What to know about CBD oil for seizures
CBD oil is a carrier oil mixed with the compound cannabidiol, or CBD. CBD is one of many different types of cannabinoids found mainly in the cannabis plant.
CBD oil may help with some symptoms of seizures and epilepsy, though most people prefer to use the isolated CBD compound as a treatment.
There has been a recent spike in research into compounds such as CBD, fueled partly by more open legislation surrounding cannabis in general.
It is essential to be aware of any side effects or risks when taking CBD oil, and it is essential to work closely with a doctor to decide if CBD oil is a suitable treatment option.
Keep reading to learn more about cannabis and CBD oil for seizures.
Is CBD legal? Hemp-derived CBD products with less than 0.3% THC are legal federally but still illegal under some state laws. Cannabis-derived CBD products, on the other hand, are illegal federally but legal under some state laws. Check local legislation, especially when traveling. Also, keep in mind that the Food and Drug Administration (FDA) have not approved nonprescription CBD products, which may be inaccurately labeled.
Share on Pinterest Research into the health benefits of CBD oil is ongoing.
CBD oil is a mixture of cannabidiol (CBD) and a carrier oil, such as olive, coconut, or other ingestible oils.
Cannabidiol is one of the main compounds in the cannabis plant. The other most familiar compound is Tetrahydrocannabinol (THC), which causes the “high” when smoking or ingesting cannabis.
CBD is not psychoactive and will not cause the changes in perception associated with cannabis use.
However, some CBD oils that manufacturers label as full-spectrum or broad-spectrum may contain other compounds. Ingredients may include other cannabinoids or terpenes, depending on the manufacturer and the quality of the oil.
Some CBD oil manufacturers will include CBD and a small amount of these compounds in their oils. They suggest that these compounds work together to enhance some of the effects in the body, a process known as the entourage effect.
Seizures are surges of electrical activity in the brain that occur at inappropriate times. Underlying conditions, such as epilepsy, can cause seizures.
About 30% of people with epilepsy have difficulty controlling their symptoms using traditional methods. These people may want to talk to their doctor about using CBD for seizures.
CBD may play a role in helping to reduce seizures in some cases. That said, cannabis research takes time. The Epilepsy Foundation note that although there is some evidence to suggest that CBD may help control seizures, scientists have struggled to expand on this research due to the strict government regulations surrounding cannabis.
Cannabis products containing more than 0.3% of THC remain illegal in most states and countries worldwide. However, the Food and Drug Administration (FDA) have approved Epidolex, a schedule V drug that contains CBD.
Although Epidolex is the only FDA-approved drug to utilize CBD, other products that contain CBD, such as oils and edibles, are legal across the United States, provided they contain less than 0.3% THC.
Research has grown in recent years thanks to the rescheduling of CBD, and newer studies support the claim that CBD products might help treat certain groups of people with epilepsy.
However, researchers did not control the dosage or preparation of CBD in the majority of studies using CBD products, so researchers must continue to explore this area.
For more information and resources on CBD and CBD products, please visit our dedicated hub.
Some experts think CBD may be particularly beneficial for two rare forms of epilepsy, Lennox-Gastaut syndrome, and Dravet syndrome. The syndromes typically appear in childhood, resist treatment, and cause severe symptoms, including seizures.
Some doctors prescribe the FDA -approved CBD isolate Epidiolex to treat the seizures that these rare forms of epilepsy cause.
Their report notes the importance of the drug’s uniform strength and consistent delivery. This can give a person taking Epidiolex the confidence that they are getting the exact dose they need.
Epidiolex contains about 98% purified CBD, so it is likely to have a greater, more consistent effect than other forms of CBD isolates and oil.
Anecdotally, people, especially those with difficult to treat symptoms, have used other forms of CBD and CBD oils to treat symptoms of epilepsy and other concerns.
Anyone considering using CBD and broad-spectrum oils should talk to a doctor before using them to discuss their options.
Children with epilepsy whose symptoms do not respond well to conventional treatments may also benefit from using CBD. For instance, the FDA have approved Epidiolex for people over the age of 2 with Lennox-Gastaut and Dravet syndromes.
A review in the Journal of Clinical Neurophysiology notes that CBD, either isolated or part of a CBD-enriched herbal extract, helps decrease seizure frequency in children with treatment-resistant epilepsy.
A second review in Epilepsia notes that even though evidence suggests CBD likely reduces seizures among children with drug-resistant epilepsy, these results do not extend to other cannabis compounds in the plant. Researchers think that CBD is the only accepted compound with these properties.
