CBD Oil for Epilepsy: What Does the Research Say?

Individuals with epilepsy often experience numerous weekly or even daily seizures. There are two primary seizure types. Focal seizures, also called partial seizures, affect one part of the brain. Generalized seizures affect the entire brain. Epilepsy is a condition that can cause significant detriment to a person’s quality of life.

There are many treatment options with anti-epileptic drugs (AEDs) among the most popular. However, these drugs can sometimes have adverse effects. In recent times, research into CBD suggests that the non-intoxicating cannabinoid could help reduce the severity and frequency of seizures in epilepsy patients. Moreover, it could achieve this and produce fewer side effects than AEDs.

This article looks into epilepsy and the available treatment options. It also looks into the research outlining how CBD could help epilepsy patients and investigates the best CBD oil brands, not to mention dosage information.

Epilepsy: What Is It, What Causes It, and Who’s at Risk?

Epilepsy is a neurological disorder wherein individuals suffer from recurring, sporadic, and unpredictable seizures. It’s a far-reaching and somewhat random disease with no known cause in over 70% of diagnosed cases.

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Viral brain infections, localized brain injury/trauma, stroke, Alzheimer’s disease, autism, brain tumors, and blood vessel abnormalities could increase the risk of epilepsy. Experts believe that heredity is likely to play a vital role in developing epileptic disorders, though the specific genes and triggering events are still relatively unknown.

According to the CDC, epilepsy affects about 3.4 million people in America, with over 150,000 new cases arising each year.

What used to be a more common disorder among children is becoming more prominent in individuals of all ages. According to San Francisco’s VA Epilepsy Center for Excellence, there are now as many people with epilepsy aged 60 and older as aged ten or younger.

Other than heredity or traumatic brain injury, no known causes spark the onset of epilepsy, and it seems anyone at any age can develop the disorder.

Conventional Epilepsy Treatments

The need to effectively treat epilepsy is because recurrent seizures, especially severe ones, can cause significant wear and tear on both the body and the brain. If left unchecked, they can give rise to an array of other health problems down the road.

In mild cases, simple lifestyle changes (including anything from diet modifications to vagus nerve stimulations) are sometimes enough to reduce seizure intensity and frequency. However, pharmaceutical medications and even surgery are often deemed necessary for patients that suffer from more intense and severe forms.

Functionally, all anti-epileptic drugs inhibit or otherwise halt various parts of the brain and central nervous system. While relatively effective (these medicines only reduce the occurrence of seizures in up to about 50% of patients), the major downfall of these drugs is that many have serious side effects.

Why CBD?

The side effects of medications that reduce seizures caused by epilepsy have been significant enough to send many patients on a hunt for other options. This is where CBD has provided a promising alternative.

Ever since medical publications have begun filtering in and word has started getting out about the potential of CBD for seizures, patients of all ages and walks of life have started using CBD for their seizure symptoms.

Generally speaking, the non-intoxicating cannabinoid has increased its appeal over pharmaceutical medications for five main reasons.

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1 – It’s Safe

Unlike high-strength prescription meds, CBD has been shown to produce minimal side effects in most individuals. In one particular study on rodents, published in the neuropsychiatric journal Epilepsia, CBD was categorically presented to effectively reduce seizures with a negligible risk of adverse side effects.

2 – It’s Effective

As we cover below, many scientific publications have studies that outline the efficacy of CBD for epilepsy. Seizures have traditionally been one of the most thoroughly researched and well-documented areas of cannabis research within the last three decades.

3 – It’s 100% Natural

CBD is a naturally occurring extract directly from the hemp (cannabis) plant.

4 – It Doesn’t Have Intoxicating Properties

The vast majority of all CBD products come from the hemp plant, which is different from the marijuana plant. Hemp contains less than 0.3% THC (the cannabinoid responsible for the stereotypical, mind-altering marijuana highs). This is why CBD oils and other CBD products produce zero intoxicating activity.

5 – It Targets Whole Body Homeostasis Rather Than Localized Neuronal Inhibition

Every pharmaceutical epilepsy medication is the same in that it functions by inhibiting neuronal circuits at some specific location in the central nervous system. While they may decrease seizure frequency and intensity, the drugs could cause unpleasant side effects.

