Although many people are familiar with CBD’s benefits for managing pain, anxiety and stress, CBD is perhaps best known for its ability to treat epilepsy. In 1980, Dr. Raphael Mechoulam performed a breakthrough study that demonstrated CBD’s promise as an epilepsy remedy. Although its use was controversial at first, CBD has been losing its stigma as more people become familiar with its benefits.
What Is Epilepsy?
Epilepsy is a seizure disorder that affects people of all ages. The term describes a wide range of disorders that involve seizures. Symptoms can vary from person to person.
Epilepsy is characterized by recurrent seizures that aren’t always caused by a particular trigger. Infections, brain malformations, low oxygen levels, tumors, fever and genes can cause epilepsy. In most cases, the reason for the seizures is unidentified. About 50 percent of people with this disorder have not identified the cause.
People with epilepsy can have different types of seizures. They may also exhibit other neurological problems. The convulsions begin because of electrical activity the brain but can affect different parts of the body.
Some researchers have focused on treatment options for people with epilepsy. Other scientists are still trying to pinpoint what causes the disorder.
The Story Behind CBD for Epilepsy
Charlotte Figi, who was born in 2006, has such a severe form of epilepsy that doctor’s didn’t expect her to survive. She experienced her first seizure, which lasted for 30 minutes, when she was 3 months old. Within a few months, she was having several seizures a day.
Blood tests and brain scans didn’t reveal any abnormalities. Doctors were perplexed.
Charlotte was put on seven medications, which affected her energy levels and cognition. Her seizures also slowed her down. By the time she was 2 years old, Charlotte’s brain function was declining. She wasn’t hitting the same milestones as her brother.
When she was 2 and a half, Charlotte was diagnosed with Dravet syndrome. This form of epilepsy is resistant to medication. Doctors put Charlotte on a ketogenic diet, which encourages the body to produce an abundance of ketones, natural chemicals that keep seizures in check.
The diet helped for a while, but the seizures came back. Eventually, Charlotte wasn’t able to walk, talk or eat. Her heart had stopped several times. The Figis were told that there were no other options to help their daughter.
The Figis heard that cannabis treatments had improved the symptoms of another child’s Dravet syndrome. They applied for a medical marijuana card for Charlotte, and she became the youngest candidate for a marijuana prescription in Colorado.
The family had a friend extract the oil from a high-CBD strain of cannabis so that they could administer it to their daughter without requiring her to smoke marijuana. In the first hour after she used CBD, Charlotte didn’t have any seizures.
It was the first time in months that she was seizure-free. The seizures stopped for a week, and the Figis were desperate to replenish their supply. They got in touch with the Stanley brothers, who were having trouble selling a CBD-rich strain of marijuana that they had developed using cross-breeding.
They couldn’t sell it to recreational marijuana users because it was so low in THC that it didn’t make anyone high. For this reason, it was referred to as “Hippie’s disappointment.” It was perfect for Charlotte Figi, however. It didn’t make her high, and the high CBD levels helped reduce the frequency of her seizures.
There are many other anecdotes online about children with epilepsy who have benefited from using CBD oil. Trystan Pearson developed epilepsy when he was 12 years old. Even though he had a device implanted in his chest to control his seizures, he experienced detrimental symptoms that affected his quality of life.
CBD oil was used as a last resort. It worked.
The Biological Actions of CBD
CBD works by influencing two related endocannabinoid receptors, CB1 and CB2. These receptors are distributed throughout the central nervous and immune systems.
Endogenous substances, chemicals that are found in our bodies, interact with these receptors to help regulate communication between neurons. Many studies have revealed that abnormalities in the endo-cannabinoid signaling pathways are involved in the development and progression of epilepsy. Modifying these systems using exogenous cannabinoids, chemicals that act on endocannabinoid receptors, has been shown to reduce or eliminate seizure activity.
CBD is one of the exogenous cannabinoids that has been studied for this purpose. CBD interacts mainly with CB2 receptors, but it doesn’t appear to exert anti-seizure activity by communicating with the endocannabinoid receptors directly. Instead, it may activate certain neurotransmitters that influence the endocannabinoid receptors.
One way that CBD does this is by enhancing anandamide signaling. Anandamide is an endogenous cannabinoid that works as a natural antidepressant.
Anandamide is also implicated in certain diseases, such as epilepsy. Researchers have found that epileptic patients have lower anandamide concentrations in their spinal fluid.
The mechanisms by which CBD controls seizures are not fully understood. Scientists believe that the cannabinoid’s influence on certain neurotransmitters may play a role. They theorize that CBD dampens neuronal activity and excitation by acting on certain receptors and channels that make up the endocannabinoid system.
