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How to Use CBD for Epilepsy: Cannabidiol Research Revealed

There are many medicinal uses of CBD, but the one that has shown the most spectacular and well-publicized results is for the use of seizure control. It is dramatic and potentially life-threatening when someone, especially an infant or child, has an epileptic seizure. Following administration of the correct dose of medical-grade, plant-based cannabidiol medicine, for a wide variety of people, seizures are largely reduced, and in some people, it stops them altogether. The research shows variance in the rate of efficacy, but many who use CBD experience a huge reduction in intensity, frequency, and the duration of seizures.

CNN Documentary: CBD for Seizures

CNN broadcasted a documentary series called Weed that was produced by Dr Sanjay Gupta who started the series off by featuring a three-year old girl named Charlotte Figi, with a form of epilepsy called Dravet's syndrome. The film crew captured her having seizures before using CBD and after. The differences were like the difference between night and day. Before using CBD, her seizures couldn’t be controlled, and the drugs put her into a stupor. After receiving a dose of a whole-plant CBD extract, she transformed into an almost different person, playing, laughing, fully alive, and able to function as a normal toddler. A common and popular cannabidiol strain, “Charlotte’s Web”, was named after her, and thousands of parents of children with similar issues flocked to Colorado, where it was being grown legally. It saddens us to share of Charlotte's passing at 13 years of age in April 2020. CNN created a tribute story to her inspiring a CBD movement of parents across the world, which you can watch below.

Many children who have epilepsy or one of the many similar disorders have tried or are utilizing many different pharmaceutical drugs in combination to control their seizures. These drugs that are used, may cause dependency. Cognitive impairment and sedation are common side effects. Most of the time, they are taking a variety of types of drugs at the same time. In much of the cases, the person has “intractable epilepsy” (which is also referred to as uncontrolled or refractory epilepsy), which means all pharmaceutical drugs simply do not work.

The information contained in this article is for informational purposes only and is not considered medical advice. Our policy is that prior to making changes to your lifestyle or treatment plan, or exploring the use of cannabidiol or medical cannabis, always consult with your doctor. At the same time, educated and aware person’s, may become their own highly informed health consultants.

How to Use CBD for Epilepsy

CBD Dosage for Epilepsy

Dr Bonnie Goldstein, recommends 0.5 mg/lb/day of cannabidiol (CBD) as a starting dose for pediatric epilepsy, increasing by 0.5 mg/lb/day every two weeks, depending on response. It is preferable to divide this daily dose into three separate doses of 0.16 mg/lb, taken every seven to eight hours, preferably between meals. Monitor the results consistently and regularly. Many of her patients who respond positively end up taking between 2 and 8 mg/lb/day. Following this suggestion, a 50-pound child would take 25 mg of CBD per day to begin, or 8.3 mg three times daily. 

Always start with a micro dose to test for sensitivity and go up as needed using the titration method until symptoms subside.

For children, CBD-only oil infusions, glycerin tinctures, sublingual products, or pure CO2-extracted concentrates are recommended (no alcohol tinctures). The oil can be taken straight, mixed with food such as yoghurt or nut butters, made into capsules, or made into suppositories for infants.

If the seizures are not eliminated or reduced, blends that add a small micro amount of THC or THCA are sometimes effective. Health practitioners must err on the side of caution with all tetrahydrocannabinol (THC) or THCA use so as to minimize side effects or impairment.

Best Strains for Seizures

Adults can utilize any of the above, along with capsules, edibles, or alcohol-based tinctures. For immediate relief of symptoms, vaporizing or smoking work well. The medication effect is immediate and lasts one to three hours, whereas most ingested products take thirty to sixty minutes before taking effect (faster on an empty stomach) and last six to eight hours. Vaporizers that utilize a cartridge filled with a CO2 concentrate can be very advantageous, and these are also available in many ratios of CBD to THC. Herbal vaporizers that utilize the whole plant are also an effective delivery method. Tinctures or sublingual sprays taken as liquid drops also take effect quickly and last longer than inhaled products.

What are the best strains for epilepsy?

Changing strains or changing ratios of CBD to THC can occasionally be effective if someone isn’t responding or builds a tolerance to a certain strain. AC/DC and Valentine X have proven to be effective strains to control seizures (Saint Valentine is the patron saint of epilepsy, and this strain was named after him). Charlotte’s Web and Remedy are also effective strains.

