Dosage Related Efficacy and Tolerability of Cannabidiol in Children With Treatment-Resistant Epileptic Encephalopathy: Preliminary Results of the CARE-E Study
Copyright © 2019 Huntsman, Tang-Wai, Alcorn, Vuong, Acton, Corley, Laprairie, Lyon, Meier, Mousseau, Newmeyer, Prosser-Loose, Seifert, Tellez-Zenteno, Huh, Leung and Major.
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The datasets generated for this study are available on request to the corresponding author.
Purpose: There is uncertainty regarding the appropriate dose of Cannabidiol (CBD) for childhood epilepsy. We present the preliminary data of seven participants from the Cannabidiol in Children with Refractory Epileptic Encephalopathy (CARE-E) study.
Methods: The study is an open-label, prospective, dose-escalation trial. Participants received escalating doses of a Cannabis Herbal Extract (CHE) preparation of 1:20 Δ 9 -tetrahydrocannabinol (THC): CBD up to 10–12 mg CBD/kg/day. Seizure frequency was monitored in daily logs, participants underwent regular electroencephalograms, and parents filled out modified Quality of Life in Childhood Epilepsy (QOLCE) and Side Effect rating scale questionnaires. Steady-state trough levels (Css, Min) of selected cannabinoids were quantified.
Results: All seven participants tolerated the CHE up to 10–12 mg CBD/kg/day and had improvements in seizure frequency and QOLCE scores. CSS, Min plasma levels for CBD, THC, and cannabichromene (CBC) showed dose-independent pharmacokinetics in all but one participant. CSS, Min CBD levels associated with a >50% reduction in seizures and seizure freedom were lower than those reported previously with purified CBD. In most patients, CSS, Min levels of THC remained lower than what would be expected to cause intoxication.
Conclusion: The preliminary data suggest an initial CBD target dose of 5–6 mg/kg/day when a 1:20 THC:CBD CHE is used. Possible non-linear pharmacokinetics of CBD and CBC needs investigation. The reduction in seizure frequency seen suggests improved seizure control when a whole plant CHE is used. Plasma THC levels suggest a low risk of THC intoxication when a 1:20 THC:CBD CHE is used in doses up to 12 mg/kg CBD/kg/day.
Keywords: cannabidiol, Δ 9 -tetrahydrocannabinol, cannabis, epileptic encephalopathy, cannabinoid plasma levels
Recent trials with pharmaceutical grade cannabidiol (CBD) or CBD-enriched Cannabis Herbal Extract (CHE) support CBD’s ability to reduce seizure frequency in children with intractable epilepsy, including those with epileptic encephalopathy (1–5). Yet, there are significant knowledge gaps regarding the use of CBD and other cannabinoids in children, including the pharmacokinetics (PK), pharmacogenetics, and dose-concentration-effect relationships for these compounds (6). The resultant inability to provide evidence-based dosing and therapeutic monitoring of Cannabis-based products in children, combined with concerns regarding potential intoxicant effects of Δ 9 -tetrahydrocannabinol (THC), leads to a reluctance by many physicians to authorize CHE to these patients.
The age-related developmental changes that influence drug PK and pharmacodynamics (PD) complicate the development of appropriate dosing regimens for pediatric age groups (6). Without an understanding of dose concentration-effect relationship, a dosing regimen is largely empirical and/or anecdotal, and fraught with potential safety concerns.
CARE-E is a multi-center, phase 1, open-label, dosage escalation study using a Health Canada approved and Good Manufacturing Practices certified 1:20 THC:CBD CHE as adjunct therapy to treat children with epileptic encephalopathy. The primary objectives were to assess the safety and efficacy of CBD-enriched CHE, whereas secondary objectives included an analysis of trough steady state (CSS, Min) levels of CBD, THC, and cannabichromene (CBC); as well as an assessment of the correlation between cannabinoid levels and therapeutic effect. CBC levels were measured as the CHE used in this study contained 4% CBC by volume. We present results for seven CARE-E participants recruited at the University of Saskatchewan site.
The study is a phase 1, open-label, dosage-escalation clinical trial in which participants receive a 1:20 THC:CBD CHE in twice daily dosing. Upon enrollment (Visit 1) participants continue their current anticonvulsant regimen and baseline seizure frequency is determined for 1 month. At Visit 2 CHE dosing is initiated with a CBD dose of 2–3 mg/kg/day. At Visits 3–5 the CHE is increased at 1-month intervals with CBD doses of 5–6 mg/kg/day at Visit 3, 8–9 mg/kg/day at Visit 4, and 10–12 mg/kg/day at Visit 5. At Visit 6 the CHE is weaned over a 1-month period after which the participants have their end of study visit (Visit 7). Care-givers monitor and record seizure frequencies in daily seizure logs. The complete study design and methodology have been described previously (7).
Prior to enrollment, written and informed consent was obtained from the child’s parents or legal guardian. This study received a No Objection Letter (NOL) from Health Canada, was approved by the University of Saskatchewan Biomedical Research Ethics Board and registered with ClinicalTrials.gov ( > NCT03024827).
Inclusion criteria included pediatric patients between the ages of 1 to 10 years with epileptic encephalopathy resistant to standard medical treatment (as per International League Against Epilepsy definition of drug resistant epilepsy) and at minimum one major seizure per week or four major seizures per month (8). Seven participants from Saskatoon who met the inclusion criteria completed the study. All study data were collected and managed using the REDCap electronic data capture tool hosted at the University of Saskatchewan (9).
Efficacy Outcome Measures
Seizures occurring in a cluster were counted as a single seizure due to challenges arising from caregivers individually recording each seizure within a cluster. The data from the seizure logs was entered into REDCap (9) at each visit and underwent an independent audit performed by the University of Saskatchewan Clinical Trial Support Unit. To allow for variations in the length between study visits, the average daily number of seizures between visits was calculated by dividing the number of seizures recorded between each visit by the number of days between visits.
At Visits 2–6, participants underwent a 2-h EEG for assessment of degree of background slowing and spike index. The first EEG was performed prior to starting the CHE and each subsequent EEG was performed prior to a scheduled CHE dosage increase. To ensure consistency in EEG interpretation, an EEG rating scale for background slowing (encephalopathy) proposed by Lüders was used (10). A spike index ranked on a five-point scale ranging from 0 (= No Spikes) to 4 (= Continuous Spiking, defined as spikes occupying more than 70% of the EEG) was also calculated for each EEG.
