When CBD was first legalized, it was often touted as the only solution many found to treat epilepsy and seizures. How far has research come since legalization, and how effective is cannabis in treating epilepsy?

With the Food and Drug Administration (FDA) approval of Epidiolex - the only federal prescription made from cannabis - there’s a lot of evidence to suggest you may be able to use cannabis for epilepsy. ¹

However, research isn’t concrete; more is necessary to understand the relationship properly. Certain cannabinoids - such as cannabidiol (CBD) - have been found to have more of an impact on epilepsy than others.

This article will take a deeper look at cannabis and epilepsy. We offer a proper understanding of how epilepsy works within the body and how cannabis directly influences those mechanisms.

What is Epilepsy?

As the fourth most common neurological disorder, many out there struggle with epilepsy - some of which don’t find results from traditional forms of treatment.

Simply put, epilepsy is caused by surges of electrical activity within the brain that cause seizures. A seizure is defined by a sudden surge of abnormal electrical activity in the brain that will affect how you act and appear. ²

Seizures can occur for several different reasons, including brain injury, high levels of sugar or salt in the blood, or a brain tumor. However, people diagnosed with epilepsy will experience seizures with no identifiable underlying cause.

For this reason, scientists and researchers have had a difficult time treating epilepsy - especially in those who struggle with rare forms of epilepsy.

We know that the disease disrupts the activity of brain cells (neurons) and makes it much more difficult for them to transmit messages through electrical impulses. Due to this interruption, people will experience a seizure.

Traditionally, anti-epileptic drugs (AEDs) can change chemicals within the brain to prevent seizures from occurring. While this will not cure epilepsy, most people (7 out of 10) will find relief from this treatment.

In more extreme cases, surgery may be performed to remove a part of the brain causing the seizures and replace it with a small electrical device. Again, this helps to control seizures but doesn’t cure epilepsy.

Being the extremity of surgery and the unwanted side effects brought upon by AEDs, many seek out remedies in all-natural supplements. With that in mind, the question arises, can you use cannabis for epilepsy?

Cannabis for Epilepsy: How Can it Help?

While research concerning cannabis and epilepsy (along with other neurological disorders) has been ongoing for several years, it remains a highly debated topic. ³

According to early evidence, cannabidiol (CBD) has the most potential to control seizures. One review found that all reported evidence shows CBD can be effective in infants, children, and teens who experience epilepsy resistance to AEDs. ⁴

Though, this review did note that we still don’t entirely understand how CBD works in the brain and how that impacts the frequency of seizures.

As mentioned, the FDA approved a cannabis-derived drug called Epidiolex, which incorporates CBD into its oral solution. This can be prescribed for two rare forms of epilepsy syndromes - Lennox-Gastaut syndrome and Dravet Syndrome.

Tetrahydrocannabinol (THC) has also found support in the treatment of epilepsy. However, most evidence suggests it works better in lower concentrations and alongside CBD. Some evidence suggests high concentrations of THC may have negative aftereffects on those who experience seizures (more on this later). ⁵

This is exactly what researchers are currently seeking - what are the perfect concentrations of cannabinoids to reduce the number of seizures caused by epilepsy effectively?

What Does the Research Say

Unfortunately, similar to traditional forms of treatment, it doesn’t seem as though cannabis compounds can act as a cure for epilepsy. Still, it holds a lot of potentials - especially in reducing seizures in those resistant to traditional forms of treatment.

Some notable studies include:

• A 2014 report observed cannabis’s effects on 60 children and adolescents with seizures. About one-third experienced a significant reduction in seizures. However, nearly 50% experienced more seizures and other side effects (such as fatigue). ⁶
  
  
• The same report observed 23 patients (ages 10 and below) receiving Epidiolex. It discovered that nine of these patients experienced a reduction of seizures by 50% - with one-third of Dravet Syndrome patients becoming seizure-free.
  
  
• A 2020 study revealed that while CBD was effective in Lennox-Gastaut syndrome and Dravet Syndrome, there isn’t much evidence to suggest it can be effective for other forms of epilepsy. ⁷

As you can see, research on the topic remains divided. Furthermore, most conclude that CBD is more effective in treating epilepsy than any other cannabinoid. It should be noted that less common cannabinoids - such as cannabigerol (CBG) and cannabinol (CBN) - have yet to be adequately observed.

Can Cannabis Be Harmful to Epilepsy Patients?

As with any substance available, cannabis can have negative effects on epilepsy. When it comes to medical cannabis, THC is the obvious outlier. Mainly since it causes psychoactivity (or a “high”), which has led to psychosis (another brain disorder) in some individuals. ⁸

Even more so, we mentioned a study earlier that revealed THC can have negative aftereffects on people with epilepsy. The researchers found compounds within those with epilepsy may cause disorientation and amnesia.

However, it should be noted that they were observing an endocannabinoid (a chemical compound naturally produced in our bodies) rather than a phytocannabinoid (a chemical compound found within the cannabis plant). It holds prevalence because this endocannabinoid is the brain’s equivalent to THC.

Even still, as research suggests, CBD is likely the best option for those experiencing epilepsy. And in terms of medical cannabis, high concentrations of CBD can counteract the effects of THC - meaning it’ll likely prevent the cannabinoid mentioned above from getting out of hand. ⁹

Still, CBD has the potential to cause mild side effects. The most common include: ¹⁰

• Diarrhea
• Drowsiness
• Dry mouth
• Fatigue
• Reduced appetite

Furthermore, you should always consult your doctor before using cannabis for epilepsy. Since evidence remains slim, other options are likely to improve your situation.

Pregnant women or breastfeeding and people currently on other prescription medications should avoid cannabis products altogether.

Final Word

As you can see, cannabis does hold the potential to help in the treatment of epilepsy. More specifically, CBD has been found to have the best results - with the FDA approving a drug for rare forms of epilepsy.

Still, research remains uncertain. Beyond the fact that we don’t 100% understand how epilepsy works within the body, we also don’t have this knowledge of cannabis. Therefore, the two’s interaction remains very much up in the air.

If you plan on taking cannabis for epilepsy, you must seek advice from a doctor beforehand. Everyone’s situation is different, and not everyone will likely benefit from cannabis.

Reference Sources

¹ Food and Drug Administration (FDA): FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy: https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms

² Centers for Disease Control and Prevention (CDC): Epilepsy (Index): https://www.cdc.gov/epilepsy/index.html

³ Epilepsia: Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders: https://pubmed.ncbi.nlm.nih.gov/24854329/

⁴ molecules (MDPI): Use of Cannabidiol in the Treatment of Epilepsy: Efficacy and Security in Clinical Trials: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6514832/

⁵ Stanford Medicine: Marijuana-like brain substance calms seizures but increases aftereffects, study finds: https://med.stanford.edu/news/all-news/2021/07/marijuana-like-brain-substance-calms-seizures-but-increases-afte.html

⁶ American Epilepsy Society (AES): Patient use of cannabis in epilepsy: https://www.sciencedaily.com/releases/2014/12/141208144146.htm

⁷ The Mental Health Clinician (MHC): Cannabidiol in epilepsy: The indications and beyond: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653733/

⁸ Indian Journal of Psychiatry: Cannabis and psychosis: Neurobiology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927252/

⁹ frontiers in Psychiatry: Does Cannabidiol Protect Against Adverse Psychological Effects of THC? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797438/

¹⁰ Current Neuropharmacology: Cannabidiol Adverse Effects and Toxicity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052834/