CBD Oil Dosage For Seizures

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Low Dose of CBD Liquid Eases Epilepsy Seizures: Study

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WEDNESDAY, May 16, 2018 (HealthDay News) — Less appears to be more when it comes to treating epilepsy with the marijuana extract cannabidiol, a new clinical trial suggests.

Patients taking a 10-milligram (mg) daily dose of pharmaceutical grade cannabidiol (CBD) experienced nearly as great a reduction in seizures as patients on 20 mg, and with fewer side effects, said lead researcher Dr. Orrin Devinsky. He is director of NYU Langone’s Comprehensive Epilepsy Center in New York City.

This is the third clinical trial to show that the cannabidiol medication Epidiolex is useful in treating two rare forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, Devinsky said.

An advisory panel for the U.S. Food and Drug Administration unanimously recommended in April that Epidiolex be approved for use in the United States. The FDA does not have to follow the recommendations of its advisory panels, but it typically does.

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Epidiolex is manufactured by the British firm GW Pharmaceuticals, which funded the latest clinical trial.

“This is a historic moment in medicine,” Devinsky said. “Hopefully, the FDA will approve this medication in their June meeting and cannabidiol will be available for children and adults with these two rare epilepsies.”

Although CBD oil has become a trendy cure-all, treatment of epilepsy is the only use that has garnered significant scientific evidence supporting its usefulness.

This latest study is the first to compare two different doses of Epidiolex head-to-head and against an inactive placebo, Devinsky said.

A total of 225 patients suffering from Lennox-Gastaut syndrome were divided into three groups. Those taking 20 mg of Epidiolex a day had 42 percent fewer seizures, on average, compared with 37 percent fewer seizures in the group taking 10 mg of the drug, and a 17 percent reduction in the placebo group.

But while the 20-mg dose was slightly more effective, it was not the first choice of parents, Devinsky said.

“When parents were asked to rate how their children did best, they actually had a slight preference for the 10-mg dose without knowing what it was,” he added.

That’s because these kids did not experience as many side effects from the cannabidiol, which can include tiredness, decreased appetite, diarrhea and signs of possible liver damage, Devinsky explained.

“They got the vast majority of the benefits with fewer of the side effects,” he said.

The study also showed that Epidiolex is a safe treatment, with only seven patients dropping out of the trial due to side effects — six from the 20-mg group and one from the 10-mg group.

“Compared to other drugs used to treat epilepsy, I think Epidiolex, which is 99-percent pure cannabidiol, has a better side-effect profile than many of the available drugs,” Devinsky said.

According to Dr. Angel Hernandez, of the Helen DeVos Children’s Hospital in Grand Rapids, Mich., these results prove that pharmaceutical-grade CBD helps suppress seizures and “increases our options to treat many of these patients with very, very difficult-to-control epilepsies.” Hernandez is division chief of neuroscience at the hospital.

“We’re talking about types of epilepsy that are extremely difficult to treat with medication,” he said. “Most of these children and adults do not respond to normal pharmacological treatment.”

No one is exactly sure why CBD has this beneficial effect, both Devinsky and Hernandez said. It appears to work on receptors that alter brain chemistry in a way that reduces the chances of a seizure.

The doctors noted that these effects were seen in patients taking a highly refined form of CBD produced by a drug maker. It’s not known whether patients in states where medical marijuana is legal would see the same effects in CBD oil produced by small companies with no federal oversight.

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It’s also not clear whether CBD would help people with more common forms of epilepsy. Devinsky said small clinical trials have so far found no benefit in people with focal epilepsy, where seizures start on one side of the brain.

“I think we need more studies,” Devinsky said. “It’s not been investigated in generalized epilepsy, and I think we need a larger study in focal epilepsy.”

The findings were published online May 17 in the New England Journal of Medicine.

CBD for Seizures- Use, Effectiveness, Side Effects, and More

If you have seizures or are the parent of a child who has seizures, then you are probably constantly on the lookout for ways to control seizures with as few side effects as possible. CBD oil is one of the latest things to be touted as a miracle cure for seizures. While its effects are not the miracle cure some people suggest, it is a promising treatment that might be right for you.