CBD also reduces inflammation, which is a factor in the development of epilepsy. Scientists think that targeting inflammation with epilepsy treatments may be a novel way to create better drugs to treat the disease. Because we know that CBD has anti-inflammatory properties and few side effects, it may be worth introducing it into a comprehensive treatment plan.
Research on CBD for other medical conditions has found that the compound has neuroprotective qualities.
One of the problems with traditional epilepsy medications is that they don’t always work. If a patient doesn’t respond positively to the first two types of medications that are used, he or she is not likely to experience improvements with a third medication. However, research indicates that the same people who are resistant to pharmaceutical medication may respond well to CBD oil.
Scientific Evidence Supporting CBD for Epilepsy
CBD is the only non-THC exogenous cannabinoid to have been studied in clinical and preclinical trials for its ability to reduce seizures. There are many other cannabinoids found in cannabis, but most exist in much smaller concentrations than CBD does. Small studies on these other compounds have found that some other cannabinoids also have anti-seizure effects.
The study that launched a new decade of research into CBD for epilepsy took place in 1980. This small study was promising.
In the first phase of the study, eight healthy volunteers were given CBD, and eight took a placebo. Physical and neurological examinations were conducted weekly to check for adverse reactions to the CBD.
In the second phase, 15 patients with epilepsy received either 200 to 300 milligrams of CBD or a placebo each day for as long as 4.5 months. These patients continued to take their epilepsy medication even though it had stopped being effective. CBD reduced the frequency of seizures in all but one patient.
Even though this research was groundbreaking, the progress of CBD research was slow.
A study that was published in May 2017 in the New England Journal of Medicine concentrated on CBD’s ability to treat children with Dravet syndrome. The researchers gave 120 young people with the medical condition 20 milligrams of CBD oil or a placebo every day for 14 weeks.
The volunteers who took CBD saw a reduction of more than 50 percent in their seizure frequency. The average number of seizures per month diminished inconsequentially for those who consumed the placebo. None of the controls became seizure free. However, 5 percent of the subjects who used CBD oil experienced a complete cessation in their seizures.
The data shows an objective improvement in the symptoms of the children who used CBD. Subjective impressions of CBD’s effectiveness were also measured. More than 60 percent of the parents whose children took CBD said that they noticed improvements in their kids’ conditions. Only 34 percent of people in the control group parents had the same reaction.
Although several other studies have revealed that CBD can reduce seizure activity, more research needs to be done on CBD’s long-term effects. The science behind CBD and epilepsy is still relatively new.
Much of the research is being conducted in Israel, where government standards are more lenient and using a cannabis-based compound isn’t so controversial. In 2018, Israeli researchers found that approximately 33 percent of epileptic patients that use CBD for their disorder develop a tolerance to it.
In these individuals, CBD became less effective over time. The dose had to be increased by at least 30 percent to produce the same results as it did when the participants started taking the compound. It took about 7 months for these users to develop a tolerance.
Some of the patients who increased their dosage continued to experience a reduction in seizure frequency. The compound stopped working for other participants. These individuals had treatment-resistant epilepsy and age ranges of 1 to 37. Those who had epilepsy for a shorter period of time were more likely to develop a tolerance.
A CBD-Based Medication Is Approved for Epilepsy
So much research surrounding CBD and epilepsy has found the compound to be effective that the FDA has approved a CBD-based pharmaceutical for epilepsy. Epidiolex was approved in June 2018 to treat seizures in individuals with Dravet or Lennox-Gaustaut syndrome. It is derived from CBD and is available with a prescription.
Epidiolex is the first medication sourced from the cannabis plant to be approved for use in the U.S. Some other cannabinoid pharmaceuticals that have been approved for pain are derived from synthetic chemicals. However, Epidiolex is extracted from the natural plant.
The prescription medication isn’t cheap, though. CNN reports that the drug can cost more than $30,000 per year. The price tag parallels the cost of other conventional epilepsy medications.
However, Epidiolex is often covered by insurance. Other CBD oils are not.
Because Epidiolex is so expensive, some people wonder how it differs from CBD oil that can be purchased at a cannabis pharmacy or online. Epidiolex delivers a dependable dose of pure CBD from a known, constant source. It contains sesame oil, ethanol, sweetener and a flavoring compound. The substance and the dosage have been studied in clinical trials, and consumers can count on receiving a consistent product every time they refill their prescriptions.
The problem with CBD oils that you buy online is that they’re unregulated. There is no strict oversight or enforcement of the CBD manufacturing process. Manufacturers don’t always make their products using the same strains or ingredients.
A 2017 study found that approximately 70 percent of CBD products sold online were not labeled accurately. If you use Epidiolex, there is no question about the ingredients that the product contains.
