CBD is one of the main cannabinoids in marijuana whose medicinal properties are being increasingly recognized. For this reason, there are many different CBD products on the ever-expanding cannabis market that are used as medical cannabis. CBD oil is one of those products, and in recent years, its benefits have been studied and proven to be effective for treating various medical conditions.
Some of the more recent research on CBD oil has been about its effects on drug-resistant seizures related to different forms of epilepsy. The discoveries made through these studies have become an important stepping stone towards a new and effective option for treatment that can improve the patients’ quality of life.
That’s exactly what we’ll talk about in this article, including how the use of CBD oil can help with treating some types of seizures related to epilepsy.
What Exactly Is CBD Oil?
CBD (cannabinol) is a non-psychoactive compound in cannabis, meaning it doesn’t make you high like THC (tetrahydrocannabinol) does, which is one reason why it’s preferred by medical marijuana patients who want to avoid the psychoactive effects and focus on CBD’s medical use.
CBD oil is made by extracting CBD from the cannabis plant and diluting it with an edible oil, like coconut oil, olive oil, or others. The CBD is usually extracted from the industrial hemp variety of the Cannabis sativa plant, which naturally has a high CBD content and a very low THC content (about less than 0.3%), compared to the other cannabis varieties. This is different from cannabis oil which can also be extracted from recreational marijuana plants.
Depending on the manufacturer, there can be three types of CBD oil:
- CBD isolate, which contains the CBD cannabinoid extract alone;
- Full-spectrum CBD oil, which contains CBD, but also some other cannabinoids and terpenes, including THC, but it must be below 0.3%. The idea behind this formulation is to get the content of the oil as close as possible to the content of the cannabis plant so that the cannabinoids work together to enhance their benefits – a process known as “the entourage effect”;
- Broad-spectrum CBD oil is similar to the full spectrum variety, the difference being that in this variety the THC is completely removed.
CBD oil is often recommended as medical marijuana treatment for chronic pain relief, insomnia, muscle spasms, and even for treating anxiety and depression. CBD oil has also found its place as a very promising treatment option for seizures because of its anticonvulsant effects on the nervous system.
About Epilepsy-Related Seizures and CBD Oil
Seizures are sudden and uncontrollable electrical surges in the brain that activate certain receptors in the brain and cause a disturbance in its electrical activity. They can range in severity and they cause changes in behavior and movement, and can happen anytime. The most common cause of seizures is epilepsy, which is a neurological disorder.
There are two rare severe forms of epilepsy called Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) that are considered as pediatric forms of epilepsy. They both cause severe symptoms and are typically resistant to conventional treatment.
According to the Epilepsy Foundation, for 30% of people with epilepsy, traditional treatment is not enough to control the symptoms. This is the main reason why many of them are looking into potentially using CBD oil as an alternative or adjuvant therapy to control seizures.
Research on CBD has been somewhat slower in the past because of the legal status of marijuana. Even though the government regulations have changed in some states, cannabis products that contain more than 0.3% THC are still illegal in some states and countries worldwide.
However, the research is still ongoing, even though the mechanism of action is still not fully clear. A 2019 review of previous literature on the subject concluded that CBD could be very effective as adjuvant therapy, as well as an alternative therapy for children and teenagers resistant to common anti-epileptic drugs. (Silvestro et al, 2019)
Cannabis-Derived Medical Treatment
One successful implementation of CBD in the pharmaceutical world is the U.S. Food and Drug Administration (FDA)-approved CBD prescription medication called Epidiolex. It was developed by GW Pharmaceuticals, a British pharmaceutical company, and its United States subsidiary Greenwich Biosciences.
It was approved in 2018 and it’s the first official cannabis drug currently on the market. Epidiolex is a purified oil-based CBD oral solution that contains more than 98% of CBD, and it was specifically developed to treat Lennox-Gastaut and Dravet syndromes in adults and children over the age of 2. (Sekar & Pak, 2019)
There were placebo-controlled clinical trials that lasted for a few months during which the participants were given either Epidiolex or placebo medication. Those groups with Lennox-Gastaut and Dravet syndromes who were taking Epidiolex showed a significant decrease in the frequency of drop seizures. These patients also experienced some side effects, like liver enzymes, that were dose-dependent. Higher doses caused both more pronounced side effects and a greater reduction of seizure frequency.
However, these results are not a guarantee that patients will become seizure-free. Not everyone responds to this treatment, which is why there’s still ongoing research, and getting professional medical advice is necessary before trying this option.
How Can CBD Oil Help Seizures Related to Epilepsy?
As we previously mentioned, the exact mechanism of action is still somewhat unclear, however, the approval of Epidiolex, as well as its clinical trials, demonstrate that CBD oil has anticonvulsant properties, making it a very promising option for the treatment of seizures.
In states where cannabis is legal, CBD oil with less than 0.3% THC is widely available in dispensaries. Despite the research on Epidiolex, there has also been research on CBD extracts. A 2018 meta-analysis paper published in the journal Frontiers in Neurology has examined the difference in efficacy between CBD-rich extracts and purified CBD products.
They found that patients treated with CBD-rich extracts showed significantly more improvements in their symptoms than patients treated with purified CBD products. They believe that the entourage effect of CBD with the other cannabinoids may have caused these results. The treatment with CBD-rich extracts also caused fewer side effects than purified CBD products. (Pamplona et al, 2018)
CBD Oil Safety and Side Effects
CBD oil is usually very well tolerated, however, depending on the person’s individual tolerance or in reaction to some other medications. The most common side effects are:
- Feeling sleepy;
- Feeling fatigued;
- Digestive discomfort or diarrhea;
- Appetite and weight changes.
Even though CBD oil is a natural product, it can still interact with other medications that you’re taking, especially if they’re anticonvulsants. Always consult with a medical professional before taking CBD oil.
How to Use CBD Oil
It’s difficult to talk about one set dosage with CBD oil as it will depend on the manufacturer. That said, pay attention to the purity of the oil you buy and always make sure you get the highest quality CBD oil you can find.
The best recommendation we can give you regarding dosage is to start with smaller doses and then build it up over time. As with any new medicine, the body will need some time to get used to the compounds, therefore it’s safer to take it slow at first. The goal is to find the most effective minimal dose, so, once again, consult with a healthcare professional for drug interactions before you begin any treatment.
Silvestro S, Mammana S, Cavalli E, Bramanti P, Mazzon E. Use of Cannabidiol in the Treatment of Epilepsy: Efficacy and Security in Clinical Trials. Molecules. 2019;24(8):1459. Published 2019 Apr 12. doi:10.3390/molecules24081459
Sekar K. and Pack A. Epidiolex as adjunct therapy for treatment of refractory epilepsy: a comprehensive review with a focus on adverse effects [version 1; peer review: 3 approved]. F1000Research 2019, 8(F1000 Faculty Rev):234 https://doi.org/10.12688/f1000research.16515.1
Perucca E. Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last?. J Epilepsy Res. 2017;7(2):61-76. Published 2017 Dec 31. doi:10.14581/jer.17012
Pamplona FA, da Silva LR, Coan AC. Potential Clinical Benefits of CBD-Rich Cannabis Extracts Over Purified CBD in Treatment-Resistant Epilepsy: Observational Data Meta-analysis [published correction appears in Front Neurol. 2019 Jan 10;9:1050]. Front Neurol. 2018;9:759. Published 2018 Sep 12. doi:10.3389/fneur.2018.00759
Commissioner, Office of the. “FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy.” U.S. Food and Drug Administration, FDA, www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms.