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CBD for Seizures: Research, Benefits, and How to Use it

CBD has shown remarkable efficacy in improving treatment-resistant epileptic seizures. Here’s what the science says about how CBD works and the best way to use it.

Does CBD for seizures work?

Out of all the research done on CBD, perhaps the most promising findings have come from studies of seizure disorders. Multiple CBD studies for seizures have shown that it can improve epilepsy in children and adults who couldn’t find relief from standard medications.

The evidence is so strong that in 2018, the FDA approved the use of the first CBD-based pharmaceutical drug called Epidiolex for treating two rare, severe types of childhood epilepsy: Lennox-Gastaut syndrome (LGS) and Dravet syndrome.

What are seizures?

In simple terms, seizures are uncontrolled bursts of electrical activity in the brain. Seizures can cause abnormal movements, loss of consciousness, changes in behavior, and other effects 1 Seizures - Symptoms and causes. Mayo Clinic. (2020) Seizures - Symptoms and causes. Retrieved December 18, 2020, from https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711 Mayo Clinic. . Recurrent seizures are the main symptom of epilepsy.

Generalized seizures

These types of seizures affect both sides of the brain. They can further be broken down into absence seizures, which can cause rapid blinking or staring into space, and tonic-clonic seizures, which may lead to loss of consciousness and muscle spasms 2 Types of Seizures CDC. (2020) Types of Seizures | Epilepsy | CDC. Retrieved December 18, 2020, from https://www.cdc.gov/epilepsy/about/types-of-seizures.htm CDC .

Focal seizures

Meanwhile, seizures occur in a specific part of the brain. They can be:

  • Simple seizures that can cause twitching and changes in your senses, such as a strange smell.
  • Complex seizures, which can lead to feeling dazed and confused.
  • Secondary generalized seizures, which begin in one area of the brain and spread to both sides of the brain.
Epilepsy syndromes

When there are specific signs and symptoms, epilepsy can also be classified as a syndrome. One example is Lennox-Gastaut Syndrome, which is characterized by multiple types of seizures, a unique brain wave pattern, and mental deficits 3 Lennox-Gastaut syndrome MedlinePlus. (2020) Lennox-Gastaut syndrome. Retrieved December 18, 2020, from https://medlineplus.gov/genetics/condition/lennox-gastaut-syndrome/ MedlinePlus .

What studies exist to support the use of CBD for seizures?

Numerous studies have shown that CBD can help with epilepsy. For example, a 2018 study in 132 patients with treatment-resistant epilepsy found that CBD for seizures significantly improved severity and frequency 4 Cannabidiol improves frequency and severity of seizures and reduces adverse events in an open-label add-on prospective study. Szaflarski, J. P., Bebin, E. M., Cutter, G., DeWolfe, J., Dure, L. S., Gaston, T. E., ... & Thomas, A. E. (2018). Cannabidiol improves frequency and severity of seizures and reduces adverse events in an open-label add-on prospective study. Epilepsy & Behavior, 87, 131-136. Szaflarski, J. P., Bebin, E. M., Cutter, G., DeWolfe, J., Dure, L. S., Gaston, T. E., ... & Thomas, A. E .

However, the strongest evidence comes from randomized controlled trials (RCTs) — the gold standard of medical research. Most of these studies about CBD for seizures focused on severe types of childhood epilepsy that are resistant to standard treatment. Instead, they used Epidiolex, a pharmaceutical drug containing pure CBD.

Randomized controlled trials of CBD for epilepsy

One 2017 trial looked at 120 children with Dravet syndrome, a rare type of childhood epilepsy. They took CBD or placebo alongside anti-epileptic medication. In the CBD group, 43% of the children had a 50% or greater reduction in seizures compared to only 27% for placebo. Additionally, 5% of those taking CBD became seizure-free 5 Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome Devinsky, O., Cross, J. H., Laux, L., Marsh, E., Miller, I., Nabbout, R., ... & Wright, S. (2017). Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. New England Journal of Medicine, 376(21), 2011-2020. Devinsky, O., Cross, J. H., Laux, L., Marsh, E., Miller, I., Nabbout, R., ... & Wright, S . Although CBD was effective, it was also associated with more side effects, such as diarrhea and fatigue.

