Around 3.4 million people in the United States have epilepsy, with 3 million being adults and around 470,000 being children (CDC). Though this is only roughly 1% of the country’s population, epilepsy and seizures can be anxiety-inducing, can negatively affect quality of life, and can lead to serious injury or death. Epilepsy is a neurological disorder in which there is an abnormality and excessive neural electrical activation in the brain—which causes seizures, and there are two main forms of seizures: focal or generalized (NIH). Focal seizures start at one area in the brain and can either travel to other regions or not, and generalized seizures occur in both sides of the brain (NIH). Epilepsy however can come in several different forms, some affecting specific areas in the brain, others affecting at different points in lifetimes (such as during childhood). New and innovative treatments are constantly underway to determine the best treatment for epilepsy and seizure-related disorders to ensure that a person can live a normal life. One surprising treatment is currently being discussed, with research highlighting its potential effectiveness in reducing seizures: cannabidiol (CBD).

CBD is a chemical that is found in marijuana alongside tetrahydrocannabinol (THC). THC is the main psychoactive component in marijuana and what is associated with the “high” feeling you get after using cannabis products. CBD, however, is different from THC due to it being a non-intoxicating substance, meaning you will not get that “high” feeling through CBD usage alone. There is evidence to suggest that both CBD and THC contain anticonvulsant properties and can be used to treat epilepsy and related disorders; however, it may be better to use CBD instead (Perucca, 2017).

THC does have anti-seizure effects by it acting on CB1 and CB2 receptors in the brain (Chesher et al., 1974; Blair et al., 2016), however in preclinical animal studies, THC has been shown to have both anti and proconvulsant effects depending on the dosage. In one study, mice given an orally administered low dose of 50 mg/kg THC had proconvulsant effects, meaning they were experiencing seizures, while a dosage of 160-200 mg/kg of THC had anticonvulsant effects and mice did not display any seizures (Boggan, Steele, and Fredman, 1973). Furthermore, because epilepsy can be a lifelong disorder, it can be difficult to use THC continuously with its psychoactive and motor side effects. In addition, more research is still needed to see THC’s effects on pediatric epilepsy and overall long term usage in regards to tolerance, withdrawal, and side effects. This is where CBD comes in.

One of the earliest pre-clinical studies that revealed CBD’s anticonvulsant effects was conducted by Izquierdo, Orsingher, and Berardi in 1973. In the study, 66 mice were injected with 1.5-12 mg/kg of CBD one hour before induction of seizures in the hippocampus, and results showed a significant decrease in seizures in the mice who were given CBD. In Boggan et al.’s study that was previously mentioned, the proconvulsant effects of low-dose THC were reversed by co-administration of CBD at 50 mg/kg (Boggan et al., 1973). Another animal study showed that CBD administration in mice (5–400 mg/kg) was effective in reducing convulsions in 6 of 8 different mouse seizure models (Consroe et al., 1982). The mechanism of action of CBD and its antiseizure effects are not yet fully understood, but it seems that CBD has a wide range of effects and mechanisms in the endocannabinoid system and calcium signaling through several different models of seizures in animal studies (Rosenberg et al., 2017; Lazarini-Lopes et al., 2020).

Though there is a lack of clinical trials on CBD’s effects on seizures in humans, there is anecdotal evidence of CBD being effective in childhood epilepsies. Parents in Facebook groups have documented their experience with using CBD-rich cannabis to their children who have treatment-resistant epilepsy. In a survey, 84% of parents in the Facebook groups reported their child having a reduction in seizure frequency after taking CBD-rich cannabis, with two parents reporting a complete stopping of seizures (Porter and Jacobson, 2014). Furthermore, parents also reported their children having an increased sense of alertness, better mood, and improved sleep, with side effects being drowsiness and fatigue. Because epilepsy is usually a lifelong condition, CBD specifically can be used as a potential treatment due to its non-intoxicating effects, and there is a collection of animal models and anecdotal evidence suggesting its efficiency in reducing seizures. Of course, that is not to say that CBD will magically cure epilepsy and should be recommended over traditional anti-seizure medications—that, you will have to take up with licensed medical professionals. However more research is urgently needed, especially in human clinical trials, in order to identify CBD’s mechanism of action in the body, safety in pediatrics, and its long term effects; overall there needs to be more controlled studies being done to assess this gap in knowledge—which hopefully will be revealed in the upcoming years. CBD though can be a potential alternative to treating epilepsy and seizure-related disorders, and I am hopeful that research is currently underway to reveal more information.

Resources:

Blair, R. E., Deshpande, L. S., & Delorenzo, R. J. (2015). Cannabinoids: Is there a potential treatment role in epilepsy? Expert Opinion on Pharmacotherapy, 16(13), 1911-1914. https://doi.org/10.1517/14656566.2015.1074181

Boggan, W. O., Steele, R. A., & Freedman, D. X. (1973). δ-tetrahydrocannabinol effect on audiogenic seizure susceptibility. Psychopharmacologia, 29(2), 101-106. https://doi.org/10.1007/BF00422641

CDC. (2023). Epilepsy data and statistics. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/epilepsy/data/index.html 

Chesher, G. B., Jackson, D. M., & Malor, R. M. (1975). Interaction of delta9-tetrahydrocannabinol and cannabidiol with phenobarbitone in protecting mice from electrically induced convulsions. Journal of Pharmacy and Pharmacology, 27(8), 608.

Consroe, P., Benedito, M. A. C., Leite, J. R., Carlini, E. A., & Mechoulam, R. (1982). Effects of cannabidiol on behavioral seizures caused by convulsant drugs or current in mice. European Journal of Pharmacology, 83(3), 293-298. https://doi.org/10.1016/0014-2999(82)90264-3

Izquierdo, I., Orsingher, O. A., & Berardi, A. C. (1973). Effect of cannabidiol and of other cannabis sativa compounds on hippocampal seizure discharges. Psychopharmacologia, 28(1), 95-102. https://doi.org/10.1007/BF00413961

Lazarini-Lopes, W., Do Val-da Silva, Raquel A., da Silva-Júnior, R. M. P., Leite, J. P., & Garcia-Cairasco, N. (2020). The anticonvulsant effects of cannabidiol in experimental models of epileptic seizures: From behavior and mechanisms to clinical insights. Neuroscience and Biobehavioral Reviews, 111, 166-182. https://doi.org/10.1016/j.neubiorev.2020.01.014

NIH. (2022). Curing the epilepsies: The promise of research. National Institute of Neurological Disorders and Stroke. Retrieved from https://www.ninds.nih.gov/current-research/focus-disorders/focus-epilepsy-research/curing-epilepsies-promise-research 

Perucca, E. (2017). Cannabinoids in the treatment of epilepsy: Hard evidence at last? Journal of Epilepsy Research, 7(2), 61-76. https://doi.org/10.14581/jer.17012

Porter, B. E., & Jacobson, C. (2013). Report of a parent survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant epilepsy. Epilepsy & Behavior, 29(3), 574-577. https://doi.org/10.1016/j.yebeh.2013.08.037

Rosenberg, E. C., Patra, P. H., & Whalley, B. J. (2017). Therapeutic effects of cannabinoids in animal models of seizures, epilepsy, epileptogenesis, and epilepsy-related neuroprotection. Epilepsy & Behavior, 70(Pt B), 319-327. https://doi.org/10.1016/j.yebeh.2016.11.006