CBD for Epilepsy: What the Studies Say

When it comes to determining the effects of CBD oil treatment, users must often rely on anecdotal evidence and their own experience. For most ailments, regrettably, little formal research has been completed, so conclusions are sparse. But when it comes to CBD oil for epilepsy, it’s a different story entirely.

Of all CBD’s therapeutic treatments, the use of this wonderful cannabinoid to treat seizures is, without doubt, the most widely studied and, arguably, the best understood. Indeed, even the Food and Drug Administration has recognized this potential, as evidenced by their 2018 approval of Epidiolex, the first FDA-approved CBD-based drug.

Over 44 clinical trials have been conducted in the U.S. alone; moreover, the results of these studies overwhelmingly support the use of CBD oil to treat many types of seizures. This article will break down some of the most current such studies and aim to provide you with a better idea of whether using CBD oil for epilepsy is an appropriate option for your needs.

The Origins of CBD Oil for Epilepsy

The use of CBD for epilepsy was first brought into the spotlight by the case of Charlotte Figi, a young girl whose struggle with Dravet Syndrome drew national attention. According to the Epilepsy Foundation, Dravet’s Syndrome is a rare, drug-resistant type of epilepsy that afflicts infants in their first years and persists throughout the patient’s lifetime.

From a very early age, Charlotte suffered multiple daily seizures. As is common with Dravet Syndrome patients, traditional antiepileptic drugs failed to address her symptoms. The family turned to CBD oil and discovered that it had a significant effect, dramatically reducing the frequency and severity of her seizures.

Charlotte’s experience attracted national media coverage. Combined with the social outreach performed by her family, this attention spurred both formal research and a legion of new users who were desperate to help their loved ones. 

The Food and Drug Administration Approves Epidiolex for Treating Drug-Resistant Epilepsy

Following public pressure, and supported by mounting clinical evidence, the Food and Drug Administration (FDA) approved the first-ever CBD-based drug, Epidiolex, on June 25, 2018.

And indeed, available data suggests that Epidiolex and CBD oil may be effective for treating even the most drug-resistant forms of epilepsy.

the use of CBD in clinical applications could represent hope for patients who are resistant to all conventional anti-epileptic drugs.

Epidiolex’s only active ingredient is a high dose of cannabidiol. It is typically administered twice daily and has been shown to significantly reduce the severity and frequency of seizures for a majority of users.

According to an FDA statement, Epidiolex has been shown effective for treating at least two drug-resistant forms of epilepsy: Dravet Syndrome and Lennox-Gastaut Syndrome. Moreover, Epidiolex was the first approved drug of any sort for treating Dravet Syndrome, the type of epilepsy from which Charlotte Figi suffered.

Clinical Trials on Epidiolex

While Epidiolex is effective for a significant number of users, its efficacy varies depending on the types of epilepsy being treated. For a thorough overview of existing research, see this 2020 review published in Frontiers of Pharmacology. However, some of the most salient points are as follows:

• Epidiolex for Lennox-Gastaut Syndrome: In a 169-patient double-blind study, 43.9% of Lennox-Gastaut Syndrome patients experienced an improvement in the frequency and severity of their seizures.
• Epidiolex for Dravet Syndrome: In a 120-patient double-blind study, over 90% of Dravet Syndrome patients experienced at least a 25% reduction in the frequency and severity of their seizures, and 5% experienced a 100% reduction.

Considering that both forms of epilepsy are known to be highly resistant to typical antiepileptic drugs, these results are nothing short of extraordinary. Moreover, the types of seizures they cause can impact not only day-to-day life but also cognitive development, growth, and quality of life. For users suffering from these debilitating forms of epilepsy, CBD oil and drugs such as Epidiolex may offer a truly life-changing treatment option.

CBD and Traditional Antiepileptic Drugs

Another fascinating field of research concerns the interactions between CBD and traditional antiepileptic drugs (AED’s).

Research shows that CBD oil, Epidiolex, and similar treatments are an often-effective way to treat seizures, even when the types of seizures in question are resistant to AED’s.

