February 10, 2022

CBD & Epilepsy: Everything You Need To Know About Cannabidiol For Seizures

In 2018, the US FDA approved a drug featuring CBD as the active ingredient for the treatment of two forms of epilepsy.

This is the first-ever green light for a cannabis-derived drug. And it’s brought hope to people living with the rare and severe epilepsy syndromes for which the treatment was approved.

It’s also brought up a lot of questions about using CBD for seizures, like:

  • How does CBD help with seizures, exactly?
  • Can you get a prescription for CBD oil if you have epilepsy?
  • What’s the difference between Epidiolex and regular CBD?
  • Are there any risks or side effects of using CBD for seizures?
  • Can you use over-the-counter CBD if you have epilepsy?

It’s natural to be curious about any new therapy, especially one that has a controversial past. That’s why we’re answering all of the above questions and more in this article.

Read on for the science that led to CBD’s use as a seizure treatment plus need-to-know info for anyone interested in using CBD for seizures.

What Is CBD?

There are over 400 compounds in the cannabis plant. One class of these compounds is called cannabinoids. Among these cannabinoids you’ll find cannabidiol (CBD), one of the main cannabinoids, along with tetrahydrocannabinol (THC).

The effects many associate with cannabis — like the munchies, bloodshot eyes, and being “high” — are caused by THC. But CBD doesn’t carry the psychoactive properties that cause these outcomes, making it more accessible and acceptable for medicinal use.

CBD is extracted from cannabis, then formulated into a range of CBD products, including Epidiolex.

All About Epidiolex: The First & Only FDA-Approved CBD For Seizures

Meet the first prescription-pad friendly form of CBD, Epidiolex. This medicine was initially approved for the treatment of two conditions:

  • Dravet syndrome, a form of epilepsy that usually begins in infancy.
  • Lennox-Gastaut syndrome, a rare form of childhood epilepsy.

In 2020, a third condition called tuberous sclerosis complex was added to the list of qualifying conditions. Tuberous sclerosis complex is a genetic disorder that causes benign tumors which can affect the brain and cause seizures.

Epidiolex is taken orally, usually multiple times a day.

Epidiolex Vs Regular CBD

In the same year that Epidioilex was approved for epilepsy, the US Farm Bill legalized industrial hemp and products made from it, including CBD oil.

Hemp-derived CBD products are now not only legal, but incredibly easy to find. Health food stores, hemp shops, and even corner markets often carry CBD, though some states have restrictions on in-person sales. Even if it’s more sparse in your area, you can buy CBD online.

However, the headlines about Epidiolex’s FDA-approval and CBD’s legalization shouldn’t be confused with each other. While CBD is legal to buy and sell, doctors can’t write a prescription for any ol’ CBD product. They can only prescribe Epidiolex, and only for the above conditions.

Here are some other differences between CBD you pick up at the store and Epidiolex:

  • Like all other FDA-approved drugs, Epidiolex has been put through rigorous testing to measure its efficacy and safety.
  • Epidiolex is formulated to be a specific potency that has proven to be effective for specific conditions.
  • There might be some THC present in non-pharmaceutical (artisanal) CBD. Epidiolex has zero THC.

Ultimately, you can think of artisanal CBD like over-the-counter CBD, and Epidiolex like the pharmaceutical-grade stuff. Both have their place, and both can be helpful in certain situations.

How Does CBD Help With Epilepsy & Seizures?

That is a great question, and one we wish we had a super clear answer for.

Although research and drug trials have proven that CBD is effective for reducing seizures, the mechanics behind it are still being figured out. Here’s what we know right now.

CBD Can Significantly Reduce Seizures

Seizures occur when nerve activity in the brain is disrupted and electrical activity becomes erratic.

Anti-seizure drugs slow this activity. It’s believed that CBD might have the same effect, but indirectly, by interacting with a network of neurotransmitters, receptors, and enzymes called the endocannabinoid system (ECS).(1)

What’s interesting is that CBD can help when other medications don’t, which is why Epidiolex is approved for seizure conditions that are resistant to other therapies.(2) Clinical trials for Epidiolex found the drug reduced the number of seizures by over 40% in patients with these drug-resistant conditions.(3)

Further research could reveal how CBD might help people with other seizure conditions.

It May Make Life With Seizures Easier

Although epilepsy is one of the most common neurological conditions with more than 30 syndromes under its umbrella, Epidiolex can only be prescribed for the three rare disorders above.