At Visits 2–7, parents completed a modified Quality of Life in Childhood Epilepsy (QOLCE-55) survey which, in addition to questions assessing the domains including cognition, physical independence, social engagement, well-being, behavior (11), contained 13 additional items about sleep, verbal and non-verbal communication, interpersonal interactions, and irritability. Each item was rated from 1 (= Very Often) to 5 (= Never) or marked “Not Applicable.” The scores for reverse items were inverted and then all scores were transformed using (Score-1) × 25. The mean score for each subscale was calculated ignoring those marked “Not Applicable.”
Safety Outcome Measures
During the study caregivers recorded a description all adverse events associated with CHE in a participant diary. From Visit 3 to Visit 7, caregivers rated adverse effects previously described with CBD. Sleepiness/Lethargy and Irritability were rated from 0 (= Not Present) to 4 (= Present All The Time). Nausea/Vomiting and Diarrhea were rated from 0 (= Not Present) to 5 (= More Than Once Per Day). At each visit, the information for the preceding month was self-reported and provided to the study nurse.
At Visits 2–6, blood samples were collected for complete cell count and differential cell count, sodium, potassium, chloride, calcium, magnesium, phosphate, creatinine, urea, aspartate transaminase, alanine transaminase, alkaline phosphatase, and gamma glutamyltransferase, total and direct bilirubin, lipase, albumin, cholesterol, and triglycerides. Elevations in liver enzymes or lipase were considered significant if they were more than three times the upper limit of the normal reference range.
Quantification of Cannabinoids in Plasma and Steady State Trough Levels (CSS, Min)
To measure plasma trough steady-state (CSS, Min) cannabinoid levels, blood was collected on Visits 2–5 into lithium heparin Barricor vacutainers and centrifuged for 10 min in a clinical centrifuge (1,500 rpm) (12). These plasma samples (200 μL) were prepared and analyzed for CBD, CBC, and THC levels according to a validated liquid chromatography-mass spectrometry (LC-MS/MS) method that while developed independently in our lab is similar to a previously reported validated plasma cannabinoid assay (7, 13). All samples were stored at −70°C prior to analysis. Analytical method validation indicated the assay was specific and linear from 0.49 to 125 ng ml −1 , for THC and CBD, and 0.98–125 ng ml −1 CBC with r 2 > 0.998. Matrix effects ranged from 40 to 50% depending upon analyte resulting in extraction efficiencies in a similar range but recoveries were >88%. Intra- and inter-day precision and accuracy of the method was within ± 15%. The samples were analyzed in three batches (October 2017, May 2018, and March 2019). While most samples were analyzed within 3 months of collection, some were analyzed up to 8 months after collection. Stability analysis indicates stability of cannabinoids stored frozen for 3 months but stability beyond this is unknown. Full details of the quantification method of cannabinoids in plasma samples are available as Supplementary Protocol provided with this manuscript.
Steady-State Trough Anticonvulsant Levels
During the study, the participants’ anticonvulsant medications were not adjusted. The exception was clobazam, which was decreased if it was felt that clobazam side effects were being exacerbated by the known interaction between CBD and clobazam (14). Prior to decreasing the dose of clobazam, trough clobazam, and norclobazam levels were measured.
Trough anticonvulsant levels were measured at Visits 2–6 to identify a possible drug interaction with CBD, a known competitive inhibitor of CYP2C and CYP3A isozymes (15). CSS, Min levels were obtained for valproic acid, lamotrigine, levetiracetam, topiramate, and clonazepam. CSS, Min levels for stiripentol were not obtained as this assay was not available to us through the Saskatchewan Provincial Health Laboratory or its partnering laboratories.
Due to the small sample size reported a formal statistical analysis was not performed. Data are presented from individual participants and as the mean ± standard error of the mean (s.e.m.) ( Figures 1 , ,3) 3 ) and in a descriptive manner to illustrate trends emerging from the data ( Figure 2 ). A formal analysis will be done when all patients are included in the trial.
(A) Percentage reduction in daily average seizure frequency as compared to baseline. The value shown at each visit represents the decrease in seizure frequency from baseline during the preceding month. (B) Average percentage reduction in daily average seizure frequency from baseline for all seven participants at each study visit. (C) Average percentage reduction in daily seizure frequency from baseline for all seven participants broken down into seizure type. Data are shown as mean ± s.e.m.
Pooled QOLCE-55 scores and subscores for all seven participants. The values shown at each visit represent the QOLCE-55 total and subscores for the preceding month. Data are mean from seven participants.
Participant minimum steady state (CSS,Min) plasma concentrations and average plasma CSS,Min levels for each cannabinoid of cannabidiol (CBD) (A,B), cannabichromene (CBC) (C,D), and Δ 9 -tetrahydrocannabinol (THC) (E,F) analyzed with LC-MS/MS. Values shown represent steady state levels after 1 month on the corresponding dosage of CBD measured just prior to a dose administration. Data are mean ± s.e.m.
Demographic Characteristics and Compliance
At time of enrolment, all participants failed at least 2 appropriate anticonvulsants, and none were using the ketogenic diet or had a vagal nerve stimulator. All participants were fully compliant with all study protocols. Table 1 summarizes study participant characteristics. As per the publishing guidelines of this journal the participants’ gender is not included and age at recruitment is provided in ranges (1–3, 4–6, 7–10 years).
Participant characteristics at time of recruitment into CARE-E including age, epilepsy diagnosis, and concomitant anticonvulsant medications.
|Participant ID||Age (years)||Weight (kg)||Epilepsy diagnosis||Predominant seizure types||Number of seizures in baseline month||Concomitant anticonvulsant therapies and daily dosage (mg/kg/day)|
|A-01||4–6||17.2||Dravet syndrome (SCN1A mutation)||Tonic-clonic, tonic, myoclonic||11||Stiripentol (50 mg/kg/day)
Clobazam (1.3 mg/kg/day)
|A-02||4–6||14.6||Dravet syndrome (SCN1A mutation)||Dialeptic, myoclonic (in clusters), Tonic-Clonic||343||Clobazam (0.3 mg/kg/day)
Stiripentol (63 mg/kg/day)
Topiramate (20 mg/kg/day)
|A-03||4–6||23.7||Lennox Gastaut syndrome, continuous spike wave in sleep (evolved from cryptogenic infantile spasms)||Dialeptic, atonic, tonic||195||Valproic Acid (29 mg/kg/day)
Clobazam (1.2 mg/kg/day)
Lamotrigine (5.3 mg/kg/day)
Levetiracetam (59 mg/kg/day)
|A-04||1–3||11.4||Lennox Gastaut syndrome (Cerebral palsy-perinatal asphyxia)||Epileptic spasms, tonic, myoclonic||1,223||Lamotrigine (4 mg/kg/day)
Valproic Acid (53 mg/kg/day)
|A-05||1–3||14.3||Lennox Gastaut syndrome (cerebral palsy-perinatal asphyxia)||Atonic (in clusters), tonic, tonic-clonic||56||Lamotrigine (10.2 mg/kg/day)
Clonazepam (0.08 mg/kg/day)
|A-06||7–10||20.9||Dravet syndrome (SCN9A mutation)||Tonic clonic||10||Topiramate (9.6 mg/kg/day),
Clonazepam (0.17 mg/kg/day)
Valproic Acid (36 mg/kg/day)
|A-07||4–6||18.6||Dravet syndrome (SCN1A mutation)||Atonic, tonic clonic, versive partial||165||Valproic Acid (19 mg/kg/day)
Clobazam (1.1 mg/kg/day)
Stiripentol (29 mg/kg/day)
Underlying aetiology of epileptic encephalopathy listed in parentheses.
