Cbd oil for seizures
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CBD Oil for Seizures: A Comprehensive Overview
Introduction to CBD Oil and Seizures
Cannabidiol (CBD), a major component of the Cannabis sativa plant, has garnered significant attention for its potential in treating epilepsy. Unlike tetrahydrocannabinol (THC), CBD does not induce euphoric effects, making it a promising candidate for medical use, particularly in managing seizures 126.
Efficacy of CBD in Epileptic Conditions
FDA and EMA Approvals
Highly purified CBD formulations, such as Epidiolex, have been approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for treating seizures associated with Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex 16. These approvals are based on robust clinical trials demonstrating significant reductions in seizure frequency.
Broader Epileptic Syndromes
Beyond the well-known syndromes, CBD has shown promise in treating other epileptic conditions. Studies indicate that CBD can reduce seizure frequency in patients with CDKL5 deficiency disorder, Aicardi syndrome, Dup15q syndrome, Doose syndrome, SYNGAP1 encephalopathy, and epilepsy with myoclonic absences 1. Open-label studies and randomized controlled trials have consistently reported significant reductions in seizure frequency with CBD treatment 134.
Comparative Efficacy: CBD-Rich Extracts vs. Purified CBD
A meta-analysis comparing CBD-rich extracts to purified CBD products found that patients using CBD-rich extracts reported higher rates of seizure improvement. Specifically, 71% of patients using CBD-rich extracts reported improvements compared to 46% using purified CBD 10. This suggests a potential "entourage effect," where other phytocompounds in the extracts may enhance CBD's efficacy.
Safety and Tolerability
Common Adverse Events
The most frequently reported side effects of CBD treatment include somnolence, decreased appetite, diarrhea, and increased serum aminotransferases 167. These side effects are generally mild and transient, making CBD a relatively safe option for long-term use.
Specific Populations
In pediatric populations with intractable epilepsy, CBD has shown a significant positive effect on seizure load, with 89% of children reporting a reduction in seizure frequency 4. Similarly, in treatment-resistant epilepsy (TRE) patients, 73% reported more than a 50% reduction in seizures 3.
Mechanisms of Action
The exact mechanisms by which CBD exerts its anti-seizure effects are not fully understood. However, it is believed to involve multiple pathways, including the modulation of G protein-coupled receptor 55 (GPR55), transient receptor potential vanilloid type 1 (TRPV1) channels, and inhibition of adenosine reuptake 78.
Conclusion
CBD oil has emerged as a promising treatment for various forms of epilepsy, including those resistant to conventional therapies. Its efficacy in reducing seizure frequency, coupled with a favorable safety profile, makes it a valuable addition to the therapeutic arsenal against epilepsy. Further research is warranted to explore its full potential and optimize its use in clinical settings.
Sources and full results
Most relevant research papers on this topic
Highly Purified Cannabidiol for Epilepsy Treatment: A Systematic Review of Epileptic Conditions Beyond Dravet Syndrome and Lennox–Gastaut Syndrome
Highly purified CBD oil-based oral solution shows potential in treating epilepsy in patients with conditions beyond Dravet syndrome and Lennox-Gastaut syndrome, with common adverse events including somnolence, decreased appetite, diarrhea, and increased serum aminotransferases.
Systematic Review
Very Rigorous JournalA prospective open‐label trial of a CBD/THC cannabis oil in dravet syndrome
TIL-TC150, a CBD/THC cannabis oil, shows potential in reducing seizures and improving quality of life in children with Dravet syndrome.
RCT
Rigorous Journal
Highly CitedAn Open Retrospective Study of a Standardized Cannabidiol Based-Oil in Treatment-Resistant Epilepsy
A standardized CBD-based oil formulation is effective and well-tolerated in treating treatment-resistant epilepsy with few significant side effects.
Observational StudyCBD-enriched medical cannabis for intractable pediatric epilepsy The current Israeli experience
CBD-enriched medical cannabis significantly reduces seizure frequency and improves behavior in children with intractable epilepsy.
Observational StudyHighly CitedRandomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy.
Oral CBD administration in dogs with intractable idiopathic epilepsy significantly reduced seizure frequency, but the proportion of dogs considered responders to treatment was similar between groups.
RCT
Animal StudyHighly CitedEfficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis
CBD is an effective and safe adjunctive treatment for patients with epilepsy, reducing seizure frequency by at least 50% without causing significant withdrawal or adverse events.
Meta-AnalysisHighly CitedThe proposed mechanisms of action of CBD in epilepsy.
CBD reduces seizures in epilepsy patients by targeting multiple targets, including TRPV1, GPR55, and ENT-1, potentially modulating neuronal excitability and affecting seizure activity.
Highly CitedSafety and efficacy of cannabidiol-cannabidiolic acid rich hemp extract in the treatment of refractory epileptic seizures in dogs
CBD/CBDA-rich hemp extract at 2 mg/kg every 12 hours can effectively reduce epileptic seizure frequency in dogs when used in conjunction with other anti-seizure medications.
RCTAnimal StudyPotential Clinical Benefits of CBD-Rich Cannabis Extracts Over Purified CBD in Treatment-Resistant Epilepsy: Observational Data Meta-analysis
CBD-rich extracts show a better therapeutic profile than purified CBD in treating refractory epilepsy, likely due to synergistic effects with other phytocompounds.
Meta-AnalysisHighly Cited