On the other hand, CBD functions very differently on a molecular level. Rather than targeting and inhibiting a molecular pathway at one specific location, it interacts with endocannabinoid receptors in all parts of the body and brain to help regulate homeostasis.

The National Organization for the Reform of Marijuana Laws (NORML) has gone so far as to call the endocannabinoid system “…the [single] most important physiologic system involved in establishing and maintaining human health.”

CBD Oil for Epilepsy: Side Effects and Risks

Patients living in states where medical cannabis isn’t legal can use CBD instead. While it isn’t specifically legal (barring Epidiolex for certain conditions), CBD is sold throughout the United States.

CBD is typically well-tolerated in people with epilepsy. In a review of studies published in The Mental Health Clinician in 2020, researchers noted that while cannabidiol had adverse effects, they were mainly mild. Common side effects of CBD oil may include:

  • Drowsiness
  • Diarrhea
  • Weight changes
  • Appetite changes
  • Fatigue
  • An upset stomach
  • Pyrexia
  • Vomiting

However, 14% of LSG patients who volunteered for a study published in Lancet in 2018 withdrew because of adverse effects.

There are also concerns over drug interactions since CBD is heavily metabolized by the cytochrome P450 (CYP450) system of enzymes, particularly by CYP3A4 and CYP2C19. As the CYP450 system metabolizes a high percentage of medication, there is a strong risk of a potentially harmful interaction. Individuals on prescription medication or who regularly use OTC drugs should consult a doctor before using CBD.

Finally, there is a possibility that regular CBD users could develop a tolerance to the cannabinoid. Such individuals will find that they stop feeling its effects after a few months.

A study of over 90 people with TRS who used cannabis oil for an average of almost 20 months revealed that almost one-third reported tolerance to CBD. According to the research presented at the 2018 American Epilepsy Society meeting, the mean time until tolerance was slightly over seven months[1].

Of the 30 patients deemed to have shown a tolerance, 12 achieved their previous response level when the dose was increased. The positive news is that overall, CBD effectively reduced seizures in two-thirds of the patients in the long term.

CBD for Epilepsy: What Does the Research Say?

There is a significant level of research into CBD’s potential efficacy for reducing the effect of seizures associated with epilepsy.

A study out of New York University’s Comprehensive Epilepsy Center looked at how CBD impacted 120 Dravet syndrome (DS) patients. Dravet is a rare, life-threatening, and debilitating epilepsy disorder. Researchers noted a reduction in seizure frequency in over 39% of patients, with 5% going ultimately seizure-free after the 14-week test period had ended.

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A review of studies published in Molecules in 2019 looked into the use of CBD in the treatment of epilepsy. It went through various completed clinical trials to showcase the efficacy and safety of CBD in different forms of epilepsy. The researchers noted that the available results highlighted the effectiveness of CBD as adjunctive to standard AEDs.

There have been numerous studies on the use of CBD for epilepsy; usually, it is found to be effective for seizure treatment.

The review of studies published in The Mental Health Clinician similarly found positive results when epilepsy patients used CBD.

It highlighted two double-blind, placebo-controlled studies featuring patients with treatment-resistant Lennox Gastaut syndrome (LGS). The first involved 225 patients who used either 10mg/kg/day, 20mg/kg/day of CBD, or a placebo. Those who used CBD experienced a reduction in drop seizures of 37% to 41% compared to 17% in the placebo group.

The second study featured 171 patients who consumed 20mg/kg/day of CBD or a placebo for 14 weeks. The median reduction in drop seizure frequency was almost 44% in CBD users compared to 22% in the placebo group.

Many more studies outline how CBD decreases the severity and frequency of seizures in epilepsy patients.

What Is the Difference Between Epilepsy and Seizures?

Medical experts tend to describe seizures as electrical storms in the brain. The human brain consists of billions of neurons. These nerve cells process and transmit information by interacting with one another. Generally, there are few issues during these interactions, but small neuron misfires can have consequences.