A similar 2020 study in 199 children with Dravet syndrome compared the effects of two CBD doses to placebo. All three treatment groups also took standard anti-epileptic medication. The regular-dose Epidiolex group saw a 48.7% decrease in seizures, compared to 45.7% for high-dose and 26.9% for placebo. Five people in the high-dose CBD group withdrew from the study due to side effects such as decreased appetite and diarrhea 6 Dose-ranging effect of adjunctive oral cannabidiol vs placebo on convulsive seizure frequency in Dravet syndrome: a randomized clinical trial Miller, I., Scheffer, I. E., Gunning, B., Sanchez-Carpintero, R., Gil-Nagel, A., Perry, M. S., ... & Knappertz, V. (2020). Dose-ranging effect of adjunctive oral cannabidiol vs placebo on convulsive seizure frequency in Dravet syndrome: a randomized clinical trial. JAMA neurology, 77(5), 613-621. Miller, I., Scheffer, I. E., Gunning, B., Sanchez-Carpintero, R., Gil-Nagel, A., Perry, M. S., ... & Knappertz, V. .

Meanwhile, a 2018 study compared the effects of Epidiolex with placebo in 171 children and adults with Lennox-Gastaut syndrome, another serious type of childhood epilepsy. They continued taking standard anti-epilepsy drugs. Patients in the CBD group experienced 43.9% fewer seizures, compared to only 21.8% in placebo. However, those taking CBD also had more side effects, with 14% dropping out as a result versus only 1% in the placebo group 7 Cannabidiol in patients with seizures associated with Lennox-Gastaut Thiele, E. A., Marsh, E. D., French, J. A., Mazurkiewicz-Beldzinska, M., Benbadis, S. R., Joshi, C., ... & Gunning, B. (2018). Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. The Lancet, 391(10125), 1085-1096. Thiele, E. A., Marsh, E. D., French, J. A., Mazurkiewicz-Beldzinska, M., Benbadis, S. R., Joshi, C., ... & Gunning, B. .

Similar findings were reported by another 2018 study of 225 Lennox-Gastaut patients. Here, the participants took a placebo or one of two CBD doses plus their usual medication. The high-dose CBD group saw a 41.9% reduction in seizures, the regular dose 37.2%, and placebo 17.2%. Seven patients taking CBD withdrew due to side effects such as decreased appetite, sleepiness, and diarrhea 8 Effect of cannabidiol on drop seizures in the Lennox–Gastaut syndrome Devinsky, O., Patel, A. D., Cross, J. H., Villanueva, V., Wirrell, E. C., Privitera, M., ... & Zuberi, S. M. (2018). Effect of cannabidiol on drop seizures in the Lennox–Gastaut syndrome. New England Journal of Medicine, 378(20), 1888-1897. Devinsky, O., Patel, A. D., Cross, J. H., Villanueva, V., Wirrell, E. C., Privitera, M., ... & Zuberi, S. M. .

A systemic review of CBD for epilepsy

More importantly, a 2018 systematic review of 36 studies concluded that . However, the researchers added that more studies looking at other epilepsy syndromes are needed.

Systematic reviews offer the highest quality of evidence in medical research because they combine and analyze the findings of all available studies on a specific topic 10 An introduction to systematic reviews Gough, D., Oliver, S., & Thomas, J. (Eds.). (2017). An introduction to systematic reviews. Sage Gough, D., Oliver, S., & Thomas, J .

How CBD works to improve/lessen seizures

Researchers don’t yet fully understand how CBD for seizures works to improve or lessen these outbursts. The most popular, evidence-based explanation is that CBD affects calcium (Ca2+) and the brain chemical adenosine, both of which play a role in seizures.

CBD achieves this by interacting with three molecular “targets”: GPR55, TRPV1, and proteins that help transport adenosine 11 The proposed mechanisms of action of CBD in epilepsy. Gray, R. A., & Whalley, B. J. (2020). The proposed mechanisms of action of CBD in epilepsy. Epileptic Disorders, 22, S10-S15. Gray, R. A., & Whalley, B. J. .

CBD and GPR55

GPR55 is a cell receptor — a protein on the surface of a cell that binds to specific compounds, producing an effect in the cell 12 Physiology, Cellular Receptor Miller, E. J., & Lappin, S. L. (2020). Physiology, Cellular Receptor. In StatPearls [Internet]. StatPearls Publishing. Miller, E. J., & Lappin, S. L .

GPR55 receptors are abundant in the brain, where their activation can increase calcium levels and promote neuron excitability (increased activity), which plays a role in seizures. CBD has been shown to act as an antagonist of GPR55, blocking its effects.

CBD and TRPV1

Meanwhile, TRPV1 is another cell receptor that can increase neuron excitability by increasing calcium levels and glutamate release — an excitatory brain chemical 13 Use of cannabidiol in the treatment of epilepsy: Efficacy and security in clinical trials Silvestro, S., Mammana, S., Cavalli, E., Bramanti, P., & Mazzon, E. (2019). Use of cannabidiol in the treatment of epilepsy: Efficacy and security in clinical trials. Molecules, 24(8), 1459. Silvestro, S., Mammana, S., Cavalli, E., Bramanti, P., & Mazzon, E .

