Living with intractable or drug-resistant epilepsy can be challenging. Is it possible that CBD can help? Read on to find out more.
CBD has been clinically proven to control seizures caused by certain types of seizure disorders, especially when taken in combination with other, more traditional epilepsy medications. However, scientists aren’t exactly sure how CBD treats epilepsy, nor are they certain if CBD can have a role in treating other, more general types of seizure disorders in the future.
In this article, we will first go over the specifics and nuances of whether CBD can help with seizures. We will then also cover proposed pathways through which CBD can prevent seizures, warnings regarding combining CBD with other medications, the history of attempts to use CBD to treat epilepsy, and the state of CBD research on epilepsy right now.
Can CBD control seizures?
CBD is touted as a remedy for various things, not the least of which being seizure relief. While, yes, CBD can control certain types of seizures, it’s essential to go over the basics of how seizures work to recognize the role that CBD plays in seizure relief:
What causes seizures?
On an individual level, seizures are caused by abnormal electrical impulses in the brain, causing uncontrolled movements, tension, or staring spells that may not end for seconds to minutes. These impulses can be excessive or even massively simultaneous, which can cause multiple unwanted muscular movements at once.
On the level of disease, however, seizures can be caused by multiple sources. The general term for suffering from seizures is epilepsy, and numerous epilepsy disorders can cause issues.
However, seizures can be caused by other health issues that do not necessarily characterize seizure disorders, such as:
- High fever due to infection
- Severe sleep deprivation
- Traumatic brain injuries
- Certain medications
- Low blood sodium
- Stroke
- Autoimmune disorders
- Recreational drugs
- Alcohol withdrawal
Anyone can suffer a seizure; however, not everyone has the difficulty of having seizures frequently enough that it may impact their day-to-day lives.
CBD’s impact on seizures
Cannabis sativa, the plant from which CBD products originate, has been reported to be an effective anticonvulsant throughout a wide variety of cultures, spanning back thousands of years.
Records from ancient Sumerian and Akkadian writing imply that something like cannabis was used to suppress uncontrollable night-time convulsions, likely early seizure records. Arabic and Islamic records, too, indicate that cannabis was explicitly used as a treatment for seizures.
These findings hold true today, though there is still much we don’t know about cannabis and its role in treating epilepsy. For one thing, the compound THC, the other principal constituent in the cannabis plant, has been reported to even cause seizures at high enough doses. CBD, however, has been shown consistently to have anticonvulsant effects, though its impact does seem to vary depending on the type of seizures and epilepsy disorders it is intended to treat.
Treating certain types of epilepsy disorders is currently CBD’s only broadly accepted medical use. Claims of CBD’s benefits in the face of epilepsy are more than just talk or hypotheticals based on highly experimental pre-clinical testing — CBD is demonstrably impactful for seizures on a highly rigorous clinical level. And while anecdotes are not a replacement for hard evidence, when you hear the stories of peoples’ lives being wholly changed after their intractable seizure disorder was successfully treated by cannabis or CBD, it’s hard to ignore.
However, it’s important to note that CBD has not been approved to treat epilepsy at large, but instead, it shows the most promise for particular and rare epilepsy disorders like Dravet syndrome. Epilepsy can be caused and modulated by an extensive variety of mechanisms, not all of which we understand. Even more confusingly, the exact pathway through which CBD can have an anticonvulsant effect is unknown, so scientists cannot be sure how CBD operates against the wide variety of causes for seizures.
In summary:
- CBD can control certain types of seizures caused by specific disorders and not all types of epilepsy.
- Seizures are caused by a variety of seizure disorders and epileptic disorders and individual health problems that are not necessarily linked to epilepsy.
- CBD and cannabis have historically been used to treat seizures and convulsions, even before we understood what seizures were and what causes them.
- CBD’s only widely accepted medical use as of right now is in treating seizures. But there is still a lot we don’t know about how CBD works, and CBD typically treats specific, rare seizure disorders, and not always epilepsy as a whole.
How does CBD oil stop seizures?
The exact mechanism by which CBD oil helps to prevent and lessen seizures is not currently known. However, it is clear — both due to what we know about how CBD interacts with the endocannabinoid system (ECS) and what we can see regarding CBD’s beneficial effects in clinical studies — that CBD and other cannabinoids can play a role in the systems that cause and inhibit epilepsy.
Seizures are caused by electrical errors in your body — usually large bursts of electrical activity — that prevent your nervous system from correctly functioning by mixing up and bungling signals. Your body fires off more neurons than are necessary and more neurons at once than usual. This causes the uncontrollable movements or absences associated with seizures. However, the ECS, as a significant regulatory structure in the human body, plays something of a role in regulating neuronal signaling. As a result, cannabinoids like CBD may interact with receptors in the ECS to reduce signaling and electrical errors that cause or prolong seizures.
