An in-depth look at how CBD might benefit people with epilepsy or other seizure disorders, including the latest research, medical insights and potential risks. Best CBD Oil for Seizures & Epilepsy in 2022 According to the Michigan Epilepsy Foundation, 1% of Americans suffer from some form of epilepsy — a recurring neurological disorder known for Epidiolex contains cannabidiol (CBD) from the marijuana plant. It is approved to treat Lennox-Gastaut syndrome and Dravet syndrome. Learn about safety and more.
CBD For Seizures: Benefits, Risks And More
Dr. Jessica Cho practiced medicine with a single mission: Help patients attain wellness and create a life full of joy, vitality and balance.
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Table of Contents
- What Is a Seizure?
- Can CBD Help Seizures?
- Potential Risks of Using CBD for Seizures
- Should You Use CBD for Seizures?
- Talk to Your Doctor
One in 26 people in the United States are diagnosed with epilepsy at some point in their lives. Although anyone could potentially experience a seizure, individuals diagnosed with epilepsy are considered to be at a higher risk of developing recurring seizure episodes. Despite the fact that millions of people live with epilepsy and seizure disorders, there is no cure for these conditions. However, many medications, including cannabidiol (CBD), can help manage epileptic symptoms in certain diagnoses.
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What Is a Seizure?
A seizure is a sporadic, short-term burst of electricity in the brain that alters a person’s awareness and ability to function and can lead to spastic movements and other related symptoms, such as staring, loss of consciousness and loss of bowel and bladder control, among others.
Common Causes of Seizures
Common causes of seizures include brain damage and genetic changes that lead to seizure activity, according to Anup Patel, M.D., a board certified specialist in epilepsy, clinical neuropsychology and neurology at Nationwide Children’s Hospital in Columbus, Ohio and president of the Child Neurology Foundation.
Marisa Gardner, M.D., associate professor of neurology and chief of the pediatric neurology and epilepsy division at Benioff Children’s Hospital in Oakland, California, says most seizures fall into one of three categories:
- A structural lesion or process in the brain causing seizures to originate from that area
- A known underlying genetic mutation causing epilepsy
- Idiopathic seizures in which the cause is unknown.
Can CBD Help Seizures?
CBD is a compound found in the cannabis sativa plant and does not include significant amounts (less than 0.3%) of delta-9 tetrahydrocannabinol (THC), which is the psychoactive constituent of cannabis known to cause intoxication.
CBD has been shown to act on the brain’s G protein-coupled receptor 55 (GPR55)—the part of the brain that decreases the release of calcium into cells, thereby decreasing excitatory currents and leading to seizure activity. Through clinical studies, it has been determined that CBD can help reduce neuron excitability.
Can CBD Help Prevent Seizures?
“CBD is an effective treatment for seizures and epilepsy,” says Dr. Gardner. “It has been shown in studies to be similarly effective to other anti-epileptic medications that we commonly use,” she says. “However, it may not work for every type of seizure or all epilepsy patients. For some patients it leads to full seizure control, other patients have a reduction in seizure frequency and others have no improvement at all.”
For patients with epilepsy, CBD is shown to control their seizures and prevent breakthrough seizures from happening. However, CBD does not treat or cure the underlying cause of the epilepsy, and responses vary from person to person, Dr. Gardner adds.
“Data showed that there was approximately 40% reduction in the median seizure count compared to baseline, and over 50% of patients saw at least a 50% reduction in seizures,” says Dr. Patel.
FDA-Approved CBD for Seizures
Studies in the past five years have evaluated a mostly purified plant-based version of CBD in the treatment of different types of epilepsy such as Lennox Gastaut syndrome (LGS) and Dravet syndrome, says Dr. Patel. These studies lead to the development of Epidiolex, the first FDA-approved prescription CBD used to treat seizures associated with these syndromes in patients two years and older.