The Cannabis Health Index (CHI) is a scoring system for cannabis (not just CBD) based on the best available in the medical literature. Using this rubric, seizure disorders scored in the likely probable range of efficacy (3 out of 5 stars) for treatment based on over thirty studies.

Cannabis: A Millenia of Use

Although cannabis has been utilized to treat epilepsy dating back to the Middle ages, according to Arabic medical texts, [1] the western world and its scientific research has only relatively recently started to grasp an understanding of the relationship between cannabinoids and seizure disorders. Human clinical trials are still relatively few in number. It has already been found that cannabinoids can be both proconvulsant and anticonvulsant, [2] that dosage is key, and that it is important to know the chemical makeup of the strain being used. Cannabidiol proves the most promising among the different cannabinoids studied for the control of seizures, but some types of seizures do seem to respond better to higher ratios of THC. The research indicates that the effects of CB1 receptor signaling on seizures is connected to the way in which specific cannabinoids interact with the receptor, as either agonist or antagonist. [3]

How does CBD help with epilepsy?

Can CBD oil make seizures worse?

In a 2020 study, it was discovered that patients self-medicating with over-the-counter CBD products purchased in the US had a 70% increase in seizures, whereas the group being administered prescription CBD saw a 39% reduction. [6] Commercially available CBD products can contain harmful contaminants, and incorrectly labeled ratios of cannabinoids, such as THC, which can be a trigger for seizures in some epileptic patients.

In a 2015 open-label study of 162 pediatric epilepsy patients (children) at hospitals across the United States, researchers provided CBD at a dosage of 4-10 mg/lb per day and up-titrated until intolerance or to a maximum dose of 50 mg/lb/day. This approach resulted in a reduction of seizures at a similar rate to that of existing drugs, a median of 36.5 percent, though, without the side effects of commonly prescribed medications. Alongside this, four percent of patients became completely free of motor seizures, which is just extraordinary.

How does CBD help with epilepsy?

In a 2016 study, 201 children with epilepsy were treated with high-CBD oil at doses recommended by Dr Bonni Goldstein, with 68% of them experiencing a greater than 50% improvement, and a whopping 15% of them became seizure free. Over 40 percent of those given the CBD, were able to reduce or totally eliminate pharmaceutical drugs, [4] which is a very big deal. The positive effects noted were improved mood, energy, and sleep; along with improvements in focus and appetite, as well as reduced ER visits and hospitalizations. The only negative side effects noticed in few patients was diarrhea and some drowsiness.

Another study from the same year included 74 children given CBD, which resulted in an 89% reduction in reported seizures. Just five were reported to have experienced an aggravation in seizures. [5] 

Prescription CBD for Epilepsy

GW Pharmaceuticals has conducted a variety of randomized, double-blind, placebo-controlled human clinical trials of its investigational medicine Epidiolex (which is essentially CBD administered as an oral solution, derived from the whole cannabis plant) for the treatment of seizures. The results were extremely positive, which is why it is now an approved anti-seizure medicine for treating various forms of epilepsy (approved for use in 2018).

Epidiolex is classified as a schedule 5 drug, on the lowest level (the opposite of cannabis, which is schedule 1 federally in the US; even though Epidiolex is derived from and contains cannabis compounds), and approved for the treatment of seizures associated with LGS or Dravet syndrome and lennox gastaut syndrome, and tuberous sclerosis complex (TSC)  in patients one year of age or older. It is the first and only cannabis derived product for the treatment of seizures with Food and Drug Administration (FDA) approval in the US. Sativex, GW Pharmaceuticals other new cannabis-derived product, is an approved treatment in over 30 countries for multiple sclerosis, chronic pain, and other debilitating conditions.

For more information, read our other article on epilepsy.

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1. https://pubmed.ncbi.nlm.nih.gov/11636889/
2. https://pubmed.ncbi.nlm.nih.gov/22386872/
3. https://www.amazon.com/Cannabis-Pharmacy-Practical-Medical-Marijuana-ebook/dp/B01MRGRUNE
4. https://www.medicinalgenomics.com/wp-content/uploads/2016/05/Bonni-Goldstein-CannMed2016.pdf
5. https://pubmed.ncbi.nlm.nih.gov/26800377/
6. https://n.neurology.org/content/94/15_Supplement/710.abstract

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