Safety and Tolerability Outcome Measures
While all participants reported Sleepiness/Lethargy and Irritability during the study, no scores increased by more than two points. Irritability improved in two participants following a decrease in clobazam dosage. Occasional incidences of nausea and vomiting, diarrhea, increased appetite, difficulty sleeping and spasticity were reported. Changes in the side-effect rating scales were not consistent and, apart from nausea and vomiting, did not correlate with increased doses of the CHE. None of the side effects were severe enough to prompt withdrawal from the study. The side effects rating scale scores are provided in Supplementary Tables 1A–D.
No significant changes in complete blood count and differential, electrolytes, renal panels, triglyceride, cholesterol, albumin, or bilirubin levels were observed. All participants had elevated ALP at Visit 1; however, these levels did not increase with the introduction and titration of CHE, with the exception of participant A-07, whose ALP increased to 300 U/L (reference: 30–110 U/L) at Visit 4, but decreased back to 144 U/L at Visit 5.
Participant A-01 had a slight elevation of GGT at 44 U/L (reference 10–35 U/L) seen at Visit 3 only. Participant A-03 had a marked elevation of GGT to 738 U/L (10–50 U/L) during an admission to Pediatric Intensive Care for sepsis. GGT decreased to 73 U/L the following month and returned to normal on post-study follow up despite continuing CHE.
Participant A-04 had slight elevations of AST at Visits 3 and 6 (48 U/L and 44 U/L, respectively -reference: 10–40 U/L). GGT was elevated prior to, and remained elevated throughout, the study, reaching a peak of 88 U/L at Visit 4. Participant A-04’s serum lipase at 173 U/L (normal: 22–51 U/L) was significantly elevated at Visit 5. As he was asymptomatic and an abdominal ultrasound was normal, he continued to receive CHE. By Visit 6, lipase levels decreased to 83 U/L and returned to normal following the study after valproic acid dosing was decreased and CHE was continued at 10–12 mg/kg/day.
No clinically significant adverse events directly attributed to the CHE were encountered. Two participants had serious adverse events requiring hospitalization, but these were not related to the study drug. During their hospitalizations, both remained on their routine anticonvulsants and CHE.
Efficacy Outcome Measures
The average reduction in daily seizure frequency between visits for each participant is displayed in Figure 1A . Over the study period, all seven participants had an improvement in seizure frequency with CHE. One participant (A-04) had a transient worsening of seizures at a CBD equivalent dose of 2–3 mg/kg/day. All participants had a reduction in average daily seizure frequency at a CBD equivalent dose of 5–6 mg/kg/day with six participants having a decrease >25% and four participants having a decrease >50%. After increasing to 10–12 mg/kg/day, the average reduction across all participants was 74% ( Figure 1B ) with all participants having a >25% reduction in daily seizure frequency, five participants having a decrease >50%, and three participants being seizure free. One participant was seizure free on an 8–9 mg/kg/day CBD equivalent dose.
During the final month of the study, when CHE was weaned off completely in the first three weeks, the reduction in seizure frequency was maintained in all participants and continued to improve in three participants (A-02, A-04, A-05) despite no changes to their anticonvulsant regimens.
While there was a reduction in daily seizure frequency between visits for all seizure types recorded, the greatest reduction was seen in atonic and versive seizures while epileptic spasms increased in frequency ( Figure 1C ). The percentage reduction in frequency of reported seizure types compared to baseline for all seven participants at each visit are also provided as Supplementary Figures 1A–G.
By the time the CBD dose was increased to 10–12 mg/kg/day, all participants -except for participant A-07, who had a normal background activity on the initial EEG– had an improvement in their EEG encephalopathy rating scale with most improving by one point on the rating scale. Participant A-03 had an improvement by two points. During the course of the study, three participants had an improvement in their EEG Spike Index scores. Participants A-03 and A-04 had resolution of their continuous spike activity in sleep. Full details of EEG results are provided in Supplementary Figures 2A,B.
An improvement in the total QOLCE-55 scores was observed in all participants with the greatest improvements were found on the Cognitive, Social and Emotional Functioning subscales ( Figure 2 ). While the improvements in the QOLCE scores decreased during the weaning period following Visit 6 the scores remained improved over the baseline scores.
Plasma Cannabinoid Plasma Levels in Relation to Dosage Escalation and Decrease in Seizure Frequency
Cannabinoid CSS, Min plasma concentrations were measured at the end of each subsequent month’s dosage escalation ( Figures 3A–F ). With each dosage escalation, CBD and CBC CSS, Min values generally increased proportionally with dose in all participants, except for participant A-04, whose last dose escalation resulted in non-proportional increases in both CBD and CBC CSS, Min values ( Figures 3A–C ).
Following a month of CBD at 5–6 mg/kg/day, the four participants with a >50% reduction in average daily seizure frequency, had CSS, Min CBD levels ranging from 14.8 to 24.4 ng/mL. After a month of CBD at 10–12 mg/kg/day, the five participants with a >50% reduction in average daily seizure frequency, had CSS, Min CBD level ranging from 42.5 to 124.7 ng/mL. The CSS, Min CBD levels corresponding with the CBD dosage at which the three participants became seizure free, ranged from 54.8 to 78.9 ng/mL ( Figure 3A ).
In all but two participants (A-04 and A-07), CSS, Min THC levels were detectable at 2–3 mg/kg/day. Even at the highest dose of CHE, the CSS, Min THC levels were low—below 4 ng/mL in all but two participants with the highest level being 4.34 ng/mL ( Figure 3E ).