One proposed pathway for how CBD has an inhibitory effect on seizures is through its observed ability to regulate neuron excitability, or the tendency for neurons to fire off more frequently than is necessary (or to fire off with less of the neurotransmitter that usually triggers excitation). CBD is thought to interact with the ion channel TRPV1, not by linking to it, but by having an agonistic effect on it, heightening the number of chemicals its receptors need to be triggered. Once triggered, this channel creates excessive amounts of glutamate and ions required to create electrical impulses. Glutamate is the compound in the body that regulates how much and when neurons fire off, so preventing its release could be a potential pathway through which CBD prevents and mitigates epileptic seizures. However, scientists believe that this is not the pathway directly responsible for CBD’s anti-epileptic effects.
Another pathway is CBD’s interaction with the ion channel T-Type Ca 2+, which also helps regulate neuronal excitation. Ca 2+ peaks can cause excessive neuronal excitability, which this channel traditionally tries to control; however, individuals with epilepsy often appear to have these channels activated and hyperpolarized, which causes Ca 2+ peaks by allowing high concentrations of Ca 2+ to build up. However, CBD seems to inhibit the activation of these channels, which reduces Ca 2+ levels and keeps neuronal excitation in check.
Neurotransmitters like serotonin, and how CBD interacts with them. may also play a role in how CBD modulates epilepsy. The exact role of serotonin receptors in how epilepsy works is not currently known. However, scientists do know that they help to both polarize and depolarize neurons, which can both increase and decrease conductivity, both increasing epileptic events but also potentially decreasing them. CBD is known to interact heavily with serotonin receptors, which could be a partial explanation for how it can have an anti-epileptic effect.
In summary:
- Scientists are not exactly sure how CBD stops epileptic seizures, but CBD’s interactions with the endocannabinoid system may have something to do with it.
- Since the ECS functions in the body to regulate cells and maintain homeostasis, it may reduce the abnormal neuronal firing that causes epilepsy.
- CBD may treat epilepsy through its interactions with the ion channel TRPV1, which regulates the production of glutamate, which also regulates the amount that neurons fire off.
- Another way CBD may treat epilepsy is through its interactions with T-Type Ca 2+, an ion channel that impacts the concentration of Ca 2+ ions, which can trigger neuronal firing and affect the electrical errors that contribute to seizures.
- Finally, CBD may also impact epilepsy through its interactions with neurotransmitters like serotonin, the receptors of which impact conductivity in neuronal cells, affecting electrical signaling.
The story of Charlotte Figi
Charlotte Figi was a young girl who suffered from Dravet syndrome, a rare, incurable, and often devastating form of epilepsy in which frequent seizures onset in infancy. Her seizures began at three months old, and from then on, continued to get worse and worse, becoming more frequent and more lengthy as she grew older. Even after her diagnosis of Dravet syndrome at 2 ½, her parents did not seem to have many options for treatments. They considered everything, from a ketogenic diet to experimental drugs, but had no luck — or at the very least, they found nothing effective that did not also have unpleasant side effects.
Things changed, however, when Figi’s parents discovered the story of another child suffering from Dravet syndrome online who was using medical marijuana to manage their seizures successfully. They applied for a medical marijuana license — no easy feat when the applicant is only five years old. However, they were eventually approved, and they took to purchasing low-THC, high-CBD strains and having the oil extracted. Charlotte’s symptoms immediately improved, and she went from having thousands of seizures a week to having none.
Charlotte Figi’s journey with CBD and THC not only served to help save her life from Dravet syndrome but also helped to make CBD a well-known and potentially medically viable option for families and children dealing with Dravet syndrome who may feel as though there is no hope left. The research on CBD would not be what it is today without her family’s pioneering in the realm of CBD, and medications like Epidolex, an FDA-approved medical-grade CBD treatment for Dravet syndrome, might not exist.
Sadly, Charlotte passed away in April, 2020 at the age of 13 due to what was most likely an infection of COVID-19. Her legacy is remembered today as one of hope, strength, and perseverance through undeniably and impossibly challenging health issues, and her impact on epilepsy research and treatments will not soon be forgotten.
In summary:
- Charlotte Figi was a little girl who suffered from Dravet syndrome, an overwhelming and intractable seizure disorder.
- Most medications and diets for her epilepsy did not work until Charlotte’s family began using a high-CBD, low-THC strain of marijuana that had been used experimentally to treat Dravet in another child.