According to an Epilepsy Foundation statement, the use of CBD oil alongside AED’s is a promising option. That statement pointed to two clinical trials, both focusing on the use of CBD alongside traditional AED’s:

• In controlled and uncontrolled trials in people with Lennox-Gastaut syndrome (LGS) and Dravet syndrome, 689 people were treated with Epidiolex (CBD), including 533 people treated for more than six months and 391 people treated for more than one year.
• In an expanded access program and other compassionate use programs, 161 people with Dravet syndrome and LGS were treated with Epidiolex, including 109 people treated for more than six months.

In both studies, a significant number of users experienced a significant improvement in the frequency and severity of their symptoms. Tellingly, this was true even for users who experienced no relief from traditional AEDs alone.

These results are extraordinarily promising for users suffering from the most debilitating forms of epilepsy. Whether used alone or as a supplement to traditional antiepileptic drugs, CBD oil holds promise to improve lives and bring relief to some of the most vulnerable in our society.

CBD Resistance From Prolonged Use

Although CBD has been proven effective for treating a wide variety of epilepsy symptoms, long-time users may eventually develop a tolerance. As a result, higher doses may be required for the same level of symptom relief.

According to the American Epilepsy Society, a significant number of patients experience reduced relief after using CBD oil for epilepsy treatment after a period of approximately seven months.

In a study of 92 patients with various forms of epilepsy, the following was observed:

Researchers determined 53 people (57 percent) experienced a 50 percent reduction in average monthly seizure frequency, meaning the treatment was considered effective. Of those 53, tolerance developed in 17 (32 percent) after an average of 7.3 months.

After a 30% increase in CBD dosage, the majority of these patients achieved the same level of relief for their types of seizures. Some, however, did not respond to the increased dosage.

For users looking to treat seizures with CBD oil, it is essential to consider how tolerance may change over time. As with any medication, changes to CBD oil dosage should be handled with care, and it is always best to talk to your doctor before beginning or modifying your treatment.

Side Effects of CBD Oil for Epilepsy

While these clinical trials suggest that CBD can be a remarkably effective tool for treating many types of seizures, they also indicate that users may experience a number of dosage-dependent side effects.

According to the Epilepsy Foundation, the most common side effects of CBD for treating epilepsy include “side effects were sleepiness, decreased appetite, diarrhea, change in liver function, fatigue, malaise, asthenia (weakness or lack of energy), rash, insomnia, sleep disorder, poor quality sleep, and infections.”

In the clinical trials they considered, “Sleepiness, sedation, and lethargy led to stopping Epidiolex in 3% of people” taking a high experimental dose.

A 225-person clinical trial similarly found that a number of patients experienced “sleepiness, decreased appetite, diarrhea, upper respiratory infection, fever, [and] vomiting”. Tellingly, however, these effects were also observed in 72% of those taking a placebo, which suggests that the placebo effect plays a significant role in the incidence of side-effects. Moreover, “Side effects were generally reported as mild or moderate in severity”, and only seven participants withdrew because of more severe symptoms.

Given the possibility of side effects such as these, it is extremely important to monitor one’s reaction to CBD use to treat seizures. As always, users should consult with medical professionals regarding any developing issues with their treatment.

The Bottom Line: Should You Consider CBD Oil to Treat Epilepsy?

For epilepsy patients, clinical trials overwhelmingly support the efficacy of CBD oil for treating seizures and other epilepsy symptoms. Following the Food and Drug Administration’s approval of Epidiolex, cannabidiol-based treatment options are more widely respected and available than ever before.

CBD treatment may be an ideal option for those suffering from forms of epilepsy that resist traditional antiepileptic drugs. This is particularly true with Dravet and Lennox-Gastaut Syndromes, but growing clinical evidence suggests efficacy for other forms as well.

However, not all users respond well to CBD oil for epilepsy treatment. Depending on the types of seizures you or your loved one experience, CBD’s effectiveness may vary significantly. Moreover, given the possibility of side effects, users should carefully monitor their reactions when embarking on CBD treatment.

Given the severe impact that epilepsy can have on a patient’s quality and length of life, however, it is perfectly reasonable to consider CBD oil as a supplement to your traditional treatment.

It is crucial to consider the available evidence and to consult with a medical professional. This is necessary for determining proper dosage, determining CBD’s potential interaction with other medications, and tracking the incidence and severity of side effects that may arise. Your health is important, and only expert consultation can determine whether CBD oil is the proper option for treating your epilepsy symptoms.