Effect of CHE on Steady State Levels of Anticonvulsants
Apart from clobazam, CSS, Min anticonvulsant levels did not change significantly and remained within therapeutic limits with the following exceptions. Valproic acid levels for participant A-07 doubled between visits 2 and 6 but remained within therapeutic range (350–700 umol/L). For participant A-06, Valproic acid levels decreased to below therapeutic range at 16 umol/L between visits 4 and 5 suggesting medication non-compliance. CSS, Min clobazam and norclobazam levels of the four participants taking clobazam during the study are provided in Supplementary Table 2. For participants A-02 and A-03 these levels are not available for visit 6 due to the samples being misplaced in our hospital central laboratory. Three participants (A-01, A-02, and A-03) experienced side effects felt to be secondary to clobazam prompting a decrease in their clobazam dosage. In all three participants, these apparent side-effects of clobazam resolved with a decrease in clobazam dosing. Co-administration of clobazam did not appear to correlate with higher levels of CBD or CBC at each dosage escalation.
CARE-E is an open label dosage finding study designed to assess the safety and efficacy of a CBD-Enriched Cannabis Herbal Extract (CHE) in children with intractable epileptic encephalopathy. The study involved measurement of CSS, Min levels of CBD, THC, and CBC and their relationship with safety, tolerability, and efficacy outcome measures in hopes to identify appropriate doses of similar Cannabis products in children. This study is the first to report pediatric CSS, Min levels of CBD, THC, and CBC in any pediatric dosage escalation study and provide guidance on initial dosing of CBD-enriched CHEs.
Escalating doses of CBD-enriched CHE from 2–3 mg/kg/day to 10–12 mg/kg/day resulted in no serious adverse events related to the CHE. Parents reported sleepiness/lethargy and irritability in most participants, but these side effects were assessed after starting the study drug and were likely pre-existing. Transient increases in sleepiness and irritability in three participants taking clobazam resolved after clobazam dose was decreased, suggesting these side-effects could be secondary to an interaction between the CHE and clobazam (14). Laboratory monitoring noted significant elevations in GGT, AST, and lipase levels in two participants, both of whom were also taking valproic acid. Participant A-03’s marked elevation of GGT was likely secondary to sepsis, which occurred during the study. Participant A-04’s transient and non-significant elevation of AST and significant elevation of lipase levels were likely secondary to a predisposition to hepatic and pancreatic dysfunction from high-dose valproic acid and corroborates observations reported elsewhere (3, 16). The fact that this participant had a preexisting elevated GGT suggests that liver enzymes should be screened prior to starting CHE, especially if the child is already prescribed valproic acid.
The concentrations of CBD, THC, and CBC appeared to increase linearly with dosage in six of the seven participants, suggesting dose-independent pharmacokinetics for these participants within this dosage escalation trial. The greater than proportional increase in CSS, Min CBD with the final dosage increase in participant A-04 may suggest dose-dependent pharmacokinetics with saturation of first-pass metabolism and an increase in the oral bioavailability. Participant A-04 did not exhibit any change in clinical status or in anticonvulsant therapy to explain this disproportional increase in CSS, Min. To confirm the possible non-linear pharmacokinetics in children, a dosage escalation study involving a larger sample size and a higher dose beyond the doses used in the current trial will be necessary. The possibility of dose-dependent PK, though, raises a safety concern, which also warrants further investigation in pediatric patients and suggests a need to limit dose sizes and not to simply continue increasing doses until an appropriate effect is observed.
CBD and THC both inhibit enzymes involved in the metabolism of many anticonvulsants including CYP2C and CYP3A isoenzymes (17). While increases in Clobazam and norClobazam levels were seen in some participants taking clobazam, overall co-administration of CHE did not significantly affect Css, min levels of the other concomitant anticonvulsants. It would have been of interest to measure Css, min levels of stiripentol given that many children with Dravet syndrome would also be taking this medication and stiripentol is metabolized by CYP2C19 and CYP3A4 isoenzymes. At present it is unknown if there is a pharmacokinetic interaction between CBD and Stiripentol. Although an assay to measure stiripentol levels is described, it is not indicated for therapeutic purposes by the manufacturer or regulatory bodies such as Health Canada, FDA or the EU. As such, it was not available for us for the purposes of this study (18).
The potential intoxicating effects of any THC present in CHE remain a concern for pediatric patients. Oral consumption of Cannabis products results in lower peak levels of THC as compared to smoking due to a high first-pass effect and slow erratic absorption from the gastrointestinal tract. However, intoxication can still occur because of greater distribution into the central nervous system and conversion to 11-hydroxy-THC, which is also intoxicating and has a half-life as long as, or longer, than THC (17, 19, 20). The CSS, Min levels of THC increased in a seemingly linear relationship to dosage, and with the exception of two participants at the highest dosage level, these remained lower than levels that have been reported to cause intoxication (19). Tachycardia and conjunctival injection—felt to be reliable markers of intoxication from THC—were not seen during the study. The lack of intoxication seen in our participants whose plasma THC levels exceeded 4 ng/mL may have been due to the reported CBD-mediated attenuation of the intoxicant effects of THC (21).
An overall trend for improvement in seizure control and QOLCE scores was observed with increasing CHE dosage and CSS, Min CBD levels. A >50% reduction in average daily seizure frequency occurred in four of seven participants at a CBD dose of 5–6 mg/kg/day, and all participants had a >25% reduction in seizures at a CBD dose of 10–12 mg/kg/day. In the QOLCE scores, there was a trend toward improvements in cognitive, social, and emotional function in relation to CBD dosage. These data suggest that the initial target dose of CBD should be 5–6 mg/kg/day when a 1:20 THC:CBD whole plant extract is used and can be increased as needed up to 10–12 mg/kg/day with careful consideration of potential non-linear pharmacokinetics at higher doses.
Trembly and Sherman reported that adult patients taking purified CBD had no improvement in seizure control when their plasma CBD levels ranged from 20 to 30 ng/mL, while a significant decrease in seizure control occurred when plasma CBD levels increased above 150 ng/mL (22). While it is challenging to correlate CSS, Min levels of CBD and CBC with efficacy in reducing seizure frequency based on our data, we do note that the CSS, Min CBD levels associated with a >50% reduction in average daily seizure frequency and seizure freedom in this study were lower. Further analysis with larger sample sizes are needed to delineate which CSS, Min level of CBD is associated with optimal seizure control and improved QOLCE scores.
