Here is everything we know about CBD oil and seizures.
People have been using cannabis (also known as marijuana) to treat epilepsy for centuries. In the United States it only became legal to take marijuana products for medical reasons relatively recently. And, in 2018, a CBD oil for seizures called Epidiolex was approved by the FDA to treat certain epilepsy syndromes (CBD is a chemical found in cannabis plants).
What is CBD?
While CBD oil may provide some relief from seizures, it should always be taken with caution and under guidance from a medical professional. This is because of:
In 2018, the Food and Drug Administration (FDA) approved the use of a new drug called Epidiolex for the treatment of two severe forms of epilepsy:
It is possible to purchase CBD oil for seizures in adults from health food stores in most, but not all, US states (although the rules vary, and you should always check with your healthcare provider). Many companies promote the use of CBD oil for a range of conditions – from anxiety to insomnia to chronic pain – and it may be marketed as a solution to epilepsy too.
It should be noted that Epidiolex is designed as standardised oral solution of pure plant-derived CBD. It is not the same as the non-standardised, viscous CBD oils that contain varying amounts of CBD and can be purchased in health food shops. There is currently no good evidence that formulations of CBD oil (or indeed cannabis oil) are as effective on epilepsy seizures. Equally, there is no robust evidence – just anecdotal reports – that THC helps reduce epilepsy seizures human.
Billy was seizure-free for more than 250 days when taking the oil, but his seizures started again when his cannabis oil was withdrawn. The home secretary, Sajid Javid, was persuaded to intervene and one of the seven bottles of cannabis oil was returned, with a 20-day licence to administer the medicine.
The two main constituents of cannabis oil are THC (tetrahydrocannabinol) and CBD (cannabidiol). Oil containing CBD alone (CBD oil) can be legally bought in the UK without a prescription because it contains only very low quantities of THC. But cannabis oil that contains THC at higher levels (more than 0.3%) is illegal. THC is a schedule 1 drug, that is to say, it is deemed to have no medicinal value.
I have been approached by Dragonfly Biosciences who produce and market cannabidiol (CBD) to sit on their Advisory Panel. I do not receive funding from Dragonfly Biosciences, but would be paid a consultancy fee if I join the Advisory Boorad. My scientific publication support the use of non-THC cannabidinoids, as reflected in this article. I have previously received funding from GW Pharmaceuticals, but I am currently not in receipt of such funding.
The government has now also relented in Alfie’s case following the concerns raised around the confiscation and return of Billy Caldwell’s medicine.
University of Reading provides funding as a member of The Conversation UK.
In [animal studies], THC has weak overall effects in reducing seizures and has also been shown to be a less effective anticonvulsant than CBD. THC, being a psychoactive substance, also has a number of side effects, including the well-known euphoric “high” associated with recreational use – which is a significant disincentive for the pharmaceutical industry to develop a medicine containing this compound.
The BPNA guidance states that non-licensed medicinal cannabis should only be considered for children who:
There is also no good scientific evidence to support suggestions that the addition of THC in combination with CBD increases the efficacy of cannabis-based medicinal products for children.
Guidance from the British Paediatric Neurology Association (BPNA)
CBD does not contain any significant amount of THC, the component of cannabis associated with producing a ‘high’.
Concerns have also been raised about the effect of THC on the developing brain in children and young people. Evidence suggests that chronic exposure to THC can affect brain development, structure and mental health.
The body also has concerns about the ‘viability of the economic model’ used by GW Pharma, the company that developed the drug, to establish the cost to be charged to the NHS for it. It concluded that Epidyolex would not, at this stage, be an effective use of NHS resources.