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CBD for Epilepsy

Epilepsy is a chronic disorder characterized by recurrent, unprovoked seizures. Epilepsy is a spectrum condition that includes a wide variety of seizure types that vary from person to person. The condition affects people of all ages, races and socioeconomic statuses, and is the fourth most common neurological disorder. Although there is no cure for epilepsy, there are different ways to manage the symptoms.

Interest in cannabis-derived products to help individuals living with epilepsy manage their symptoms has skyrocketed in recent years. Several randomized, double-blind, placebo-controlled studies have demonstrated CBD’s therapeutic potential to manage symptoms of certain types of epilepsy — so much so that in June 2018, the FDA approved Epidiolex, the first plant-derived cannabinoid prescription medicine that is a purified 99% oil-based CBD extract from the cannabis sativa plant.

In addition to an overall reduction in seizures, CBD has been found to reduce adverse effects associated with other anti-seizure medication and demonstrated clinically significant improvements in depression, anxiety, sleep and overall quality of life.

How can CBD help alleviate seizures?

Endogenously produced cannabinoids, or cannabinoids produced naturally by the human body, appear to affect the initiation, propagation and spread of seizures. Studies have identified defects in the endocannabinoid system in some patients with refractory seizure disorders, including low levels of the endocannabinoid anandamide and reduced numbers of CB1 receptors. 

Because the endocannabinoid system is strongly activated by seizures, the upregulation of CB1 receptor activity appears to have an anti-seizure effect. Thus, using phytocannabinoids like CBD or THC to stimulate the body’s natural endocannabinoid system may reduce seizure activity. CBD, however, is of particular interest because it offers the anti-seizure benefits without the psychoactive effects of THC. 

What studies have explored the therapeutic potential of CBD on epilepsy?

The National Institutes of Health conducted the largest exploratory study to date to examine CBD’s anti-seizure effect. Patients aged 1-30 years with severe, childhood-onset, drug-resistant epilepsy received controlled doses of 99% pure CBD oil to examine the short and long term effects of its use on seizure frequency and severity. In a 12-week follow-up, patients reported a median 35% decrease in total seizures with the greatest seizure reduction in patients with focal and atonic seizures. Seven percent of patients were free of all seizures during the last four weeks of follow-up. In addition, CBD therapy was associated with improved scores for energy/fatigue, memory, control/helplessness, other cognitive functions, social interactions, behavior and overall quality of life.

Researchers at John Hopkins Medicine also conducted an observational study with participant-reported data to better understand how cannabis-derived products may affect individuals living with epilepsy. They found that CBD reduced the adverse effects of anti-seizure medications and improved quality of life for patients, who reported significantly lower depression, anxiety and insomnia. Even caregivers who used CBD reported significantly less burden and stress compared to the control group. 

What types of epilepsy may benefit from CBD?

Some experts believe CBD may be particularly beneficial for individuals living with Lennox-Gastaut syndrome and Dravet syndrome, two rare forms of severe childhood-onset, treatment-resistant epilepsy. Lennox-Gastaut syndrome is characterized by multiple types of seizures, learning problems, intellectual disabilities and delayed motor skills, and most individuals living with this syndrome need help with daily living. Dravet syndrome, on the other hand, is characterized by myoclonic seizures, poor language development and motor skills, hyperactivity and difficulty relating to others.

In order to help these individuals manage their day-to-day symptoms, the FDA approved Epidiolex for the treatment of seizures in patients two years of age and older with Lennox-Gastaut syndrome and Dravet syndrome. Epidiolex was studied in three randomized double-blind, placebo controlled trials involving over 500 patients with either Lennox-Gastaut syndrome or Dravet syndrome and was found to be effective in reducing the frequency of seizures when compared with the placebo.

Because conventional treatments for epilepsy do not work to control seizures in roughly one-third of patients, and because so many individuals have reported anecdotal benefits of CBD, it has become a popular option to manage symptoms. While individuals living with epilepsy may find relief when using CBD products, anyone considering using these products for the first time are highly encouraged to first consult with their doctor to determine the best possible treatment plan. There are many different methods of consumption, doses vary and drug interactions may play a role in individuals already taking medications to manage their epilepsy symptoms. CBD products are legally available in all 50 states, but be sure to choose products that undergo rigorous quality control testing to ensure the highest quality product.

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