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Finding an effective treatment for epilepsy can be difficult. For those with treatment-resistant epilepsy (also called refractory epilepsy or intractable epilepsy), seizures continue even after trying anti-seizure medications as prescribed.
Since the U.S. federally legalized hemp and hemp-derived CBD products in 2018, cannabidiol (CBD) has become popular for many uses and is increasingly discussed as a possible adjunct (add-on) treatment for certain types of epilepsy.
In this article, we’ll look at what CBD is, how it may work in the brain, and which types of epilepsy research suggests it may help, along with important safety considerations to discuss with a neurologist.
Cannabidiol (CBD) and tetrahydrocannabinol (THC) both come from the Cannabis sativa plant, which includes hemp and marijuana varieties. THC is the compound that causes the intoxicating or “high” feeling associated with marijuana.
Hemp plants naturally contain higher levels of CBD and very low levels of THC (less than 0.3 percent by dry weight, according to U.S. law). Because of this low THC content, CBD products made from hemp, such as CBD oil, do not cause intoxication or a “high.”
CBD has been studied for its potential medical uses, including neurological and mental health conditions (conditions that affect the brain, mood, or behavior) such as epilepsy. Research suggests that CBD may help reduce seizure frequency in certain types of epilepsy, especially when used alongside standard anti-seizure medications.
It’s not yet fully understood how CBD helps control seizures in epilepsy. However, scientists have several well-studied theories.
Some researchers believe CBD affects seizures through its interaction with receptors on brain cells. A receptor works like a lock on a cell that can be activated by a specific chemical “key.” One group of these receptors, called G protein-coupled receptors, helps regulate the movement of calcium into and out of brain cells. Calcium plays a critical role in how brain cells send signals to each other, and changes in calcium signaling can affect seizure activity.
Scientists also think a chemical called adenosine may be involved. Adenosine is a naturally occurring brain chemical that helps calm excessive electrical activity and has anti-seizure effects. Animal studies, including research involving rats, suggest that CBD may increase the availability of adenosine in the brain, which could help reduce seizures.
Another brain receptor that CBD may affect is TRPV1 (short for transient receptor potential vanilloid 1), also known as the capsaicin receptor (the same receptor that responds to chili peppers). TRPV1 receptors appear to be more active in some people with epilepsy, and CBD may make these receptors less sensitive, which could lower seizure risk.
CBD may also affect T-type calcium channels in human brain cells. This action is similar to how some anti-seizure medications work, further supporting CBD’s potential role as an add-on treatment for certain forms of epilepsy. Together, these overlapping effects may help decrease seizure activity, although more research is still needed.
Clinical studies have shown that CBD is most helpful for certain severe or treatment-resistant forms of epilepsy. Research so far has identified several epilepsy syndromes that appear to respond best to CBD when used as an add-on treatment.
Dravet syndrome, also known as severe genetic myoclonic epilepsy, usually begins in infancy. Seizures are often triggered by fever or overheating and are often resistant to many anti-seizure medications.
In clinical trials, prescription CBD has been shown to help reduce seizure frequency in people with Dravet syndrome. Long-term studies suggest CBD can be used safely in both children and adults, with some research showing continued benefit for three to four years.
Lennox-Gastaut syndrome (LGS) is a severe epilepsy syndrome that causes multiple types of seizures, often beginning in early childhood (typically between ages 2 and 5). Seizures tend to be frequent, difficult to control, and resistant to treatment.
Clinical trials studying CBD, including those involving people with Dravet syndrome, have also shown that CBD can reduce seizure frequency in people with LGS.
Tuberous sclerosis complex (TSC) is a genetic condition that causes noncancerous tumors (called hamartomas) to grow in different parts of the body, including the brain, skin, lungs, and eyes. Seizures affect about 80 percent of people with TSC and are often difficult to manage.
Studies have shown that CBD can reduce TSC-related seizures by nearly 50 percent, and long-term follow-up suggests these benefits may last for up to six years.
Febrile infection-related epilepsy syndrome (FIRES) is a rare and severe epilepsy condition that develops in children after a fever-causing infection. FIRES has historically responded poorly to standard anti-seizure medications.
Some clinical studies suggest that CBD may help reduce seizures in people with FIRES, with benefits lasting up to one year in certain cases. However, as of February 2026, CBD is not an approved treatment for FIRES, and more research is needed.
CBD products, including tinctures, concentrates, and capsules, are widely available over the counter at a variety of stores, from gas stations to specialty CBD boutiques. However, over-the-counter (OTC) medical cannabis products are not approved by the U.S. Food and Drug Administration (FDA) or regulated in the same way as prescription CBD products.
This means these products do not come with the same guarantees of safety, quality, and effectiveness. Studies have found that some OTC CBD products may contain more or less CBD than the label claims, and some may also contain unexpected ingredients, including small amounts of THC.
Prescription CBD products, on the other hand, are regulated by the FDA and must meet strict standards for quality, purity, and consistent dosing. For this reason, CBD prescribed by a healthcare professional offers a much higher level of safety and reliability.
Currently, only one CBD medication has FDA approval for certain types of epilepsy: Epidiolex. This medication is a purified, prescription form of CBD and is approved to treat LGS, Dravet syndrome, and seizures associated with TSC.
CBD may be helpful for some people living with treatment-resistant epilepsy. At the same time, it’s important to understand the possible risks and side effects, especially when CBD is used regularly or alongside other medications.
Potential side effects of CBD include:
Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.
Because long-term CBD use can affect the liver, healthcare providers often recommend blood tests to check liver function before starting CBD and at regular intervals during treatment, especially when using prescription CBD.
In addition to side effects, CBD can interact with other medications, which may increase side effects or change how well certain drugs work.
CBD has been shown to interact with a wide range of medications, including:
A few well-documented, higher-risk interactions include:
Drug interactions can be serious. Because CBD may affect how other medications are processed in the body, talk with your regular doctor or neurologist before starting CBD, especially OTC products. If you have questions about specific medications or side effects, your healthcare provider is the best source of guidance before trying a new treatment.
On MyEpilepsyTeam, people share their experiences with epilepsy, get advice, and find support from others who understand.
Have you tried CBD to manage your seizures? Let others know in the comments below.
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My husband has had Epilepsy for 25 years we added Charlotte's web CBD oil along with regular meds and smoking marijuana daily. It all helps he will be 2 years without gran mal in a few weeks. Still… read more
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