CBD seems to desensitize TRPV1 receptors, which means it makes them less responsive and reduces their effects on neuron excitability.

CBD and Adenosine

Finally, adenosine is a key chemical that can stop seizures and acts as the brain’s natural anticonvulsant by slowing down neuron activity — the opposite of excitation. CBD appears to block the reuptake of adenosine by special transporter proteins.

This increases the adenosine levels in the brain, which means there’s more of it to activate adenosine receptors and slow down neuron activity.

How to use CBD for seizures

Although most studies administer pure CBD orally, this isn’t necessarily the best option for seizures. For one, research in epilepsy patients has shown that whole-plant CBD formulations have fewer side effects and require smaller doses than pure CBD 14 Potential clinical benefits of CBD-rich cannabis extracts over purified CBD in treatment-resistant epilepsy: observational data meta-analysis. Pamplona, F. A., da Silva, L. R., & Coan, A. C. (2018). Potential clinical benefits of CBD-rich cannabis extracts over purified CBD in treatment-resistant epilepsy: observational data meta-analysis. Frontiers in neurology, 9, 759. Pamplona, F. A., da Silva, L. R., & Coan, A. C. .

That’s why the best way to use CBD for seizures is to go with a full-spectrum CBD oil, which will provide all of the plant’s beneficial phytochemicals. It should also have a relatively high potency (40 mg of CBD per ml or more) since the treatment of seizures tends to require large CBD doses.

Our recommended brand of CBD oil for seizures is NuLeaf Naturals. This reputable Colorado company offers high-potency, full-spectrum CBD oil of exceptional quality.

If you’re looking for more immediate relief, vaping CBD is a viable alternative. Both of these methods offer potent effects because they’re absorbed better than simply swallowing CBD in the form of edibles 15 A systematic review on the pharmacokinetics of cannabidiol in humans Millar, S. A., Stone, N. L., Yates, A. S., & O'Sullivan, S. E. (2018). A systematic review on the pharmacokinetics of cannabidiol in humans. Frontiers in pharmacology, 9, 1365. Millar, S. A., Stone, N. L., Yates, A. S., & O'Sullivan, S. E. .

If you want to try vaping CBD, you can’t go wrong with CBDfx. This popular brand offers three types of CBD e-liquids with different flavors, strengths, and CBD formulations.

As for the ideal CBD oil dosage for seizures, it differs from person to person. It depends on how much you weigh, your genetics, seizure severity, and the type of product you plan to use.

That’s why the best approach is to “start low and go slow.” 16 The pharmacokinetics and the pharmacodynamics of cannabinoids. Lucas, C. J., Galettis, P., & Schneider, J. (2018). The pharmacokinetics and the pharmacodynamics of cannabinoids. British journal of clinical pharmacology, 84(11), 2477-2482. Lucas, C. J., Galettis, P., & Schneider, J. . Take a small amount of CBD such as 10 mg, wait a few hours to see the effects, and gradually increase the dosage until you achieve the effects you’re looking for.

Cautions about taking CBD for seizures

Decades of studies have shown that CBD is a remarkably safe, non-intoxicating compound 17 Safety and Side Effects of Cannabidiol, a Cannabis sativa Constituent. Bergamaschi, M. M., Queiroz, R. H., & Zuardi, A. W. en Crippa, JA (2011). Safety and Side Effects of Cannabidiol, a Cannabis sativa Constituent. Current Drug Safety, 6(4), 237-249. Bergamaschi, M. M., Queiroz, R. H., & Zuardi, A. W. en Crippa, JA . However, it’s not without its side effects, especially when taken at the large doses required for treatment of seizures.

High doses of CBD can cause side effects such as diarrhea, drowsiness, decreased appetite, and tiredness. . That means CBD can make certain medications more or less effective, so if you’re taking any prescriptions you should consult with your doctor before trying CBD.

Another thing to keep in mind is that full-spectrum CBD products contain small amounts (0.3% or less) of THC, the main intoxicating component of cannabis. This isn’t an issue for the vast majority of people. However, even small amounts of consumed THC may show up on a drug test. Some people are also highly sensitive to THC, which means they can experience a slight high from taking a large dose of a full-spectrum CBD product. If the inclusion of THC is something you’re concerned about, consider products that instead contain CBD isolate or broad-spectrum CBD.

Final thoughts on CBD for Seizures

High-quality research evidence suggests that CBD can relieve epileptic seizures, making it a promising option for people with treatment-resistant epilepsy. Researchers believe that CBD works by interacting with certain parts of the brain.

The best way to use CBD for seizures is to go with a full-spectrum CBD oil or CBD vape juice. CBD is generally safe, although it may cause some side effects, especially at high doses.

CBD for Seizures FAQs

How do I use CBD oil for seizures?