Two recent systematic reviews of clinical trials assessing pharmaceutical grade CBD in children with treatment epilepsy provide insight into the expected outcomes at the CBD doses used in these trials. In pooled data of 17 observational studies, Stockings et al. found that CBD at 20 mg/kg/day resulted in 48.5% of patients having a 50% reduction in seizures and QoLCE scores improved in 55.8% (23). Lattanzi et al. also performed a systematic review of the four clinical trials assessing pharmaceutical grade CBD in children with treatment resistant Lennox Gastaut and Dravet Syndromes. They reported that the pooled average difference in seizure frequency between CBD and placebo with CBD at 10 mg/kg/day was 19.5% while that with CBD at 20 mg/kg/day was 19.9% both in favor of CBD. A seizure frequency reduction of 50% (for all seizure types) was 37.2% with CBD at 20 mg/kg/day and 21.2% with placebo (24).
An “entourage” effect in which the clinical efficacy of cannabinoids when used in combination are greater than when used individually has been demonstrated in several animal models of epilepsy but has yet to be reported for human trials (25–27). While we saw clinical efficacy with regards to reduction in seizure frequency and improvements in QoL scores with CBD doses lower than those reported in studies using pharmaceutical grade CBD, the small number of participants reported require caution when interpreting the results and preclude drawing definite conclusions in particular with regards to possible entourage effect. Additionally, CARE-E was not designed to compare efficacy of CHE to pharmaceutical grade CBD. This can only be addressed in a head to head comparative study.
The preliminary findings presented in this manuscript are however, in keeping with the results of a metanalysis of clinical studies comparing whole plant Cannabis CHE to pharmaceutical grade CBD in children with refractory epilepsy. This metanalysis found that while there was no significant difference between the CHE and pharmaceutical grade CBD in attaining 50% reduction in seizures, 71% of children taking CHE had improvement in seizure frequency compared to 46% taking purified CBD (p < 0.0001). The average CBD dose for children taking CHE was 6 mg/kg/day (28).
The three participants who became seizure free were taking long acting benzodiazepines (clobazam or clonazepam) but clobazam and clonazepam levels did not increase for two of these participants. This suggests that, while CBD and long acting benzodiazepines likely have a synergistic effect, this is not necessarily due to an increase in plasma benzodiazepine levels.
The reported half-life of CBD ranges from 9 to 32 h; however, the influence of age and concomitant anticonvulsants on the half-life remain largely unknown (29). These influences on half-life, however, would not explain the month-long continued improvements in seizure control and QOLCE scores observed in our three participants during the wean-off CHE. Such sustained effects often involve epigenetic changes and therefore it is possible that any long-term beneficial effect of CBD may reflect, in part, an as-of-yet unrecognized epigenetic effect (30). In order to assess if any long-lasting effect might be mediated through an active metabolite of CBD, we will measure participants’ plasma levels of CBD, CBC, THC, and their metabolites upon completion of the 1-month weaning period in subsequent participants who are enrolled in CARE-E.
While an improvement in background EEG activity was seen in four participants, there was no correlation between CBD dosing and improvements on the background score. A more complete examination of a potential relationship between the improvement in cognitive functioning seen in the QOLCE scores and improved background activity seen on EEG is warranted. The reduction in spike count following CBD treatment in three participants is reminiscent of the effect observed with broad-spectrum anticonvulsants such as benzodiazepines and valproic acid (31).
Although the reported improvement in seizure control and quality of life are promising, these findings must be interpreted with caution as there are several limitations in this preliminary report, in particular the small sample size and potential reporting bias inherent with open label studies. The lack of a placebo group and self-reporting of outcomes may limit the ability to discern any placebo effect which is seen in many drug trials. Reporting fatigue experienced by caregivers also may be a confounder, in particular for seizure frequency data.
The preliminary results of seven participants from the CARE-E study suggest CBD-enriched CHE up to 10–12 mg/kg/day is generally well tolerated. All participants had improvements in seizure frequency, modified Quality of Life in Childhood Epilepsy (QOLCE), and electroencephalogram (EEG) rating scores. Steady state CSS, Min data for CBD, THC, and CBC suggest linear PK, although one participant gave possible evidence of non-linear PK at higher doses. The preliminary data suggest an initial CBD target dose of 5–6 mg/kg/day when using a 1:20 THC:CBD CHE in children with treatment resistant epileptic encephalopathy. CSS, Min CBD levels suggest that dosing with a CHE containing THC and other cannabinoids may be more effective than purified CBD alone. Based on clinical observations and measurement of plasma THC levels, intoxication from THC is unlikely to occur when a 1:20 THC:CBD CHE is used within therapeutic doses. The anticonvulsant effect of CHE persisted after it was weaned off, suggesting an enduring anticonvulsant effect.
The datasets generated for this study are available on request to the corresponding author.
This study was carried out in accordance with the University of Saskatchewan Biomedical Research Ethics Review Board with written informed consent from the parents/legal guardians of all subjects. The parents/legal guardians of all subjects gave written informed consent in accordance with the Declaration of Helsinki. The protocol was approved by the University of Saskatchewan Biomedical Research Ethics Review Board.
RH, RT-W, JA, BA, SC, RL, AL, SM, DM, DN, EP-L, BS, and JT-Z contributed to the design of the study protocol. RH, LH, EL, and PM are site investigators for CARE-E. SC analyzed the data. RH, RT-W, JA, RL, and AL interpreted the data. SV assisted with the development and validation of the plasma cannabinoid assay used in this study. RH drafted the manuscript. All authors contributed to the revision of the manuscript and approved it for submission.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The authors would like to acknowledge the financial support to perform this study received from the Jim Pattison Children’s Hospital Foundation, the Durwood Seafoot Estate, the Saskatchewan Health Research Foundation and the Savoy Foundation. We also acknowledge the operational support provided by the Department of Pediatrics, University of Saskatchewan and the Saskatchewan Health Authority.
Funding. This study was funded through research grants from the Saskatchewan Health Research Foundation, the Jim Pattison Children’s Hospital Foundation, the Durwood Seafoot Estate, and the Savoy Foundation. As grant numbers were not provided with these awards, copies of the award letters from these granting agencies to our research team are available upon request. The granting agencies and CanniMed, from whom we purchased the study drug at cost, had no influence on study design, or the collection, interpretation, and/or reporting of data.
CBD Oil for Seizures & Epilepsy: How Cannabis Oil Can Stop Seizures
According to the Michigan Epilepsy Foundation, 1% of Americans suffer from some form of epilepsy — a recurring neurological disorder known for frequent, often unprovoked seizures.