Epidiolex is closely regulated and monitored to ensure that the product is pure CBD, according to Dr. Gardner. It’s proven to be an efficacious treatment for epilepsy, especially in patients with treatment-resistant epilepsy, (such as Dravet Syndrome or LGS). This is the safest form of CBD to take on a daily basis for seizure control, since it doesn’t contain THC. Epidiolex also allows medical professionals to treat patients at higher doses, as high-dose CBD is proven to be safe, whereas the effects of higher amounts of THC taken on a daily basis (especially in a developing brain) require more research.
“It is important that a patient with epilepsy be treated with a product that is high in CBD and as low as possible in THC (in other words a high CBD to THC ratio),” says Dr. Gardner.
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Potential Risks of Using CBD for Seizures
All cannabis products, including CBD, are broken down in the liver. This can increase liver enzymes to the point where damage can occur, says Dr. Patel, adding that liver enzyme testing is recommended when using CBD products to treat seizure disorders. Drug interactions can also occur: For example, Epidiolex can interact with Clobazam, a prescription medicine used to treat patients diagnosed with Lennox-Gastaut syndrome who are experiencing seizures.
Side effects specifically related to Epidiolex are relatively minimal, says Dr. Gardner. However, because it’s an oil, some patients may experience diarrhea. CBD use can also cause decreased appetite and fatigue.
Should You Use CBD for Seizures?
Patients considering incorporating CBD in their epilepsy treatment should discuss the risks and benefits with their health care provider to determine if CBD is safe for their condition. Dr. Patel notes only FDA approved products should be used—and should be accompanied by proper monitoring from your neurologist.
Talk to Your Doctor
Patients living with seizures should discuss the risks and benefits of this medication with their epilepsy provider, to determine if it is safe and effective for their type of epilepsy. Only FDA approved products should be used and proper monitoring with a neurology provider is highly recommended. Do not start CBD products on your own.
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Best CBD Oil for Seizures & Epilepsy in 2022
According to the Michigan Epilepsy Foundation, 1% of Americans suffer from some form of epilepsy — a recurring neurological disorder known for frequent, often unprovoked seizures.
Epilepsy compromises all aspects of a person’s daily life. The violent tremors caused by a seizure attack can put the individual in grave danger, not to mention that people with epilepsy are also prone to suffer from sleep issues, migraines, anxiety disorders, and depression.
Of all epilepsy forms, up to 40% are drug-resistant, meaning the patient doesn’t react to Antiepileptic Drugs (AEDs). For these patients, AEDs are simply ineffective, or the side effects are too severe to allow for continuous treatment.
As a result, many turn to natural resources to help manage their condition. CBD oil is one promising option whose antiepileptic effects have been thoroughly studied by scientists.
In this article, I’ll cover the potential benefits of CBD oil for epilepsy and seizures — and share the top brands I trust when it comes to manufacturing high-quality CBD oil.
Best CBD Oil Brands for Epilepsy & Seizures
There are lots of different CBD companies trying to make their name in the market with their CBD oil. Some brands provide high-quality products and can back up their claims with third-party lab reports. In contrast, others tend to take advantage of unaware consumers with lots of fancy buzzwords and unrealistic promises.
If you want a clean and potent CBD oil, you need to find a manufacturer that makes organic products with proper quality assurance.
Don’t have time for that? Don’t worry — I did the research for you.
Here are my top 3 brands that make premium CBD oil for different types of consumers.
1. Royal CBD
Get 15% off all Royal CBD products. Use code “CFAH” at checkout.
- Royal CBD comes from organic hemp grown on American farms
- The company employs CO2 extraction so their extracts are clean and safe
- Their CBD oil comes in three different strengths: 250 mg, 500 mg, 1000 mg, and 2500 mg
- Up to 83.3 mg of CBD per mL
- Hemp extract is suspended in premium MCT oil
- Every batch of product has been tested by a third-party laboratory
- No vapes or vape oils available (yet)
- The price is on the higher end, although justified
My Thoughts on Royal CBD:
Royal CBD is a premium brand that uses only high-quality ingredients in its product lineup. The company’s product range includes every basic CBD format, from sublingual drops to gummies and capsules.
