CBD for Seizures- Use, Effectiveness, Side Effects, and More
If you have seizures or are the parent of a child who has seizures, then you are probably constantly on the lookout for ways to control seizures with as few side effects as possible. CBD oil is one of the latest things to be touted as a miracle cure for seizures. While its effects are not the miracle cure some people suggest, it is a promising treatment that might be right for you.
What is CBD?
CBD is short for cannabidiol, which is a chemical found in marijuana. It is not the same as tetrahydrocannabinol (THC), the chemical in cannabis that is responsible for the “high” feeling people get from marijuana.
What does CBD do?
Well, people make many claims about what CBD can do. Not all of them have been tested and verified. However, there is support for claims that CBD may help reduce pain and anxiety.
Does CBD help seizures?
The short answer is yes. CBD can help prevent some types of seizures in some people and animals. Clinical trials have demonstrated a significant reduction in seizures for people taking CBD to treat Lennox-Gastaut, Dravet syndrome, or tuberous sclerosis complex. Research in other areas is still in early stages, but there are indications that CBD may help prevent other types of seizure or increase the efficacy of other antiepileptic medications. Early clinical trials suggest that CBD may dramatically reduce seizures in people with CDKL5 deficiency disorder, Aicardi syndrome, Doose syndrome, and Dup15q syndrome. In addition, CBD appeared to retain its efficacy over the length of the clinical trial.
How does CBD help prevent seizures?
That is a wonderful question, but, unfortunately, the research simply is not sufficient to give a definitive answer. What we do know is that bodies contain natural neurotransmitters and receptors known as the endocannabinoid system. CBD is believed to interact with that system, which is believed to influence a range of bodily functions and systems including immune response, appetite, pain, and sleep.
Is CBD approved by the FDA to treat seizures?
Yes, but not all CBD oils and not all types of seizures. Currently, Epidolex, a prescription form of CBD, is approved to treat seizures caused by Lennox-Gastaut, Dravet syndrome, and tuberous sclerosis complex.
Does CBD interact with other seizure medications?
Yes. We know that CBD interacts with brivaracetam, clobazam, eslicarbazepine, stiripentol, rufinamide, topirimate, valproic acid, and zonisamide. It also possible that it interacts with other antiepileptics, and as research continues, we should have a better idea of other possible interactions.
How do I use CBD or CBD oil to treat seizures?
If you have a seizure disorder, you should be seeing a neurologist for treatment. It is very important to discuss whether you should use CBD oil with your neurologist. While it is generally safe to use, there is always a risk of potential drug interactions. In addition, some people actually experience an increase in seizures when they use CBD. Therefore, just like with any antiepileptic drugs, you want to have a professional monitoring your use of CBD.
What is an average clinical use of CBD to treat seizures?
The starting dose for CBD is 2.5 mg/kg of Epidolex, two times a day. A normal maintenance dosage is 5mg/kg twice daily, and the maximum dosage is 10mg/kg twice daily. As with other antiseizure medications, it should be introduced or stopped gradually, as sudden changes can increase seizure activity.
What are the potential side effects of CBD when used to treat seizures?
Whether used alone or with other seizure medications, there are some potential side effects of using CBD to treat seizures. It can lead to an increase in suicidal thoughts or behaviors, sleepiness, drowsiness, diarrhea, and loss of appetite. While most of these side effects are inconvenient, interactions can also cause liver damage.
Can CBD increase my seizures?
This is a tricky question to answer. Anecdotally, it seems clear that some percentage of people will have an increase in the number of seizures in response to using CBD. However, why is not so clear. Research seems to suggest that people who use commercial CBD products are likely to see an increase in seizures, while people using prescription CBD are likely to see a reduction in seizures. The speculation is that commercial products are not pure CBD, but are tainted with THC, which is known to be a potential seizure trigger.
Can I use over-the-counter CBD to treat epilepsy?
The problem with OTC CBD is that it is not regulated by the FDA. This makes it impossible to know what dose you would be getting, if the product is contaminated with impurities, or if it even is CBD. If you want to explore using CBD to treat seizures, talk with your doctor about adding Epidolex, an FDA regulated product that eliminates the specific risks posed by an OTC product, to your treatment plan.
Cannabidiol (CBD) for Epilepsy Treatment
Epidiolex, a precription form, is approved for some seizures
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles. She helped co-author the first integrative geriatrics textbook, “Integrative Geriatric Medicine.”
Cannabidiol (CBD)—a component of the marijuana plant—has gotten a lot of attention for medical use, including the treatment of epilepsy. Epidiolex is the only prescription form of CBD available, and it was approved by the U.S. Food and Drug Administration (FDA) in June 2018 for the treatment of seizures in two hard-to-treat forms epilepsy—Lennox-Gastaut syndrome (LGS) and Dravet syndrome. Epidiolex is approved for adults and children over the age of 2 who have one of these rare disorders.
How It Works
Seizures are caused by erratic electrical activity in the brain that can spread and cause uncontrolled physical movements and/or alterations of consciousness. Most anti-seizure drugs work by slowing down excitatory nerve activity in the brain.
However, LGS and Dravet syndrome may be treated with medications that aren’t commonly used for most types of epilepsy. Additionally, they often require two or more anti-seizure drugs for seizures to be under control.