As for long term effectiveness, CBD may not be suitable for all children. A study in CNS Drugs notes that over 4 years, CBD was effective in about 27% of children with treatment-resistant epilepsy. However, about 81% of participants experienced side effects, and about 23% experienced severe side effects.
There are several potential risks and side effects that people need to be aware of when using CBD oil for epilepsy and seizures.
CBD oil usually causes few side effects, which are typically mild. Common side effects from CBD may include:
- sleepiness or fatigue
- an upset stomach
- changes in weight
- changes in appetite
For some people, CBD may make it unsafe for them to operate heavy machinery or drive.
There may be a link between CBD use and suicidal ideation in some cases. One 2020 article notes a correlation between the two but emphasizes that CBD may not be responsible for this outcome.
More research will help to determine the link between CBD and suicidal ideation. Anyone using CBD should watch for any unusual signs and changes in behavior.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.
Possible liver damage
CBD may increase the risk of liver damage in some people, especially when taken in combination with other medications. Anyone with a history of liver damage should work with a doctor to monitor their liver function if they choose to use CBD.
Although CBD is a natural compound, it might still interact with some drugs. Always talk to a doctor before using CBD to check for any contraindications.
Some medications, for example, those that take the CYP450 enzymatic pathway, carry a caution on the label warning people not to drink grapefruit juice while taking them, as it can interfere with the drugs.
Using CBD can carry similar potential risks.
People must also be aware of drug and herb interactions. This is especially important for those with liver or renal disease, as unmonitored changes in their blood levels can be dangerous.
Research into plant products and how they may interact with certain drugs is in its early stages. However, some research shows that certain herbs may interact with CBD and other electrolytes taking the CYP450 pathway, such as:
- milk thistle
- Ginkgo biloba
- St. John’s wort
Ensuring purity is an crucial factor for anyone looking for CBD oil. This is especially true for people who want to use CBD oil as a supplementary treatment for conditions such as epilepsy.
Reputable manufacturers will offer third-party lab testing that details the amounts of compounds, such as CBD, in each bottle. This ensures that a person gets as measured a dose as possible.
An independent lab test also helps ensure that the product is free from other contaminants, such as chemicals, pesticides, or heavy metals.
All CBD products featured on Medical News Today have undergone rigorous third-party testing and meet standards of quality.
Though CBD oil contains mostly CBD, it can contain trace amounts of THC. While this is not enough to produce a psychoactive effect in the brain, it may still show up on a drug test.
Anyone using CBD for treatments who has to undergo drug testing should be aware of this possibility and take the appropriate steps to avoid any consequences.
CBD oil may help with some symptoms of seizures and epilepsy, though the isolated CBD compound may be the preferred treatment in most cases. Learn more.
Cannabis oil for epilepsy
Published on 23 February 2020
Updated: 2 February 2021
Authored by Anonymous
Cannabis oil for epilepsy
On 1 November 2018, the Government’s landmark decision to reschedule some cannabis based products for medicinal use, came into force. The change in law means that specialist doctors in the UK can now prescribe medicinal cannabis to people with a limited number of conditions, including epilepsy. Here we explain what the change in law means for people with epilepsy.
What is cannabis?
Cannabis is made up of hundreds of different components. The most well known are two cannabinoids: CBD – cannabidiol – and THC – tetrahydrocannabinol. These are found naturally in the resin of the cannabis plant.
THC is the psychoactive compound in cannabis. It is responsible for the “high” people feel. The legal limit of THC content in a product, as stipulated by the Home Office, is 0.2%.
CBD is not psychoactive and it is thought to be responsible for many of the medical benefits associated with cannabis.
What is medicinal cannabis?
The Government has defined a cannabis-based product for medicinal use in humans as one that:
“Is or contains cannabis, cannabis resin, cannabinol or a cannabinol derivative; is produced for medicinal use in humans and is a medicinal product, or a substance or preparation for use as an ingredient of, or in the production of an ingredient of, a medicinal product”.
Guidance around prescribing cannabis-based products
In August 2019, NICE – the National Institute of Health and Clinical Excellence – announced that it would not be recommending that cannabidiol, a medicinal cannabis in the form of Epidyolex, should be prescribed on the NHS for children with two severe forms of epilepsy. This is on account of the fact that its long-term effect remains unclear.