Occasionally, various cells have a misfire simultaneously, in what is called a seizure. It is a sudden, disorganized electrical discharge in the brain, causing symptoms such as changes in mood, thought, sensation, or behavior, along with muscle spasms and twitches, according to The Epilepsy Center at Johns Hopkins Medicine.

Epilepsy is classified as a neurological condition where the patient experiences recurrent seizures.

While it is possible to have a seizure without epilepsy, seizures are a prominent side effect of epilepsy, even if they don’t have obvious effects. Apart from DS and LGS, there are various forms of epilepsy, including:

  • Reflex epilepsy
  • Refractory epilepsy
  • Progressive myoclonic epilepsy
  • Rasmussen syndrome
  • Sturge-Weber syndrome

Regardless of the form, individuals intent on reducing seizure frequency gravitate towards CBD, although it isn’t easy to determine how much one should use.

CBD Oil Dosage for Epilepsy

The FDA approves Epidiolex to treat seizures associated with DS, LGS, and tuberous sclerosis complex (TSC), which means there are dosing recommendations. The oral solution contains 100mg of cannabidiol per ml of liquid. This means a 100ml bottle contains 10,000mg of cannabidiol. In general, users consume Epidiolextwice a day, and the doctor who prescribes the medication outlines the starting dose.

However, it is common for patients with DS or LGS to begin with 2.5mg of CBD per kilogram of body weight twice a day in the first week. In the second week, the daily dose is often increased to 10mg per kg, divided into 2 x 5mg/kg doses. Therefore, someone who weighs 50 kilograms (110 pounds) would use 250mg a day in the first week and 500mg daily from the second week onward.

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CBD itself is not FDA-approved, so there are no dosing guidelines. However, most studies into the cannabinoid’s efficacy for LGS and DS have involved patients using between 5mg/kg/day and 50mg/kg/day. For someone weighing 50 kilograms, this means consuming anywhere between 250mg and 2,500mg of CBD each day.

Yet it is better to adopt a ‘low and slow’ approach at first. Children can begin with a minimum dose of 10mg and gradually increase the dose by no more than 2mg/kg/day every 1-2 weeks. Adults can begin with 25mg and increase by 25mg daily every 1-2 weeks.

Best CBD Oil for Seizures & Epilepsy

The unregulated nature of the CBD market means that research is required when seeking trustworthy brands. When choosing any seller, ensure they offer updated third-party lab reports, and provide information on where they source their hemp. The market is saturated with brands, so to speed up your search, here are five with outstanding reputations for the quality of their products and customer service:

As epilepsy patients may require more CBD oil than other users, it is worth buying in bulk or looking for tinctures with up to 5,000mg of cannabidiol per container. Alternatively, one could purchase CBD isolate powders. They may not provide the entourage effect, but a gram of powder could contain over 990mg of CBD. Certain brands sell up to 50 grams!

Please note we are not suggesting that ANY of these CBD products effectively address epilepsy, only that they are generally reputable.

As far as administering the oil, the most direct and effective method is to use the dropper that comes with the bottle and place a few drops under the tongue, holding for about 60 seconds before swallowing. If using a CBD isolate powder, add it to an existing tincture, or else you could try to vape or dab it for faster absorption.

Final Thoughts on CBD oil for Epilepsy

Research to date suggests that CBD offers hope to epilepsy patients as it could reduce the impact the condition has on their lives.

However, it can be very tough to find a reputable brand that manufactures a reliable tincture.

The FDA had issued official warnings to several brands in the past few years for advertising their products as “pure CBD,” when in fact, they contained virtually none of the active cannabinoid. We recommend researching the five brands we mentioned above, as all have excellent reputations. Doing so will save you a huge amount of time, effort, and stress when sourcing high-quality CBD.

Most experienced CBD users recommend that patients start with a low amount and slowly increase the measurements until they achieve a practical result. However, it’s always important for consumers to research and understand that CBD for epilepsy does not produce the same results in every individual and is not a cure.

Some users may not experience any improvement at all. Before consuming CBD, always speak with a healthcare professional, especially if you use any other medication, particularly AEDs.

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