It is not completely clear why CBD can reduce some types of seizures. It is known to have a range of biochemical effects on nerve cells in the brain, some of which may have an impact on seizures. Medical research on CBD is still in its early stages.
Prescription CBD is specifically recommended for control of seizures in LGS and Dravet syndrome.
LGS is a developmental disorder that begins in early childhood and is characterized by multiple seizure types, as well as physical and cognitive deficits. The seizures of LGS are difficult to control and are managed with a different medication regimen than that which is used for most epilepsy types.
Dravet syndrome is a developmental disorder that begins in early childhood and is associated with multiple seizure types as well as seizures triggered by fevers. People with Dravet syndrome often have behavioral challenges and learning difficulties.
Even with treatment, people with LGS or Dravet syndrome may continue to experience persistent seizures.
However, studies have shown that CBD, when taken with other anti-seizure medications, reduces the frequency and severity of seizures in people who have these disorders.
A 2019 review of studies on Epidiolex showed a sustained seizure frequency reduction of between 30 and 63 percent. Additionally, seizures were about half as severe and the postictal (after seizure) state was less severe as well.
What About Other Seizure Types?
Studies using CBD for seizure control are focused on refractory seizures, which are seizures that are not easily controlled with anti-seizure treatments. It’s still too soon to tell whether it will be beneficial and tolerable for people with other seizure types. As such, CBD is not approved for other types of seizures or epilepsy itself at this time.
Cannabidiol is a controversial treatment because it is one of the components of marijuana, a widely known recreational drug. There are strong opinions about the drug, and proponents advocate for its legalization for medical uses, while some advocate for the legalization of recreational use as well.
At this time, cannabidiol has been proven effective for only a few medical conditions. Due to the side effects, it is recommended to be used with caution.
If you have questions regarding whether cannabidiol is an appropriate treatment for you or someone you know, talk to your healthcare provider first. You can use our Doctor Discussion Guide below to help start that conversation about treatment options and more.
Epilepsy Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Epidiolex comes in an oral solution (liquid form), and the recommended dose is initiated based on weight.
It is generally started at a dose of 2.5 mg/kg twice per day and increased weekly. It can be increased up to a dose of 20 mg/kg per day if needed, but increased side effects have been found to occur at the higher dose.
Anti-seizure medications should be taken at the regularly scheduled times without skipping or combining doses.
Sometimes, children and adults who have LGS or Dravet syndrome have some difficulties taking oral medication due to difficulty swallowing, behavioral problems, and/or cognitive issues. It may be a challenge to get your child to take any medication, and you might need to develop strategies to help with this process.
The side effects of CBD that have been reported in the studies when it was added to other antiseizure medications included:
- Upper respiratory tract infection/rhinitis
- Generalized fatigue
- Sleeping difficulties
- Decreased appetite
- Vomiting (prolonged seizure requiring emergency attention)
In studies, these were more common in the first two weeks on Epidiolex, after which time they tended to diminish. Additionally, many of the studies on the drug involved at least one other anti-seizure drug as well, so the side effects may not all have been due to Epidiolex.
More severe side effects, which you should contact your healthcare provider about right away, include:
- Symptoms of liver injury:Jaundice (a yellowish color of the skin and eyes), abdominal pain, vomiting, and dark colored urine
- Mood changes: Depression, anxiety, and suicidal ideation
CBD itself does not have abuse potential and does not produce the “high” that is typical of marijuana, so you do not need to worry about your child abusing the drug or becoming addicted to it. However, it is possible that others may misunderstand the effects of the drug, particularly because it is new and because it is derived from the same plant that marijuana is derived from.
There’s still much to be learned about how CBD interacts with other anti-seizure drugs.
It’s possible that CBD may raise the blood level of certain other anticonvulsants such as Topamax and Onfi (clobazam), and may result in side effects.
When used with other anti-seizure drugs, CBD can cause elevated liver enzymes, which is often a sign of liver injury.
In the aforementioned 2019 review of studies on this drug, however, researchers found that while adding Epidiolex to a treatment regimen may increase certain specific side effects, it may actually decrease the overall amount of side effects participants experienced.
Over-the-Counter CBD Products
A multitude of CBD-containing products are on the market, and some people have chosen to use them for seizure control. This trend is likely to grow, especially since the 2018 Farm Bill made hemp-derived products, including CBD, legal at the federal level.
However, these products aren’t regulated by the FDA and are largely untested. The FDA has warned that CBD products are often mislabeled or overpromise their supposed benefits. Dosage and quality are likely to be far less consistent with other CBD products, which may put you at risk for more seizures.
In fact, the FDA has issued warnings to many CBD businesses for illegal practices, including those related to the marketing of their products. In some cases, actual CBD content was negligible or less than 1 percent of what the label claimed.
A 2017 study published in JAMA found that 26 percent of products purchased online contained less CBD than their labels claimed.
Some other CBD products contained other compounds from the marijuana plant, including tetrahydrocannabinol (THC)—the part that gets you “high.”
A Word From Verywell
Given that CBD is a fairly new therapy for epilepsy, you may experience challenges when it comes to health insurance coverage or availability of the medication. If you do, be sure to involve your healthcare provider, who can provide documentation that can help you get an approval for coverage and may be able to refer you to a source that will fill your prescription.