Epilepsy compromises all aspects of a person’s daily life. The violent tremors caused by a seizure attack can put the individual in grave danger, not to mention that people with epilepsy are also prone to suffer from sleep issues, migraines, anxiety disorders, and depression.
Of all epilepsy forms, up to 40% is drug-resistant, meaning the patient doesn’t react to Antiepileptic Drugs (AEDs). For these patients, AEDs are simply ineffective, or the side-effects are too severe to allow for continuous treatment.
As a result, many turn to natural resources to help manage their condition. CBD oil is one promising option whose antiepileptic effects have been thoroughly studied by scientists.
In this article, I’ll cover the potential benefits of CBD oil for epilepsy and seizures — and share the top brands I trust when it comes to manufacturing high-quality CBD oil.
Best CBD Oil Brands for Epilepsy & Seizures
There are lots of different CBD companies trying to make their name in the market with their CBD oil. Some brands provide high-quality products and can back up their claims with third-party lab reports. In contrast, others tend to take advantage of unaware consumers with lots of fancy buzzwords and unrealistic promises.
If you want a clean and potent CBD oil, you need to find a manufacturer that makes organic products with proper quality assurance.
Don’t have time for that? Don’t worry — I did the research for you.
Here are my top 3 brands that make premium CBD oil for different types of consumers.
1. Royal CBD
Get 15% off all Royal CBD products. Use code “CFAH” at checkout.
- Royal CBD comes from organic hemp grown on American farms
- The company employs CO2 extraction so their extracts are clean and safe
- Their CBD oil comes in three different strengths: 250 mg, 500 mg, 1000 mg, and 2500 mg
- Up to 83.3 mg of CBD per mL
- Hemp extract is suspended in premium MCT oil
- Every batch of product has been tested by a third-party laboratory
- No vapes or vape oils available (yet)
- The price is on the higher end, although justified
My Thoughts on Royal CBD:
Royal CBD is a premium brand that uses only high-quality ingredients in their product lineup. The company’s product range includes every basic CBD format, from sublingual drops to gummies and capsules.
The oil and capsules are full-spectrum, meaning they also contain other cannabinoids and terpenes from hemp. Gummies, on the other hand, contain 99% pure isolate.
The Royal CBD oil comes in three different potencies: 250 mg, 500 mg, 1000 mg, and 2500 mg. The strongest option gives you 83 mg of CBD/mL. I would recommend this variant for stronger symptoms. Those who need noticeably higher doses of CBD may find the weaker bottles cost-prohibitive.
If you don’t want to measure out the oil each time you need CBD, you may switch to Royal capsules. Each softgel carries 25mg of full-spectrum cannabidiol in an easy-to-swallow form.
All Royal CBD products are sent to third-party laboratories for content analysis — checking the potency of CBD as well as purity levels.
2. Gold Bee (Best Organic)
- Unique product selection
- Non-GMO, Colorado grown hemp
- Full-spectrum CBD
- Extracted with CO2
- Up tp to 1200 mg of CBD per bottle (40 mg/mL)
- Sweetened with organic honey
- Third-party lab tested for potency and purity
- No high-strength oils
- Not available in-store
My Thoughts On Gold Bee:
Gold Bee specializes in all-organic CBD products, including full-spectrum CBD oil, high-potency CBD capsules, gummies, and delicious honey sticks. The company’s CBD oil is available in one potency option, packing 1200 mg of CBD per bottle.
This concentration translates into 40 mg of CBD in each milliliter. The oil has been suspended in premium-grade MCT oil and infused with natural terpenes to enhance the synergy between CBD and other compounds in hemp. There are two flavors available: natural and kiwi. The kiwi flavor is sweetened with organic honey, which only adds to the product’s value.
I’ve been taking the Gold Bee CBD oil for 30 days, using the dosage based on the recommended serving size. At first I was skeptical because I got used to higher doses in my routine — low doses could hardly calm my nervous system.
To my surprise, 1 mL a day split into two doses was enough to boost my resistance to stress and the outside stimuli. After two weeks, I slightly decreased the dosage and was still getting pretty good results. This was the first time a potency lower 1500 mg lasted more than 1 month for me.
- CBDPure products come from organic hemp grown in Colorado
- The company uses CO2 extraction
- All products are tested by 3rd-party laboratories for potency and purity
- Available in 60 mL bottles
- 100% Satisfaction Guaranteed program — you can send your order back within 90 days for a full refund
- CBDPure only sells CBD oil and capsules
- The oil is slightly less potent than Royal CBD
My Thoughts on CBDPure:
CBDPure was established in 2016 by a group of cannabis advocates from Colorado. The company has a simple mission, which is to make premium-quality CBD oils from organic hemp.
Although CBDPure has a very narrow product range — offering only CBD oil and capsules — they seem to have perfected these products. All extracts from CBDPure are obtained using supercritical CO2 and tested in a certified laboratory for quality assurance.
The oil isn’t as potent as the one offered by Royal CBD, but if you benefit from lower doses, their 60-mL bottles will get you supplied for months to come. Their oils are a good option for people who use CBD for general health care or to ease mild symptoms.
If you’re looking for something potent, try CBDPure capsules — each softgel is infused with 25 mg of full-spectrum CBD for easier dosing and extra convenience.
CBDPure has a Satisfaction Guarantee program, so in case you ended up unsatisfied with your purchase, you can get a full refund if you send the order back within 90 days.
- CBDistillery uses Colorado-grown hemp
- Their products are available as full-spectrum or isolate
- They have an impressive product selection
- Each batch is sent to a 3rd-party lab for content analysis
- Very affordable
- Their hemp isn’t organic
My Thoughts on CBDistillery:
CBDistillery is a company founded in Denver, Colorado. They’ve been offering high-quality CBD oil products for over 5 years now. One of the driving forces behind the brand is to manufacture CBD oil for every budget and promote research and education among consumers all over the country.
CBDistillery has many different forms of CBD, from sublingual tinctures to capsules, gummies, topicals, and vapes. Their CBD oil is available as ‘full-spectrum’ or isolate.
These oils come in two different sizes — 15 mL and 30 mL
The potency of the 15 mL bottle ranges between 150–1,000 mg of CBD. The 30 mL bottle offers from 2,500–5,000 of total CBD.
With such a wide potency range, CBDistillery oils may suit both novice and experienced consumers alike. The only downside to the company’s product range is that they’re not made with organic hemp.
However, this becomes understandable once you consider the price of CBDistillery products. The company may not sell the best CBD oil on the market, but they offer the best CBD products in this price range.
