Updated on June 04, 2021
Cannabidiol (CBD) is one of over 66 different cannabinoids found in the cannabis plant.
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Everybody responds to CBD differently. Some people require high doses; others much lower. You won’t know for sure the ideal dose you need without experience.
Here are the definitions listed in their 2017 outline.
The new terminology outlined by the ILAE does not change the characterization of epileptic syndromes — of which there are quite a few.
A review on the Safety and side effects of cannabidiol by the NCBI for example suggests that controlled CBD (cannabidiol) administration is safe and non-toxic in humans and animals. It also does not induce changes in food intake; nor does it affect physiological parameters like heart rate, body temperature or blood pressure. Also, according to this review paper, “high doses up to 1,500 mg/day of CBD are reportedly well tolerated in humans.”
Evidence over the past four decades in the form of anecdotal reports, preclinical studies, observational and small clinical trials suggests that cannabidiol (CBD) can help control seizures. In fact, the anti-convulsant effects of CBD have been endorsed by the U.S. Food and Drug Administration (FDA) with the approval of Epidiolex (cannabidiol) in 2018
1. The FDA Guidelines Concerning The Use Of CBD Oil For Epilepsy and Seizures
Dosing With CBD Vapor
(Let’s get the legal stuff out of the way first)
It is important to recognize that everyone responds a little differently to CBD so there is no set dose for everyone or every condition. By following a stepwise dosing procedure you can find the most effective dosage of CBD for you.
If you feel you need a higher dosage as a starting point we have created the following chart to assist you. This chart is submitted as a suggestive guide only and is not meant to take the place of a qualified physician.
Start Low and Go Slow: The first step to finding your minimum effective dose is to establish a baseline dosage. Since many people report good results with CBD at low doses, we suggest you start with a minimal dose and slowly increase the dosage until you find results. Start with a small baseline dosage between 2-5mg, 2X or 3x daily (6-10mg total).
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.
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.
Participant characteristics at time of recruitment into CARE-E including age, epilepsy diagnosis, and concomitant anticonvulsant medications.
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.
(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.
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).
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.