Best CBD Oil For Seizures

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Best CBD Oils to Help Manage Epilepsy If you or a loved one has epilepsy, you’ve probably been prescribed an anti-epileptic drug (AED). However, one-third of the time, AEDs fail. Either the Epidiolex contains cannabidiol (CBD) from the marijuana plant. It is approved to treat Lennox-Gastaut syndrome and Dravet syndrome. Learn about safety and more.

Best CBD Oils to Help Manage Epilepsy

If you or a loved one has epilepsy, you’ve probably been prescribed an anti-epileptic drug (AED). However, one-third of the time, AEDs fail. Either the patient experiences severe side effects from the medication, or they have a treatment-resistant form of epilepsy. With the legalization of medical marijuana in many states, the medical community is discovering its plethora of applications — including anti-epileptic properties.

If it’s such a miracle treatment, why do people avoid medical marijuana? The main reason is that patients don’t want to get “high.” They’re afraid cannabis medications will cause a psychoactive reaction. This is especially true of parents looking for epilepsy treatments for their children.

As the industry grows, producers of medical marijuana can isolate different compounds of the plant. One compound that has been found to be a profound anti-epileptic is cannabidiol (CBD). Not only do CBD treatments help patients manage their epilepsy, but it also has low amounts of THC, which is the psychoactive compound found in marijuana. This means patients using CBD oils won’t get stoned, but will still receive the medicinal benefits of the plant.

How Does CBD Oil Work?

Cannabidiol is one of the many compounds found in cannabis, known as cannabinoids. The reason our body reacts so strongly to marijuana use is because we have cannabinoid receptors throughout our body. These are all part of our endocannabinoid system.

The endocannabinoid system acts as a bridge between our mind and our body. Cannabinoid receptors are found throughout all the other systems of the body — immune, digestive and even neurological. Because the cannabinoids found in marijuana mimic those found in our own body, cannabis can treat the endocannabinoid system when diseases cause it to be out of whack.

When a person is experiencing a seizure, brain cells become overly excited and fire abnormally. CBD soothes the body, allowing electrical impulses in the brain to work properly.

Because marijuana is federally banned, there’s still limited research in this field. So, no one really knows how or why cannabis treats epilepsy. Multiple studies show those with the disease have reported a decrease in the severity and frequency of their seizures when using cannabinoid treatments.

Even if your epilepsy has been found resistant to other forms of treatment, CBD could still work. In some cases, patients exhausted every other kind of treatment and turned to CBD as a last resort — they were stunned when their seizures decreased in frequency, and in some cases, went away entirely.

Tips for Using CBD Oils

There are many ways to use CBD oils for epilepsy. The most common forms are:

  • Tinctures: Drops placed under the tongue
  • Concentrates: Can also be placed under the tongue or along the cheek
  • Capsules: Swallowed with water
  • Sprays: Spray two to three sprays in mouth
  • Vape Oil: Can be smoked in a vape pen, e-cigarette or vaporizer
  • Edible: Oil can be baked into food of choice

When starting out, be sure to take it slow. Test the different types of ingestion methods and see which works best for you. Also, start with a small dosage and work up from there. Be sure to note all reactions to ensure that you don’t have any adverse side effects.

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The top CBD oils for epilepsy are:

  • Charlotte’s Web: This strain is what sparked the debate for using medical marijuana as a treatment for epilepsy. It’s cross bred between a hemp plant and marijuana with very low THC. The product only has a 0.3 percent presence of THC.
  • Ringo’s Gift: This strain is crossbred between two popular CBD dominant strains. The ratio of CBD to THC is 24:1, allowing patients little to no psychoactive side effects.
  • ACDC: Because of its relatively small CBD to THC ratio, 20:1, this strain is perfect for daily medicating.

If you’d like more information on which strains could help treat your child’s epilepsy, talk with a qualified marijuana doctor.

Additional Epilepsy & Cannabis Resources

For more information about how cannabis can be used to treat Epilepsy, check out our resources:

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.

Indications

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.  

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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.

Dosing

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.

Side Effects

The side effects of CBD that have been reported in the studies when it was added to other antiseizure medications included:

  • Fever
  • Upper respiratory tract infection/rhinitis
  • Drowsiness
  • Generalized fatigue
  • Sleeping difficulties
  • Weakness
  • Decreased appetite
  • Rashes
  • Diarrhea
  • Vomiting (prolonged seizure requiring emergency attention)
  • Fatigue
  • Lethargy

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

Myth Buster

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.

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Interactions

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.  

Warning

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.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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.

By Heidi Moawad, MD
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.

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