What is CBD?

CBD is short for cannabidiol, which is a chemical found in marijuana. It is not the same as tetrahydrocannabinol (THC), the chemical in cannabis that is responsible for the “high” feeling people get from marijuana.

What does CBD do?

Well, people make many claims about what CBD can do. Not all of them have been tested and verified. However, there is support for claims that CBD may help reduce pain and anxiety.

Does CBD help seizures?

The short answer is yes. CBD can help prevent some types of seizures in some people and animals. Clinical trials have demonstrated a significant reduction in seizures for people taking CBD to treat Lennox-Gastaut, Dravet syndrome, or tuberous sclerosis complex. Research in other areas is still in early stages, but there are indications that CBD may help prevent other types of seizure or increase the efficacy of other antiepileptic medications. Early clinical trials suggest that CBD may dramatically reduce seizures in people with CDKL5 deficiency disorder, Aicardi syndrome, Doose syndrome, and Dup15q syndrome. In addition, CBD appeared to retain its efficacy over the length of the clinical trial.

How does CBD help prevent seizures?

That is a wonderful question, but, unfortunately, the research simply is not sufficient to give a definitive answer. What we do know is that bodies contain natural neurotransmitters and receptors known as the endocannabinoid system. CBD is believed to interact with that system, which is believed to influence a range of bodily functions and systems including immune response, appetite, pain, and sleep.

Is CBD approved by the FDA to treat seizures?

Yes, but not all CBD oils and not all types of seizures. Currently, Epidolex, a prescription form of CBD, is approved to treat seizures caused by Lennox-Gastaut, Dravet syndrome, and tuberous sclerosis complex.

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Does CBD interact with other seizure medications?

Yes. We know that CBD interacts with brivaracetam, clobazam, eslicarbazepine, stiripentol, rufinamide, topirimate, valproic acid, and zonisamide. It also possible that it interacts with other antiepileptics, and as research continues, we should have a better idea of other possible interactions.

How do I use CBD or CBD oil to treat seizures?

If you have a seizure disorder, you should be seeing a neurologist for treatment. It is very important to discuss whether you should use CBD oil with your neurologist. While it is generally safe to use, there is always a risk of potential drug interactions. In addition, some people actually experience an increase in seizures when they use CBD. Therefore, just like with any antiepileptic drugs, you want to have a professional monitoring your use of CBD.

What is an average clinical use of CBD to treat seizures?

The starting dose for CBD is 2.5 mg/kg of Epidolex, two times a day. A normal maintenance dosage is 5mg/kg twice daily, and the maximum dosage is 10mg/kg twice daily. As with other antiseizure medications, it should be introduced or stopped gradually, as sudden changes can increase seizure activity.

What are the potential side effects of CBD when used to treat seizures?

Whether used alone or with other seizure medications, there are some potential side effects of using CBD to treat seizures. It can lead to an increase in suicidal thoughts or behaviors, sleepiness, drowsiness, diarrhea, and loss of appetite. While most of these side effects are inconvenient, interactions can also cause liver damage.

Can CBD increase my seizures?

This is a tricky question to answer. Anecdotally, it seems clear that some percentage of people will have an increase in the number of seizures in response to using CBD. However, why is not so clear. Research seems to suggest that people who use commercial CBD products are likely to see an increase in seizures, while people using prescription CBD are likely to see a reduction in seizures. The speculation is that commercial products are not pure CBD, but are tainted with THC, which is known to be a potential seizure trigger.

Can I use over-the-counter CBD to treat epilepsy?

The problem with OTC CBD is that it is not regulated by the FDA. This makes it impossible to know what dose you would be getting, if the product is contaminated with impurities, or if it even is CBD. If you want to explore using CBD to treat seizures, talk with your doctor about adding Epidolex, an FDA regulated product that eliminates the specific risks posed by an OTC product, to your treatment plan.

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