The oil and capsules are full-spectrum, meaning they also contain other cannabinoids and terpenes from hemp. Gummies, on the other hand, contain 99% pure isolate.
The Royal CBD oil comes in three different potencies: 250 mg, 500 mg, 1000 mg, and 2500 mg. The strongest option gives you 83 mg of CBD/mL. I would recommend this variant for stronger symptoms. Those who need noticeably higher doses of CBD may find the weaker bottles cost-prohibitive.
If you don’t want to measure out the oil each time you need CBD, you may switch to Royal capsules. Each softgel carries 25mg of full-spectrum cannabidiol in an easy-to-swallow form.
All Royal CBD products are sent to third-party laboratories for content analysis — checking the potency of CBD as well as purity levels.
2. Gold Bee (Best Organic)
- Unique product selection
- Non-GMO, Colorado-grown hemp
- Full-spectrum CBD
- Extracted with CO2
- Up to 2400 mg of CBD per bottle (80 mg/mL)
- Sweetened with organic honey
- Third-party lab tested for potency and purity
- No high-strength oils
- Not available in-store
My Thoughts On Gold Bee:
Gold Bee specializes in all-organic CBD products, including full-spectrum CBD oil, high-potency CBD capsules, gummies, and delicious honey sticks. The company’s CBD oil is available in two potency options, 1200 mg, and 2400 mg.
This concentration translates into 40 mg of CBD in each milliliter. The oil has been suspended in premium-grade MCT oil and infused with natural terpenes to enhance the synergy between CBD and other compounds in hemp. There are two flavors available: natural and kiwi. The kiwi flavor is sweetened with organic honey, which only adds to the product’s value.
I’ve been taking the Gold Bee CBD oil for 30 days, using the dosage based on the recommended serving size. At first, I was skeptical because I got used to higher doses in my routine — low doses could hardly calm my nervous system.
To my surprise, 1 mL a day split into two doses was enough to boost my resistance to stress and outside stimuli. After two weeks, I slightly decreased the dosage and was still getting pretty good results. This was the first time a potency lower than 1500 mg lasted more than 1 month for me.
- CBDPure products come from organic hemp grown in Colorado
- The company uses CO2 extraction
- All products are tested by 3rd-party laboratories for potency and purity
- Available in 60 mL bottles
- 100% Satisfaction Guaranteed program — you can send your order back within 90 days for a full refund
- CBDPure only sells CBD oil and capsules
- The oil is slightly less potent than Royal CBD
My Thoughts on CBDPure:
CBDPure was established in 2016 by a group of cannabis advocates from Colorado. The company has a simple mission, which is to make premium-quality CBD oils from organic hemp.
Although CBDPure has a very narrow product range — offering only CBD oil and capsules — they seem to have perfected these products. All extracts from CBDPure are obtained using supercritical CO2 and tested in a certified laboratory for quality assurance.
The oil isn’t as potent as the one offered by Royal CBD, but if you benefit from lower doses, their 60-mL bottles will get you supplied for months to come. Their oils are a good option for people who use CBD for general health care or to ease mild symptoms.
If you’re looking for something potent, try CBDPure capsules — each softgel is infused with 25 mg of full-spectrum CBD for easier dosing and extra convenience.
CBDPure has a Satisfaction Guarantee program, so in case you ended up unsatisfied with your purchase, you can get a full refund if you send the order back within 90 days.
- CBDistillery uses Colorado-grown hemp
- Their products are available as full-spectrum or isolate
- They have an impressive product selection
- Each batch is sent to a 3rd-party lab for content analysis
- Very affordable
- Their hemp isn’t organic
My Thoughts on CBDistillery:
CBDistillery is a company founded in Denver, Colorado. They’ve been offering high-quality CBD oil products for over 5 years now. One of the driving forces behind the brand is to manufacture CBD oil for every budget and promote research and education among consumers all over the country.
