• Cannabidiol (CBD) is a derivative of hemp that can be used to treat severe epilepsy in children and adults.
• While CBD products are available over the counter, only prescription CBD medications are approved and regulated by the U.S. Food and Drug Administration (FDA).
• CBD does not cause intoxication and is generally safe to use, but it can interfere with other medications.

Finding an effective treatment for epilepsy is extremely important, but not necessarily easy. This is particularly true for those with treatment-resistant epilepsy, also known as refractory epilepsy. One possible treatment option that has gained attention recently is cannabidiol, or CBD.

CBD and tetrahydrocannabinol (THC) are both derivatives of the hemp plant. THC is the chemical that is responsible for the “high” associated with smoking marijuana. CBD has grown in popularity ever since the passage of the Agriculture Improvement Act of 2018 in the U.S., which made it legal to sell hemp and hemp products.

Hemp is sometimes confused with marijuana. While marijuana and hemp are technically the same plant, they are different varieties. Cannabis sativa, the hemp variety, contains incredibly small amounts of THC (less than 0.3 percent). Because there is such a small amount of THC found in the hemp plant, you don’t have to worry about getting intoxicated from CBD products, such as CBD oil. CBD has been studied for potential benefits in treating several neurological and psychiatric conditions, including epilepsy.

Which Types of Epilepsy Can Be Treated With CBD?

There are many forms of epilepsy that occur in people of all ages. Clinical studies have shown that CBD is most useful for severe or treatment-resistant epilepsy. In some studies, CBD has also proven particularly effective and therapeutic for children with severe epilepsy.

Two types of epilepsy are particularly hard to treat and can be quite dangerous:

• Dravet syndrome, also known as severe myoclonic epilepsy of infancy
• Lennox-Gastaut syndrome, a combination of several seizure types at the same time

CBD has been shown in clinical trials to reduce seizure frequency in individuals who suffer from Dravet syndrome or Lennox-Gastaut syndrome. Further, these same studies have demonstrated that CBD is safe to use long-term in both children and adults, with one clinical trial treating individuals for 96 weeks.

CBD has also shown promising results in treating tuberous sclerosis complex and febrile infection-related epilepsy syndrome (FIRES), two other severe conditions associated with seizures.

How Does CBD Work To Control Epilepsy?

Although the exact process by which CBD controls epilepsy remains unknown, scientists have some theories. Some researchers theorize that CBD affects seizures through its interaction with a receptor on neurons (nerve cells) within the brain. A receptor is like a lock on a neuron that can only be activated with a specific key, such as a neurochemical. In this case, a G-protein coupled receptor acts as a gate for releasing calcium, and calcium is critical for brain cell activity and communication.

Scientists also think a neurochemical called adenosine may interact with CBD. Adenosine is the brain’s natural anticonsulvant (or antiseizure medication). The idea that CBD increases how much adenosine is available in the brain has been supported by research in rats.

Another brain cell receptor that may be affected by CBD is TRPV1 — also known as the capsaicin receptor and the vanilloid receptor 1. This receptor is more prevalent in people with epilepsy, and CBD is known to make these receptors less sensitive.

Altogether, the complex interactions between CBD and several different brain receptors and adenosine are believed to work together to decrease seizure activity.

Over-the-Counter and Prescription CBD Products

CBD products, including tinctures, concentrates, capsules, and more, are readily available over the counter at a wide variety of stores, from gas stations to specialty CBD boutiques. However, over-the-counter CBD products are not approved by the FDA or regulated in the same way as prescription CBD products. This means there is no real guarantee of safety or efficacy for the product. Further, the product may not contain the dose of CBD claimed on the label.

Prescription CBD products, on the other hand, are regulated by the FDA. Certain quality and purity standards must be met by the manufacturer. Therefore, you are more certain to acquire safe and effective CBD through a prescription from a doctor.

Understanding Possible Risks and Side Effects of CBD

If you or a loved one is suffering from a treatment-resistant form of epilepsy, CBD may help. You should also understand the possible risks and side effects of CBD in order to protect yourself.

So far, scientific research and clinical trials show that CBD is generally safe and has little-to-no negative side effects. Studies demonstrate that CBD alone does not negatively affect blood pressure, heart rate, or breathing functions. Further, there are no apparent changes in psychological function when CBD is taken by itself, without THC.

There is one big caveat in using CBD. CBD can cause interactions with other drugs or medications, including antiepileptic drugs (AEDs). Specifically, CBD interacts with other substances that are metabolized by a group of enzymes known as cytochromes P450, which are responsible for breaking down CBD. This means that if you take CBD and another drug that is broken down by these enzymes, CBD may interfere with the level of the other medication in your body.

CBD has been shown to interact with drugs including:

• Antiseizure medications (antiepileptic drugs or AEDs)
• Steroid medications
• Antidepressants
• Anxiety medications
• Calcium channel blockers
• Antipsychotics
• Antibiotics
• Antihistamines
• Anesthetics
• Beta-blockers
• Nonsteroidal anti-inflammatory drugs (NSAIDS)

Drug interactions can be dangerous and carry serious risks. Because CBD has the potential to interact with other drugs, it is important to consult with a doctor before beginning to take over-the-counter CBD products for medical use.

Finding Support as You Treat Epilepsy

Are you having trouble finding an effective way to manage your seizures? Members of MyEpilepsyTeam, the social support network for people with epilepsy and their loved ones, can relate. When you join MyEpilepsyTeam, you gain a community of more than 67,000 people who are living with epilepsy and thousands more who care for a loved one with the condition.

Have you tried CBD to manage your seizures? Did you use a prescription or over-the-counter CBD product? Share your experiences or questions in a comment below, or start a conversation on MyEpilepsyTeam today.

References

1. Agriculture Improvement Act of 2018 — Congress.gov
2. Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age — Frontiers in Immunology
3. Cannabidiol: Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders — Epilepsia
4. Long‐term safety and treatment effects of cannabidiol in children and adults with treatment‐resistant epilepsies: Expanded access program results — Epilepsia
5. Dosage Related Efficacy and Tolerability of Cannabidiol in Children With Treatment-Resistant Epileptic Encephalopathy: Preliminary Results of the CARE-E Study — Frontiers in Neurology
6. Long-term safety and efficacy of cannabidiol in children and adults with treatment resistant Lennox-Gastaut syndrome or Dravet syndrome: Expanded access program results — Epilepsy Research
7. Promising Results for CBD in Tuberous Sclerosis Complex-Related Seizures — Neurology Advisor
8. Cannabidiol as a Potential Treatment for Febrile Infection-Related Epilepsy Syndrome (FIRES) in the Acute and Chronic Phases — Journal of Child Neurology
9. The proposed mechanisms of action of CBD in epilepsy — Epileptic Disorders
10. Intrahypothalamic injection of cannabidiol increases the extracellular levels of adenosine in nucleus accumbens in rats — Neuroscience Research
11. Increased expression of TRPV1 in the cortex and hippocampus from patients with mesial temporal lobe epilepsy — Journal of Molecular Neuroscience
12. Nonpsychotropic Plant Cannabinoids, Cannabidivarin (CBDV) and Cannabidiol (CBD), Activate and Desensitize Transient Receptor Potential Vanilloid 1 (TRPV1) Channels in Vitro: Potential for the Treatment of Neuronal Hyperexcitability — ACS Chemical Neuroscience
13. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies — Cannabis and Cannabinoid Research
14. Potential adverse drug events and drug-drug interactions with medical and consumer cannabidiol (CBD) use — Journal of Clinical Medicine