Some CBD makers are more reputable than others. It’s possible to get pure CBD oil that contains consistent ingredients every time you buy it. Look for high-quality sellers with reviews and professional websites. A reputable vendor should make third-party lab results available. Our list of the best CBD Oil companies is a good place to start.
At any rate, the approval of Epidiolex may be a turning point for medical cannabis. Scientists, doctors and lawmakers are beginning to see more evidence that CBD can be effective for treating epilepsy. The fact that the FDA approved Epidiolex gives some people hope that cannabis will lose some of its stigma and become more widely available.
Epidiolex has only been studied in people with Lennox-Gastaut and Dravet syndrome. It may not be effective for every type of epileptic seizure. More high-quality CBD clinical trials are underway. Some scientists are looking into Epidiolex’s effectiveness in treating other seizure disorders, including Sturge Weber Syndrome and Tuberous Sclerosis Complex.
Is Using CBD for Children Controversial?
As people heard Charlotte’s story, many came out of the woodwork expressing their opposition to using medical marijuana for children. Some don’t understand that marijuana can be bred with different levels of cannabinoids. Many assume that all cannabis makes people high.
Marijuana and hemp plants contain up to 140 different cannabinoids, the compounds that interact with the endocannabinoid system in humans to deliver health benefits and other effects. THC is one of those cannabinoids. This is the only known major cannabinoid that produces a high.
CBD is another abundant cannabinoid in the plant. It has been shown to relieve pain, diminish inflammation, ease anxiety and suppress seizures. It has no psychoactive properties and is not intoxicating.
While much of the literature touts CBD oil as a substance that produces no side effects, adverse reactions can happen. In the 2017 New England Journal of Medicine study referenced above, side effects were definitely more pronounced in the group that took the CBD compared to the placebo group. More people from this category withdrew from the trial.
The most common side effects were:
• Raised body temperature
• Irregular results on liver function tests
Some of these side effects, such as digestive distress, might be caused by the fact that the CBD extract is combined with oil. In some studies, participants taking an oil-based placebo experienced similar stomach ailments.
On the other hand, many medications that are FDA approved for certain medical conditions and prescribed to children on a regular basis have serious side effects, including the risk of addiction and overdose. It would seem that many pharmaceuticals that are used to treat epilepsy, including barbiturates, are riskier than CBD.
When a patient has debilitating symptoms like the ones that Charlotte Figi experienced, the side effects associated with CBD would likely be the least of their worries.
Is CBD Better Than THC for Epilepsy?
Because so many marijuana dispensaries are popping up where marijuana is legal, some people might wonder if the ratio of THC to CBD really matters. Although THC has been shown to have beneficial effects for treating cancer and pain, CBD is more effective for epilepsy.
Evidence from animal studies demonstrates that CBD has a better anticonvulsant profile than THC. Plus, CBD is better suited for children than plants that contain high levels of THC because of its lack of abuse liability and psychoactive effects.
Some literature suggests that high doses of THC can cause seizures. In one case study, a man was admitted to the hospital because he was having epileptic seizures. He was 44 years old and had been smoking marijuana regularly for 26 years. He had high levels of THC in his urine.
Other small studies that have looked at the link between THC and seizures have produced mixed results. Some demonstrate that THC can reduce the frequency and severity of seizures. Others found that THC had no effects on convulsions. In one study, the offspring of rats that were given THC were more likely to develop seizures.
On the other hand, CBD is associated with more consistent anticonvulsive effects. It doesn’t work for everyone. However, traditional epilepsy medication is not 100-percent effective either.
Some CBD oils also contain THC. If you live in a state in which marijuana is legal, you might want to check the THC content of your product before purchasing it to use for epilepsy. If marijuana is illegal in your state, CBD oil that you purchase from a reputable vendor should have a THC concentration of less than 0.3 percent.
What is The Best CBD Dosage for Epilepsy?
Most experts recommend starting out with low dosages of CBD. Taking 5 to 10 milligrams once or twice a day is usually a good guideline for people who have never used the substance.
With time and awareness, the dosage can be modified.
Some evidence shows that low doses of CBD are effective for treating epilepsy. Other research demonstrates that high doses have anticonvulsant effects as well.
But higher doses might produce more side effects. In 2018, WebMD reported on a clinical trial that showed that patients taking 10 milligrams per day of pharmaceutical-grade CBD experienced a similar reduction in seizures as those who took 20 milligrams per day. The group that took the lower dose experienced fewer adverse effects.
Most of the studies on CBD for epilepsy looked at groups of people who were taking other seizure medications at the same time. It’s not a good idea to stop taking your medication without consulting with a doctor. Some doctors aren’t very knowledgeable about using CBD for seizures. However, because many laws are making it easier to access CBD, many medical professionals are learning more about it so that they can offer it to their patients.