CBDistillery has many different forms of CBD, from sublingual tinctures to capsules, gummies, topicals, and vapes. Their CBD oil is available as ‘full-spectrum’ or isolate.
These oils come in two different sizes — 15 mL and 30 mL
The potency of the 15 mL bottle ranges between 150–1,000 mg of CBD. The 30 mL bottle offers from 2,500–5,000 of total CBD.
With such a wide potency range, CBDistillery oils may suit both novice and experienced consumers alike. The only downside to the company’s product range is that they’re not made with organic hemp.
However, this becomes understandable once you consider the price of CBDistillery products. The company may not sell the best CBD oil on the market, but they offer the best CBD products in this price range.
What is CBD Oil?
CBD oil is a cannabis extract with high concentrations of CBD. This product can be sourced from both marijuana and hemp, two members of the cannabis plant family.
It’s worth noting that marijuana-derived CBD oil contains higher levels of THC, the psychoactive cannabinoid responsible for getting users “high.”
CBD oil from hemp has only trace amounts of THC — typically below 0.3% — and thus can’t produce any psychoactive effects.
That’s because CBD is non-psychoactive per se.
CBD oil reportedly has a plethora of health benefits. However, the best-documented evidence thus far comes from epilepsy trials.
Does CBD Oil Work for Seizures?
The earliest studies proving the effectiveness of cannabis compounds in the treatment of convulsions came from animal research from the 1970s. The researchers analyzed the anticonvulsant properties of both THC and CBD oils, concluding that both extracts had substantial effects on mice.
Early experiments reported that the seizure activity might in part, be regulated by the endocannabinoid system — an interconnected network of cannabinoid receptors and neurotransmitters called endocannabinoids.
The Mechanism Behind the Antiepileptic Effects of CBD
The endocannabinoid system works to keep the body in a state of equilibrium, maintaining chemical balance and controlling biological functioning, from appetite to motor control, sensory perception, sleep, and inflammation.
It sends signals to various bodily systems through its chemical messengers called endocannabinoids to do. These molecules bind to the cannabinoid receptors which occur in the brain and throughout the body. By doing so, endocannabinoids help the endocannabinoid system to maintain the healthy functioning of an individual.
Once endocannabinoids have done their work, they get broken down by enzymes to prevent overaccumulation.
As a cannabinoid, CBD is almost identical in its chemical structure to endocannabinoids produced by your body. When you ingest CBD, it’s able to affect cannabinoid receptors on top of acting on several other pathways.
While scientists still don’t know exactly how CBD oil works for seizures, they’ve observed the following interactions which may explain the positive effects:
- Endocannabinoids are neuroprotectants, lowering the risk of seizures caused by neurotoxicity. When a person ingests CBD, they introduce more cannabinoids to their system—potentially improving the performance of the endocannabinoid system with their neuroprotective properties.
- The endocannabinoid system also modulates neuroexcitation, a process that may trigger seizures. A properly functioning endocannabinoid system, bolstered by additional cannabinoids from CBD oil, may prevent the overexcitation of neurons.
- CBD is also an anti-inflammatory agent. Seizures may be triggered, or their frequency may be increased by brain inflammation. By curbing neuroinflammation, CBD may reduce both the severity and frequency of seizure attacks.
Now, let’s elaborate on the scientific findings regarding the antiepileptic properties of CBD oil.
What the Research Says
The majority of specific case studies from the late 1990s, and the early 2000s focused on the effect of THC/CBD solutions on epilepsy. Due to the psychoactive nature of THC, the eyes of modern medicine turned to CBD.
In June 2018, the FDA approved the first CBD-based drug. The oral spray, called Epidiolex, contains 99% pure CBD. It’s used for treatment-resistant forms of childhood epilepsy — such as Lennox-Gastaut syndrome and Dravet syndrome.
Both diseases begin during early childhood and often lead to delayed or poor development of the child’s motor skills, language, intellectual aptitude, and ability to communicate with others.