- Charlotte’s family found the treatment to be a total success and contacted a group of cannabis growers, the Stanley Brothers, to get a steady supply of CBD oil. This helped to boost the profile of cannabis as a potential treatment for Dravet.
- The Figi’s pioneering efforts with CBD oil helped boost not only the CBD industry as a whole but also led to the eventual creation of Epidiolex, an FDA-approved CBD oil specifically prescribed to treat Dravet.
- Charlotte passed away at the age of 13 in the spring of 2020 due to what was likely a COVID-19 infection.
Current research on CBD for epilepsy
Given that CBD oil has been approved for usage in treating three rare, severe, and intractable seizure disorders that occur in children, it’s no surprise that the medical literature on CBD’s role in treating epilepsy and seizures is thorough and wide-ranging. These studies usually focus on Epidiolex’s role in seizure relief, which means that some of these studies may neglect the value of whole-plant medication, and instead demonstrate the efficacy of CBD alone (but more on that later).
In one study, CBD given at a 20mg dosage to a testing pool of individuals suffering from atonic seizure attacks was shown to be effective at reducing the number of seizures suffered per week by over 41%, compared with the placebo group’s 17%. Side effects were minimal, though they did occasionally include sleepiness, diarrhea, and loss of appetite. Additionally, it’s worth noting that several participants were taking other seizure medications, which may impact some of the findings (including findings that indicated harmful liver activity).
In another study, CBD was given to participants with Dravet syndrome and other drug-resistant seizures. Over 43% of participants experienced a 50% drop in seizures, compared with only 27% for the placebo. Once again, participants were taking other seizure medications alongside CBD, which may have impacted results.
Another study, conducted without a placebo group, seemed to indicate that Epidiolex was able to decrease seizures by an average of 54%. Participants were individuals suffering from Dravet syndrome who were, once again, taking CBD in combination with other medications. Certain medications had better interactions with CBD, such as clobazam.
In summary:
- CBD has been demonstrated to have a beneficial effect on reducing seizures in a wide variety of trials, due to the fact that Epidiolex is a medication that was approved for clinical usage in children.
- One study demonstrated that CBD caused a 41% reduction in seizures compared with the 17% caused by a placebo.
- Another study demonstrated that 43% of patients with Dravet syndrome experienced at least a 50% drop in the frequency of seizure when taking CBD, as compared with a placebo of 27% of patients.
- Another study demonstrated that CBD could reduce seizures by an average of 54%.
Does CBD oil interfere with seizure medications?
When taking CBD oil, it’s critical to be aware of any potential drug interactions. While CBD does not generally have any dangerous side effects on its own, and while most drug interactions will ultimately not prove extensively harmful at low doses, drug interactions with CBD can cause undesirable or even dangerous side effects. Unfortunately, many anti-epileptic drugs can have harmful interactions with CBD, so it’s essential to consult a doctor before using CBD oil to treat epilepsy or any other seizure disorders.
The liver primarily metabolizes CBD and other drugs using a very particular family of enzymes called cytochrome P450 enzymes. These can break down a wide variety of both harmful and necessary compounds in the body. However, there is a limited amount of this enzyme in the body, which means that simultaneous usage of drugs that require this enzyme to break down may indicate that one or both drugs will not work as planned. One or both drugs may reach blood concentration levels that are dangerous and prevent them from working correctly. Alternatively, one or both drugs may not reach high enough blood concentration levels to work correctly, which may be dangerous in the case of life-saving and necessary medicines.
This is the same principle behind things like the grapefruit warning, which may or may not come on the labels of certain prescription drugs. Grapefruit is also broken down by the P450 enzymes, which means that it, too, may interact negatively with your prescription drugs. While drugs (and grapefruit juice) taken at low enough dosages may not have an incredibly harmful impact, it’s important to be wary of taking too much.
Unfortunately, anti-epileptic drugs (AEDs) often come with the grapefruit warning. This grapefruit warning means that AEDs should not be combined with other cytochrome P450 drugs like CBD, or if they must be, that individual’s healthcare team needs to be informed so that they can monitor things like blood concentration levels and make sure any increases or decreases in concentration are not dangerous to the patient.
However, that does not necessarily mean that you have to swear off CBD oil. Speak to your doctor about your issue, and they may be able to provide some guidance. If your current AEDs are not working and you’d like to make the wholesale switch to CBD oil, you must let them know, as they can advise you on if this is a choice that makes sense for you, your lifestyle, and your health. Additionally, if you’d like to simply take it as an addition to your current dose of AEDs, your doctor may be able to find a dosage that works for you without risking your health.
