concerns about CBD for Seizures
CBD has been demonstrated to be a relatively safe addition to epilepsy treatment plans with minor side effects. However, it takes patients time to figure out their correct CBD dosage, which can be tricky because doctors aren’t always so knowledgeable about CBD treatments.
Heather Jackson, CEO of the cannabinoid therapy education and advocacy non-profit Realm of Caring, estimates there’s “probably one handful of doctors in this nation that really understand and will guide the family with dosing.”
The larger concern with CBD treatment can be a legal one. As recent as 2018, there have been cases of parents temporarily losing custody of their children for treating them with CBD.
And epilepsy patients seeking higher-THC full-spectrum CBD, which may be derived from cannabis strains that are categorized as marijuana, have to obtain medical marijuana licenses.
“For example, in Colorado, if you’re under 18 you have to have two doctors’ recommendations and…a medical cannabis license,” Jackson says. “And all those doctors are doing is saying that yes you have a condition…that you can receive a medical cannabis license for. In some places it’s extremely restricted, like Utah, where they do have some legislation but it’s only for epilepsy.”