The body also has concerns about the ‘viability of the economic model’ used by GW Pharma, the company that developed the drug, to establish the cost to be charged to the NHS for it. It concluded that Epidyolex would not, at this stage, be an effective use of NHS resources.
The recommended guidelines are still only draft and the consultation closes on 16 September. So there is still time for you to have your say and let them know what you think. Professor Sander will be doing the same. All comments received will be considered by NICE and final guidance is likely to be published in November 2019.
The British Paediatric Neurology Association (BPNA) has drawn up interim guidance around epilepsy on behalf of NHS England.
Guidance for other conditions is being drawn up the Royal College of Physicians with the Royal College of Radiologists (RCR) and the Faculty of Pain Medicine of the Royal College of Anaesthetists.
Guidance from the Association of British Neurologists (ABN)
Interim guidance from the ABN states that there is only published evidence for the use of medicial cannabis in Dravet syndrome and Lennox-Gastaut syndrome. Prescriptions should only be for cannabidiol.
Although the label Lennox-Gastaut is often broadly attached to severe epilepsies with compatible seizure types and intellectual disabilities, it is important that there is a clear syndromic diagnosis.
Dosing data for adults is currently very limited, although more information is expected shortly.
Guidance from the British Paediatric Neurology Association (BPNA)
The BPNA guidance states that non-licensed medicinal cannabis should only be considered for children who:
- have an epilepsy that does not respond to conventional licensed anti-epileptic medications
- have not responded to the ketogenic diet or who are not suitable for the ketogenic diet
- who are not candidates for epilepsy surgery.
The BPNA states that the current best evidence for medicinal cannabis is CBD, a highly purified liquid, which has been licensed in the US by the Food and Drug Administration and is currently going through the application process for a licence from the European Medicines Agency.
CBD does not contain any significant amount of THC, the component of cannabis associated with producing a ‘high’.
What is the evidence?
The reason that the BPNA is only recommending CBD is that there is some evidence to show that this newly developed drug can be effective in reducing some type of seizures in Dravet and Lennox Gastaut syndromes.
Three double blind randomised controlled trials of pure CBD in children and young people with these syndromes has shown a greater reduction in monthly seizures compared to placebos. There was also a greater reduction in drop seizures in people taking CBD compared to those on a placebo. Further open label studies have shown that it may also have an anti-epileptic effect in the epilepsies in general.
What is the evidence around THC?
While some studies have also suggested that THC may have an anti-epileptic effect, animal studies suggest it can also trigger seizures. There is no evidence from randomised controlled clinical trials for products with higher proportions of THC (more than 0.2 per cent).
Concerns have also been raised about the effect of THC on the developing brain in children and young people. Evidence suggests that chronic exposure to THC can affect brain development, structure and mental health.
There is also no good scientific evidence to support suggestions that the addition of THC in combination with CBD increases the efficacy of cannabis-based medicinal products for children.
“Clinicians should not feel under pressure to prescribe cannabis-based medicinal products until they have undergone proper clinical trials,” says the BPNA.
“We recommend that these products undergo randomised clinical trials for efficacy and safety before they are routinely prescribed in the UK. We welcome the rescheduling of these products from Schedule 1 to Schedule 2 that will enable their investigation in clinical trials.”
Children already on products containing THC
The BPNA also recommends that where children are already taking other cannabis-based products that contain higher proportions of THC, they should be transitioned on to CBD until strong evidence for these products can be produced through clinical trials.
The Government has no plans to legalise the use of cannabis for recreational purposes. Possession of cannabis is illegal. This includes cannabis for medical use unless it has been prescribed for you.
Getting a prescription for medicinal cannabis
Cannabis-based medicinal products can only be prescribed by a specialist. A GP cannot prescribe the medication but could refer you to a specialist.
The specialist will discuss all other treatment options with you first before considering a cannabis-based product.
A prescription for medicinal cannabis would only be given when all other treatment options have been tried or are considered unsuitable, and would only be given if the doctor considers it to be in your best interests.
People always have the option of seeking a second opinion.
Health food shops
There is also a wide range of other cannabis products available on the internet and in some commercial outlets such as health food outlets and from cannabis ‘dispensaries’ internationally. These products are of unknown quality and contain CBD and THC in varying quantities and proportions.
MHRA is working with individual companies to ensure that CBD-based products that make medicinal claims should be licensed and meet safety, quality and efficacy standards to protect public health. To date, the MHRA has licensed no other cannabis based medicinal products as medicines.
With talk in the media about the use of cannabis products to treat epilepsy, generating interest…