In summary:
- CBD can have harmful drug interactions, so it’s important to do your research and listen to your healthcare providers when using CBD. One significant CBD interaction is with anti-epileptic drugs or AEDs.
- Drug interactions occur because two different drugs might be metabolized by the same enzyme, of which there are limited amounts. This sharing might mean that one or both drugs have higher or lower than average blood concentrations at a time, which can be dangerous or uncomfortable.
- CBD utilizes the CYP450 enzymes, meaning that it can interact with various drugs that also use this family of enzymes.
- Grapefruits also utilize enzymes from the CYP450 family, which is why many manufacturers issue a “grapefruit warning” with their medications, indicating that users should not drink grapefruit juice while taking it.
- AEDs commonly have interactions with CBD, which means that you should consult with a doctor if you plan on taking CBD alongside them.
What is Epidiolex?
Approved in 2018, Epidiolex is a prescription drug that is designed to treat three seizure disorders: Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. It is a specially formulated CBD oil that is clear of many contaminants and additional compounds found commonly in consumer CBD oils.
Currently, Epidiolex for the above three disorders is the only FDA-approved usage for CBD oil. It is not formulated to stop all epilepsy at large, nor is it or any other CBD-based product federally approved to treat unrelated conditions like anxiety, depression, neurological issues, or any other commonly prescribed uses for consumer CBD. However, given how young the research is on CBD and how recently the FDA gave Epidiolex the all-clear, there is still hope that CBD will have more extensive and widely medically-approved uses.
Is Epidiolex the same as CBD oil?
Epidiolex’s main ingredient is highly purified CBD oil, but that doesn’t mean that it’s the same as CBD oil you may find at your local CBD shop. Instead, Epidiolex is highly monitored, refined, and examined through extensive lab testing to make it safe for consumption and extract all contaminants, including THC. Epidiolex is FDA-approved for treating epilepsy, while CBD oil as a general product has not been approved for any usage.
While many CBD brands aim to give their customers the highest quality product available and offer extensive records of lab-testing through Certificate of Analysis documents, some of the CBD industry flies under the radar of any regulatory bodies. Many CBD products escape testing by the FDA through categorizing their products as cosmetics. Others will blatantly mislabel their products and not warn consumers of harmful additives or high THC levels.
FDA-controlled products like Epidiolex, however, are medical-grade and highly filtered to avoid any non-adherence to FDA standards, such as high levels of THC, presence of contaminants, and other indications of low purity. Because THC is still federally controlled, because the impacts of THC over time are not fully understood, and because Epidiolex is used to treat children with conditions like Dravet’s, Epidiolex must pass rigorous testing.
Furthermore, the sources of non-medical CBD oil and Epidolex are slightly different. Epidolex is derived from single-molecule CBD, while traditional CBDs are whole-plant-derived and often contain every other compound contained in Cannabis sativa, including other cannabinoids like THC and terpenes. This difference has been noted in some scientific literature as an issue with highly purified single-molecule CBD, as single-molecule CBD appears to have a distinct dosage cap at which its benefits do not seem to increase, while whole-plant CBD just becomes more and more effective at higher doses. While this study only examined the link between relief from inflammation and dosage, it does seem to correlate with an idea that is somewhat common sense, especially if you know the entourage effect: the more cannabinoids working together, the better.
In summary:
- Epidiolex is an FDA-approved anti-seizure medication that treats three seizure disorders:
- Lennox-Gastaut syndrome
- Dravet syndrome
- Tuberous sclerosis complex
- Epidiolex is the only FDA-approved CBD oil for medical purposes.
- The main ingredient of Epidiolex is highly purified CBD oil, but it is not strictly the same thing as CBD oil.
- Epidiolex has passed through more rigorous testing than typical CBD oil, and CBD oil may be more likely to contain other cannabinoids, including low levels of THC. If CBD oil does not come from a reliable source, it could include contaminants or even be mislabeled. This is not the case with Epidiolex.
- Epidiolex comes from single molecule CBD, while CBD oil comes from the whole plant.
Takeaway
CBD has been clinically demonstrated to function as an effective treatment for seizures in the case of certain rare and intractable disorders such as Dravet syndrome, but more needs to be learned about its future as a treatment for epilepsy at large. The exact pathways through which CBD alters neuronal activity and prevents seizures appear unclear as of right now, and it may take a few more years of testing to figure that out.
Because the same liver enzymes break down both CBD and other anti-seizure medications, it is imperative to consult a medical professional before consuming CBD to see if it could interact poorly with other medications you are taking.