If you’re taking CBD oil for seizures, be sure to look for a full-spectrum CBD oil. It’s also best to use a high-potency product since treatment of seizures typically requires large doses of CBD.

What CBD dosage should I use for seizures?

The ideal CBD oil dosage for seizures is different for everyone. The best approach is to start with a small amount (10-15 mg), wait to see the effects, and up the dose slowly until you find the amount that works for you.

The information provided is for informational purposes only. We do not claim to treat or cure any health ailment or condition. Please consult your doctor or healthcare provider before trying any new product. We are not responsible for any adverse reaction(s) you may have to any of the products featured on this site. See our T & C for more information.

Sources
  1. Mayo Clinic. (2020) Seizures - Symptoms and causes. Retrieved December 18, 2020, from https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711
  2. CDC. (2020) Types of Seizures | Epilepsy | CDC. Retrieved December 18, 2020, from https://www.cdc.gov/epilepsy/about/types-of-seizures.htm
  3. MedlinePlus. (2020) Lennox-Gastaut syndrome. Retrieved December 18, 2020, from https://medlineplus.gov/genetics/condition/lennox-gastaut-syndrome/
  4. Szaflarski, J. P., Bebin, E. M., Cutter, G., DeWolfe, J., Dure, L. S., Gaston, T. E., ... & Thomas, A. E. (2018). Cannabidiol improves frequency and severity of seizures and reduces adverse events in an open-label add-on prospective study. Epilepsy & Behavior, 87, 131-136.
  5. Devinsky, O., Cross, J. H., Laux, L., Marsh, E., Miller, I., Nabbout, R., ... & Wright, S. (2017). Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. New England Journal of Medicine, 376(21), 2011-2020.
  6. Miller, I., Scheffer, I. E., Gunning, B., Sanchez-Carpintero, R., Gil-Nagel, A., Perry, M. S., ... & Knappertz, V. (2020). Dose-ranging effect of adjunctive oral cannabidiol vs placebo on convulsive seizure frequency in Dravet syndrome: a randomized clinical trial. JAMA neurology, 77(5), 613-621.
  7. Thiele, E. A., Marsh, E. D., French, J. A., Mazurkiewicz-Beldzinska, M., Benbadis, S. R., Joshi, C., ... & Gunning, B. (2018). Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. The Lancet, 391(10125), 1085-1096.
  8. Devinsky, O., Patel, A. D., Cross, J. H., Villanueva, V., Wirrell, E. C., Privitera, M., ... & Zuberi, S. M. (2018). Effect of cannabidiol on drop seizures in the Lennox–Gastaut syndrome. New England Journal of Medicine, 378(20), 1888-1897.
  9. Stockings, E., Zagic, D., Campbell, G., Weier, M., Hall, W. D., Nielsen, S., ... & Degenhardt, L. (2018). Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence. Journal of Neurology, Neurosurgery & Psychiatry, 89(7), 741-753
  10. Gough, D., Oliver, S., & Thomas, J. (Eds.). (2017). An introduction to systematic reviews. Sage
  11. Gray, R. A., & Whalley, B. J. (2020). The proposed mechanisms of action of CBD in epilepsy. Epileptic Disorders, 22, S10-S15.
  12. Miller, E. J., & Lappin, S. L. (2020). Physiology, Cellular Receptor. In StatPearls [Internet]. StatPearls Publishing.
  13. Silvestro, S., Mammana, S., Cavalli, E., Bramanti, P., & Mazzon, E. (2019). Use of cannabidiol in the treatment of epilepsy: Efficacy and security in clinical trials. Molecules, 24(8), 1459.
  14. Pamplona, F. A., da Silva, L. R., & Coan, A. C. (2018). Potential clinical benefits of CBD-rich cannabis extracts over purified CBD in treatment-resistant epilepsy: observational data meta-analysis. Frontiers in neurology, 9, 759.
  15. Millar, S. A., Stone, N. L., Yates, A. S., & O'Sullivan, S. E. (2018). A systematic review on the pharmacokinetics of cannabidiol in humans. Frontiers in pharmacology, 9, 1365.
  16. Lucas, C. J., Galettis, P., & Schneider, J. (2018). The pharmacokinetics and the pharmacodynamics of cannabinoids. British journal of clinical pharmacology, 84(11), 2477-2482.
  17. Bergamaschi, M. M., Queiroz, R. H., & Zuardi, A. W. en Crippa, JA (2011). Safety and Side Effects of Cannabidiol, a Cannabis sativa Constituent. Current Drug Safety, 6(4), 237-249.
  18. Iffland, K., & Grotenhermen, F. (2017). An update on safety and side effects of cannabidiol: a review of clinical data and relevant animal studies. Cannabis and cannabinoid research, 2(1), 139-154.

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