Before receiving the FDA’s approval, Epidiolex went through three randomized, double-blind, placebo-controlled clinical trials examining 516 patients with either syndrome. When administered along with other medications, Epidiolex successfully reduced the participant’s frequency of seizures compared to the placebo group. Besides, CBD improved other associated symptoms for the participants, such as sleep and anxiety.
Currently, Epidiolex can be officially used to treat these two types of epilepsy. However, recent research suggests that CBD may help relieve other forms of this disease as well.
For instance, a 2015 study analyzing the reports from Epidiolex patients from 11 epilepsy centers across the country showed that the frequency of seizures decreased by 36.5% after a 13-week treatment.
All subjects had severe, childhood-onset forms of epilepsy, including Lennox-Gastaut syndrome and Dravet Syndrome. The researchers started with a dose of 2–5 mg/kg per day and gradually increased it to 25–50 mg/kg per day.
Can You Develop a Tolerance to CBD Oil for Seizures?
People who have treatment-resistant epilepsy tend to experience a “honeymoon” period upon switching to a new therapy. In other words, they stop feeling the effects of their new treatment after a few months. In late 2018, scientists observed that the same pattern might apply to CBD treatment.
The study examined nearly 100 patients, of which about one-third developed a tolerance to CBD. The tolerance showed up about seven months after they began the therapy. From then on, they had to increase the dose to maintain the effects. When the dose was higher, nearly half of the examined sample experienced their previous response level.
The good news, though, is that for two-thirds of participants, CBD proved effective in the long run.
How to Use CBD Oil for Epilepsy
CBD can take many forms. Epidiolex, the only approved CBD treatment for epilepsy, is an oral solution containing 99% pure CBD.
If you want to use CBD in a more natural form to see how it works for your symptoms, you may try the following formats:
- Sublingual drops: The most common form of CBD. The drops are administered via a dropper under the tongue, where they get absorbed through special membranes into the bloodstream. Sublingual drops provide the most consistent blood absorption rates according to studies.
- Capsules: CBD capsules are sold as pills and softgels. You just swallow them like any other pill. They offer a fixed dose of CBD in each serving, which makes dosing easier than sublingual drops, not to mention you can avoid any natural hemp taste.
- Vape oils: this form of CBD is inhaled through a vaporizer or vape pen. Many people prefer vape oils over other products because they find the act of inhalation relaxing, and they like the flavoring of vape oils. But most importantly, vape oils deliver more CBD to your system than any other consumption method.
CBD Oil Dosage for Epilepsy & Seizures
The dose-finding process will vary between patients. As with every new substance, a conservative approach and slow dosage increase will minimize the chance of severe side effects and leave room for adjusting the dose from the starting point.
For each individual, the optimal CBD dosage will depend on the following:
- CBD concentration
- Cannabinoid spectrum
- Route of administration
- Lifestyle choices
- Medications the patient is already taking
Dr. Karen Keough, Chief Medical Officer at Compassionate Cultivation, created general dosage guidelines for dosing CBD oil to both adults and children who have epilepsy.
Dosing Recommendations for Children
Depending on the severity of symptoms, children may go through low-dose initiation and high-dose initiation.
Low-Dose Initiation instructions:
- Start with 0.25 mg/lb/day
- The minimum dose is 10 mg
- Target dose ranges between 1–5 mg/lb/day. Higher doses are tolerated but at the cost of some mild side effects, such as dry mouth, dry eyes, low blood pressure, sedation, and dizziness.
- Average dose is 1–3 mg/lb/day
- Increase the dose every 1–2 weeks by 0.5 mg/lb/day, topping to the nearest 10 mg as long as there are no side effects.