What is CBD Oil?
CBD oil is a cannabis extract with high concentrations of CBD. This product can be sourced from both marijuana and hemp, two members of the cannabis plant family.
It’s worth noting that marijuana-derived CBD oil contains higher levels of THC, the psychoactive cannabinoid responsible for getting users “high.”
CBD oil from hemp has only trace amounts of THC — typically below 0.3% — and thus can’t produce any psychoactive effects.
That’s because CBD is non-psychoactive per se.
CBD oil reportedly has a plethora of health benefits. However, the best-documented evidence thus far comes from epilepsy trials.
Does CBD Oil Work for Seizures?
The earliest studies proving the effectiveness of cannabis compounds in the treatment of convulsions came from animal research from the 1970s. The researchers analyzed the anticonvulsant properties of both THC and CBD oils, concluding that both extracts had substantial effects on mice.
Early experiments reported that the seizure activity might in part, be regulated by the endocannabinoid system — an interconnected network of cannabinoid receptors and neurotransmitters called endocannabinoids.
The Mechanism Behind the Antiepileptic Effects of CBD
The endocannabinoid system works to keep the body in a state of equilibrium, maintaining chemical balance and controlling biological functioning, from appetite to motor control, sensory perception, sleep, and inflammation.
It sends signals to various bodily systems through its chemical messengers called endocannabinoids to do this. These molecules bind to the cannabinoid receptors which occur in the brain and throughout the body. By doing so, endocannabinoids help the endocannabinoid system to maintain healthy functioning of an individual.
Once endocannabinoids have done their work, they get broken down by enzymes to prevent overaccumulation.
As a cannabinoid, CBD is almost identical in its chemical structure as endocannabinoids produced by your body. When you ingest CBD, it’s able to affect cannabinoid receptors on top of acting on several other pathways.
While scientists still don’t know exactly how CBD oil works for seizures, they’ve observed the following interactions which may explain the positive effects:
- Endocannabinoids are neuroprotectants, lowering the risk of seizures caused by neurotoxicity. When a person ingests CBD, they introduce more cannabinoids to their system—potentially improving the performance of the endocannabinoid system with their neuroprotective properties.
- The endocannabinoid system also modulates neuroexcitation, a process that may trigger seizures. A properly functioning endocannabinoid system, bolstered by additional cannabinoids from CBD oil, may prevent the overexcitation of neurons.
- CBD is also an anti-inflammatory agent. Seizures may be triggered, or their frequency may be increased by brain inflammation. By curbing neuroinflammation, CBD may reduce both the severity and frequency of seizure attacks.
Now, let’s elaborate on the scientific findings regarding the antiepileptic properties of CBD oil.
What the Research Says
The majority of specific case studies from the late 1990s, and the early 2000s focused on the effect of THC/CBD solutions on epilepsy. Due to the psychoactive nature of THC, the eyes of modern medicine turned to CBD.
In June 2018, the FDA approved the first CBD-based drug. The oral spray, called Epidiolex, contains 99% pure CBD. It’s used for treatment-resistant forms of childhood epilepsy — such as Lennox-Gastaut syndrome and Dravet syndrome.
Both diseases begin during early childhood and often lead to delayed or poor development of the child’s motor skills, language, intellectual aptitude, and the ability to communicate with others.
Before receiving the FDA’s approval, Epidiolex went through three randomized, double-blind, placebo-controlled clinical trials examining 516 patients with either syndrome. When administered along with other medications, Epidiolex successfully reduced the participant’s frequency of seizures compared to the placebo group. Besides, CBD improved other associated symptoms for the participants, such as sleep and anxiety.
Currently, Epidiolex can be officially used to treat these two types of epilepsy. However, recent research suggests that CBD may help relieve other forms of this disease as well.
For instance, a 2015 study analyzing the reports from Epidiolex patients from 11 epilepsy centers across the country showed that the frequency of seizures decreased by 36.5% after a 13-week treatment.
All subjects had severe, childhood-onset forms of epilepsy, including Lennox-Gastaut syndrome and Dravet Syndrome. The researchers started with a dose of 2–5 mg/kg per day and gradually increased it to 25–50 mg/kg per day.
Can You Develop a Tolerance to CBD Oil for Seizures?
People who have treatment-resistant epilepsy tend to experience a “honeymoon” period upon switching to a new therapy. In other words, they stop feeling the effects of their new treatment after a few months. In late 2018, scientists observed that the same pattern might apply to CBD treatment.
The study examined nearly 100 patients, of which about one-third developed a tolerance to CBD. The tolerance showed up about seven months after they began the therapy. From then on, they had to increase the dose to maintain the effects. When the dose was higher, nearly half of the examined sample experienced their previous response level.
The good news, though, is that for two-thirds of participants, the CBD proved effective in the long run.
How to Use CBD Oil for Epilepsy
CBD can take many forms. Epidiolex, the only approved CBD treatment for epilepsy, is an oral solution containing 99% pure CBD.
If you want to use CBD in a more natural form to see how it works for your symptoms, you may try the following formats:
- Sublingual drops: The most common form of CBD. The drops are administered via a dropper under the tongue, where they get absorbed through special membranes into the bloodstream. Sublingual drops provide the most consistent blood absorption rates according to studies.
- Capsules: CBD capsules are sold as pills and softgels. You just swallow them like any other pill. They offer a fixed dose of CBD in each serving, which makes dosing easier than sublingual drops, not to mention you can avoid any natural hemp taste.
- Vape oils: this form of CBD is inhaled through a vaporizer or vape pen. Many people prefer vape oils over other products because they find the act of inhalation relaxing, and they like the flavoring of vape oils. But most importantly, vape oils deliver more CBD to your system than any other consumption method.
CBD Oil Dosage for Epilepsy & Seizures
The dose-finding process will vary between patients. As with every new substance, a conservative approach and slow dosage increase will minimize the chance of severe side effects and leave room for adjusting the dose from the starting point.
For each individual, the optimal CBD dosage will depend on the following:
- CBD concentration
- Cannabinoid spectrum
- Route of administration
- Lifestyle choices
- Medications the patient is already taking
Dr. Karen Keough, Chief Medical Officer at Compassionate Cultivation, created general dosage guidelines for dosing CBD oil to both adults and children who have epilepsy.
Dosing Recommendations for Children
Depending on the severity of symptoms, children may go through low-dose initiation and high-dose initiation.