People with other epilepsy syndromes continue to use anti-seizure medications, which can have unpleasant side effects including dizziness, nausea, fatigue, and headaches. That has them turning to artisanal CBD.

A study published in 2021 found that people with epilepsy using artisanal CBD had 13% less side effects from their medication, plus better mental health satisfaction and less anxiety and depression.(4)

Other research indicates that CBD might make some epilepsy drugs more effective.(5)

That info does come with a caution statement that CBD can cause adverse reactions when combined with other meds. Which brings us to our next point.

Risks & Side Effects Of CBD Oil For Seizures

There’s clearly evidence that CBD can help people living with epilepsy by reducing seizures and improving quality of life. But there are some things to be aware of, especially if you’re considering using CBD with prescription medications.

Side effects of artisanal CBD tend to be mild, if they occur at all. They may include:

  • Fatigue
  • Drowsiness
  • Diarrhea
  • Loss of appetite

However, for people taking medications, including anti-epilepsy medications, there’s a risk for drug interactions. Using CBD with these drugs could cause:

  • Fever
  • Weakness
  • Lethargy
  • Decreased appetite
  • Rashes
  • Vomiting
  • Liver injury
  • Depression and other mood changes

How To Use CBD Oil For Seizures

People with qualifying conditions have the option to get a prescription for Epidiolex.

For folks who don’t have a qualifying condition, artisanal CBD is an option. As you might have guessed, this starts with discussing any possible drug interactions or side effects with a doctor.

Is There A “Best” CBD Oil For Seizures?

Once you’re ready to get started, you won’t have any trouble finding a huge selection of CBD products. CBD gummies, inhalants, softgels, topicals, and tinctures are very common choices.

But to give CBD the best chance of interacting with your ECS for maximum benefits without any risks associated with smoking, ingestible CBD products (gummies, drops, edibles, etc) are your best bet.

There’s also some evidence that higher THC might trigger seizures or make the aftereffects of epileptic seizures — such as amnesia and disorientation — worse.(6,7) For these reasons, a low-THC CBD is generally recommended. That usually means broad-spectrum CBD, which is made with industrial hemp and doesn’t exceed 0.3% THC contents.

Pro tip: You can check the THC contents of a CBD product by checking the Certificate of Analysis. We have a guide calledHow To Read A Certificate Of Analysis (COA) For Your CBD Products if this process is new to you.

CBD & Epilepsy: The Bottom Line

CBD is proving to be useful in managing epilepsy in two main ways:

  • Reducing seizures
  • Making life with a seizure condition less stressful

Clinical trials have found that the CBD-based drug Epidiolex reduces seizures in people with Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. People with other epilepsy syndromes have the option to use artisanal CBD. Continued research is expected to reveal more ways to use CBD to treat epilepsy.

Ingestible forms of CBD are preferable over other formulations. Since THC can make seizures and their aftereffects worse, a no or low-THC CBD oil product is favored, such as broad-spectrum CBD.

SHOP BROAD-SPECTRUM CBD OIL PRODUCTS

References

  1. Gray, R, et al. (2020). The proposed mechanisms of action of CBD in epilepsy. Epileptic Disorders. Wiley Online Library. https://doi.org/10.1684/epd.2020.1135
  2. (2018). FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy. U.S. Food & Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
  3. (2018). Drug Trials Snapshots: Epidiolex. U.S. Food & Drug Administration. https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trials-snapshots-epidiolex
  4. (2021). CBD Products May Help People with Epilepsy Better Tolerate Anti-Seizure Medications. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/news/newsroom/news-releases/cbd-products-may-help-people-with-epilepsy-better-tolerate-anti-seizure-medications
  5. Geffrey, AL, et al. (2015). Drug-drug interaction between clobazam and cannabidiol in children with refractory epilepsy. Epilepsia. https://doi.org/10.1111/epi.13060
  6. Goldman, B. (2021). Marijuana-like brain substance calms seizures but increases aftereffects, study finds. Stanford Medicine. https://med.stanford.edu/news/all-news/2021/07/marijuana-like-brain-substance-calms-seizures-but-increases-afte.html
  7. Cohen, N, et al. (2020). Keep Off the Grass: Artisanal versus Pharmaceutical Cannabidiol in Pediatric Refractory Epilepsy Patients (710). Neurology. https://n.neurology.org/content/94/15_Supplement/710.abstract


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