The FDA approved CBD in the form of Epidiolex, a clinical medication designed to help with a few specific seizure-causing conditions. However, Epidiolex is not strictly the same thing as CBD oil, as CBD oil goes through less rigorous testing, and also often includes other cannabinoids such as THC since CBD oil is whole-plant derived.
If you are curious about purchasing CBD to help manage complex health conditions yourself, consider browsing our directory. We offer recommendations for a wide variety of CBD products from reputable sellers who care about your health, from US-grown CBD flower, to CBD pre-rolls, CBD patches, CBD isolates, CBD gummies, and more.
Frequently Asked Questions (FAQs)
How does CBD work in the body?
CBD, as well as other cannabinoids, works in the body through a system of receptors and enzymes. Receptors, which exist in various areas of the body, are what cannabinoids (and CBD) bind to in order to create the physical reactions we associate with CBD consumption.
For CBD specifically, there are two types of receptors at play: CBD1, and CBD2. CBD1 receptors are responsible for connections to the central nervous system, and CBD2 receptors are responsible for pain and inflammation.
Once broken down, cannabinoids look to bind with receptors. CBD’s influence over and effect on its relevant receptors is what causes the health and pain relief benefits users experience.
CBD can also link to other receptors in the body, notably those responsible for mental health symptoms (like anxiety, for example) as well as those responsible in regulating pain signals.
CBD oil is the most common form of CBD on the market, and it’s more popular now than ever. It’s an incredibly versatile treatment, so much so that it seems hard to find someone who wouldn’t benefit at all from CBD usage!
Is CBD oil good for seizures?
We’ve already discussed one case of using CBD for epilepsy treatment, but is CBD oil good for seizures in general? Can CBD be a possible new epilepsy treatment?
There is scientific evidence and research to support the idea that CBD can be beneficial for multiple types of epilepsy. But, as with the pre-existing CBD medication Epidiolex, whether or not CBD is effective depends on the individual.
CBD functions as an aide by blocking a specific receptor that can be the cause of recurrent seizures in some individuals. However, not every seizure can be attributed to this cause, and not every individual will actually respond to CBD treatment.
The issue with some CBD products on the commercial market is that they can contain other ingredients, both active and inactive, that are unnecessary or potentially harmful.
Access to prescription CBD (Epidiolex) for seizures or CBD for epilepsy is very limited, though, so there is still work to be done in understanding how CBD can be used as a treatment for seizures.
Can CBD oil make seizures worse?
As with any new medical treatment plan, it’s always best to consult a doctor before trying to implement CBD into your routine. This is especially true if you’re dealing with pre-existing health conditions, notably those that cause seizures.
CBD is often touted as an option for those whose seizures are especially stubborn and aren’t responding to more traditional forms of treatment. There is a lot of anecdotal and quantitative evidence to suggest that CBD can benefit those who suffer from seizures, but careful monitoring is always needed.
Individual response to medication or CBD products can change, and there is always the risk of negative side effects complicating things further. CBD can interact with some other medications that might be present in the body, so it’s always important to consider things on an individual basis.
One of the most popular forms of CBD for epilepsy treatment is CBD oil, but it can also be found in flower (the physical flowers of the cannabis plant) and other supplements like vitamins.
Some methods of consuming CBD are more harmful or irritating than others. Smoking, for example, can be harmful to the lungs or the cardiovascular system, which might be something extra important for those with pre-existing health conditions affecting those areas to consider.
What are the side effects of using CBD oil?
As with any other chemical, the effects that CBD can have on the body can vary from person to person. Generally, there aren’t a lot of negative side effects associated with CBD use. Of course, anyone who experiences an adverse reaction to CBD should discontinue use.
There are lots of positive effects associated with CBD oil and CBD in general, including:
- Help falling and staying asleep
- Pain relief
- Lowered inflammation
- Lowered levels of anxiety
- Relief from neuropathic pain
Conditions that are commonly thought to be treatable, at least in part, by CBD include:
- Insomnia
- Anxiety
- Depression
- Chronic pain conditions
- Arthritis, notably, due to the anti-inflammatory properties CBD has
- Epilepsy
- Though medication has only been officially approved to treat the two specific types of epilepsy we’ve discussed, CBD is often cited as a good option for those with epilepsy of just about any kind
Some negative side effects associated with CBD consumption/usage include fatigue, nausea, and irritability, but whether or not these symptoms come from CBD itself or other active ingredients in the product can be unclear.
Because CBD products are not regulated by the FDA and are marketed as dietary supplements, it can be tricky to find high-quality products. Fortunately, we’ve done the work so you don’t have to. For great CBD oil options and more, check out our shop here.