High-Dose Initiation in Children:
- Start with 0.5mg/lbs/day
- Target dose ranges between 1–5 mg/lb/day
- Average dose is 1-3 mg/lb/day
- Increase the dose every 1–2 weeks by 0.5 mg/lb/day and monitor the effects
- If side-effects occur, leave more time between dose increases and go up more gradually
Dosing Recommendations for Adults
Considering the factors above, such as body weight and metabolism, adults with epilepsy need more CBD in their regime than children. Use the following guidelines to reach an effective dose:
Low CBD dose in adults:
- Start with 25 mg twice daily
- Go up by 25 mg per dose every 1–2 weeks
- Target dose ranges between 100–300 mg twice a day if no side effects are observed. Clinical trials have utilized doses as high as 1,500 mg of CBD daily, but such high doses might not be necessary to achieve seizure relief in most patients
High CBD dose in adults:
- Start with 50 mg twice daily
- Go up every 1–2 weeks by 50 mg/dose
- Target dose ranges between 200–500 mg twice a day if tolerated. You may stop sooner if seizures are gone to prevent further dosage increase and possible side effects.
Where to Find CBD Oil for Sale for Epilepsy & Seizures
CBD oil is available both in cannabis dispensaries and online retail stores. Dispensaries give you access to a wide range of cannabis products, including CBD oil from hemp. However, these places may not always carry the best products, and the bottles have probably spent some time on the shelves before being sold so that they may lose potency over time due to poor storage.
That’s why I buy my CBD oil online. The majority of CBD stuff is sold this way, so you have more options to choose from. Also, you can verify the reputation of your potential vendor with the help of online research. Read user reviews, check for third-party lab reports, and learn how your company sources its CBD to make sure you’re getting a clean and potent product.
The delivery time for CBD oil is usually 2–3 business days. But in my opinion, it’s worth it to wait a few days more to get a high-quality product for a good price — CBD oil ordered online is usually less expensive than what you see in a dispensary.
Using CBD Oil for Seizures: Will It Help?
Cannabinoids have many proven beneficial effects on health, particularly in the treatment and management of epileptic seizures. Epilepsy is currently the only FDA-approved condition for treatment with CBD — although this approval doesn’t apply to hemp-derived CBD oil.
Still, if you want to try CBD oil for better management of your symptoms, I hope this guide has helped you understand how to use it to get the most out of its benefits. Just remember to start low and slow with the dosage.
But above all, consult with your doctor before purchasing any CBD product — just to make sure it won’t negatively interfere with any medications you’re taking.
Do you know any examples of people who successfully reduced the frequency of their seizures with CBD oil? Share your stories in the comments below!
- Filloux, F. M. (2016). Cannabinoids for Pediatric Epilepsy? Up in Smoke or Real Science? Translational Pediatrics, 4(4), 271–282.
- Perucca, E. (2017). Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last? Journal of Epilepsy Research, 7(2), 61–76.
- Devinsky, O. et al. (2016). Cannabidiol in Patients With Treatment-Resistant Epilepsy: An Open-Label Interventional Trial. The Lancet: Neurology, 15(3), 270–278.
- Mannila, J., Jarvinen, T., Jarvinen, K., Jarho, P. (2007). Precipitation Complexation Method Produces Cannabidiol/Beta-Cyclodextrin Inclusion Complex Suitable for Sublingual Administration of Cannabidiol. Journal of Pharmaceutical Sciences, 96(2), 312–9.
- 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.
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
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, California.
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.
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US Department of Health and Human Services, U.S. Food and Drug Administration. FDA News release: FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. June 25, 2018.
Gaston TE, Bebin EM, Cutter GR, Liu Y, Szaflarski JP. Interactions between cannabidiol and commonly used antiepileptic drugs. Epilepsia. 2017;58(9):1586-1592. doi:10.1111/epi.13852
Bonn-miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708-1709. doi:10.1001/jama.2017.11909
Reddy DS, Golub VM. The Pharmacological Basis of Cannabis Therapy for Epilepsy. J Pharmacol Exp Ther. 2016 Apr;357(1):45-55. doi: 10.1124/jpet.115.230151. Epub 2016 Jan 19.