Low-Dose Initiation instructions:
- Start with 0.25 mg/lb/day
- The minimum dose is 10 mg
- Target dose ranges between 1–5 mg/lb/day. Higher doses are tolerated but at the cost of some mild side effects, such as dry mouth, dry eyes, low blood pressure, sedation, and dizziness.
- Average dose is 1–3 mg/lb/day
- Increase the dose every 1–2 weeks by 0.5 mg/lb/day, topping to the nearest 10 mg as long as there are no side effects.
High-Dose Initiation in Children:
- Start with 0.5mg/lbs/day
- Target dose ranges between 1–5 mg/lb/day
- Average dose is 1-3 mg/lb/day
- Increase the dose every 1–2 weeks by 0.5 mg/lb/day and monitor the effects
- If side-effects occur, leave more time between dose increases and go up more gradually
Dosing Recommendations for Adults
Considering the factors above, such as body weight and metabolism, adults with epilepsy need more CBD in their regime than children. Use the following guidelines to reach an effective dose:
Low CBD dose in adults:
- Start with 25 mg twice daily
- Go up by 25 mg per dose every 1–2 weeks
- Target dose ranges between 100–300 mg twice a day if no side effects are observed. Clinical trials have utilized doses as high as 1,500 mg of CBD daily, but such high doses might not be necessary to achieve seizure relief in most patients
High CBD dose in adults:
- Start with 50 mg twice daily
- Go up every 1–2 weeks by 50 mg/dose
- Target dose ranges between 200–500 mg twice a day if tolerated. You may stop sooner if seizures are gone to prevent further dosage increase and possible side effects.
Where to Find CBD Oil for Sale for Epilepsy & Seizures
CBD oil is available both in cannabis dispensaries and online retail stores. Dispensaries give you access to a wide range of cannabis products, including CBD oil from hemp. However, these places may not always carry the best products, and the bottles have probably spent some time on the shelves before being sold so that they may lose potency over time due to poor storage.
That’s why I buy my CBD oil online. The majority of CBD stuff is sold this way, so you have more options to choose from. Also, you can verify the reputation of your potential vendor with the help of online research. Read user reviews, check for third-party lab reports, and learn how your company sources its CBD to make sure you’re getting a clean and potent product.
The delivery time for CBD oil is usually 2–3 business days. But in my opinion, it’s worth it to wait a few days more to get a high-quality product for a good price — CBD oil ordered online is usually less expensive than what you see in a dispensary.
Using CBD Oil for Seizures: Will It Help?
Cannabinoids have many proven beneficial effects on health, particularly in the treatment and management of epileptic seizures. Epilepsy is currently the only FDA-approved condition for treatment with CBD — although this approval doesn’t apply to hemp-derived CBD oil.
Still, if you want to try CBD oil for better management of your symptoms, I hope this guide has helped you understand how to use it to get the most out of its benefits. Just remember to start low and slow with the dosage.
But above all, consult with your doctor before purchasing any CBD product — just to make sure it won’t negatively interfere with any medications you’re taking.
Do you know any examples of people who successfully reduced the frequency of their seizures with CBD oil? Share your stories in the comments below!
- Filloux, F. M. (2016). Cannabinoids for Pediatric Epilepsy? Up in Smoke or Real Science? Translational Pediatrics, 4(4), 271–282.
- Perucca, E. (2017). Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last? Journal of Epilepsy Research, 7(2), 61–76.
- Devinsky, O. et al. (2016). Cannabidiol in Patients With Treatment-Resistant Epilepsy: An Open-Label Interventional Trial. The Lancet: Neurology, 15(3), 270–278.
- Mannila, J., Jarvinen, T., Jarvinen, K., Jarho, P. (2007). Precipitation Complexation Method Produces Cannabidiol/Beta-Cyclodextrin Inclusion Complex Suitable for Sublingual Administration of Cannabidiol. Journal of Pharmaceutical Sciences, 96(2), 312–9.
- Millar, S.A., Stone, N.L., Yates, A.S. & O’Sullivan, S.E. (2018) A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans. Frontiers in Pharmacology, 9, 1365.
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
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13 Best CBD Oils for Seizures
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If you or someone you know has epilepsy, it’s likely that you have been looking for a natural way to control seizures. In this article, we will explore some of the best CBD oils available right now for treating epilepsy and seizure disorders.
CBD (cannabidiol) is one of many chemical compounds found in cannabis plants. It does not produce any psychoactive effects so it can be safely used by children, adults, and pets without fear of getting high or experiencing side effects.
These benefits aside, there are also numerous studies that show that CBD oil may help with anxiety and depression as well as chronic pain relief without the side effects associated with prescription medications like opioids.
As such, CBD oil is quickly becoming an ideal supplement for those who want to live a healthier and happier life.
What is CBD?
CBD, or cannabidiol, is one of the many active compounds found in cannabis plants. Although it is not psychoactive like THC (tetrahydrocannabinol), CBD has valuable health benefits that have recently attracted the attention of medical professionals around the world for treating conditions that were once deemed untreatable.
The reason why CBD is non-intoxicating is because it does not affect the same pathways as THC. This makes it a much better option for those who are looking to achieve therapeutic benefits without experiencing mind-altering effects that may interfere with their day-to-day tasks.
While research has not yet fully determined all of the health benefits of CBD, studies have shown that this compound is extremely safe, even at high dosages. Even so, most people who are looking for the benefits of CBD oil may not be aware of the best ways to use it for maximum therapeutic benefits.
Does CBD Oil Work for Seizures?
For those who are not aware, there are actually several types of seizures, all of which can be treated using CBD oil. The most well-known form is epilepsy, which occurs in the brain.
Based on some studies, we’ve learned that CBD does not act on the same pathways as THC, it is actually one of the most ideal options for treating seizures. CBD helps calm electrical and chemical activity in the brain to promote healthy neurological development, which helps prevent seizure attacks.
Of course, you should always talk to your doctor before adding CBD to your regimen. But whether you are looking for a safe alternative option or need relief from epilepsy, CBD oil has been found to be extremely effective as a treatment option with little to no side effects.
Are There Side Effects of CBD Oils?
CBD is no longer viewed as a dangerous and addictive drug like it once was many years ago. Today’s CBD products are non-intoxicating and comprised of natural ingredients that actually work with your endocannabinoid system instead of against it.
Even so, some people who are new to CBD oil may experience mild side effects like fatigue, dry mouth, and changes in appetite. If you notice any of these side effects when using CBD for seizures, it is best to only use the recommended dosage on your product’s packaging so you can adjust accordingly.
Today we’re sharing more about CBD oils for seizures to help you find maximum relief with a more natural product.