How Does CBD Help Seizures?
How does CBD help seizures? And what are the side-effects of its use? This article explores the benefits and risks of using CBD to alleviate the effects of epilepsy.
In January clinical trials and medical research suggested that Epidyolex, produced by GW Pharmaceuticals, is beneficial in treating epilepsy. This led the NHS to approve it in January 2020 for children over two years old who suffer from two rare forms of epilepsy, namely Lennox-Gastaut syndrome (LGS) and Dravet syndrome.
Can CBD increase seizures?
The medical community is still uneasy about prescribing CBD because so little is understood about the way it interacts with our bodies. What does CBD do to the brain, especially long-term? This is still under research.
That is why, in the case of Lennox-Gastaut syndrome (LGS) and Dravet syndrome, there are important limitations and precautions to be taken. For example, many children suffered from side-effects like sleepiness, decreased appetite, diarrhoea, fever, tiredness and vomiting.
More importantly, in a few cases, treatment with Epidyolex had to stop because of increased blood levels of liver enzymes, which can be a sign of liver problems.
Also, CBD may be biphasic—i.e. a high dosage may cause the opposite effect from a low one. Naturally, people asked themselves, can CBD oil make seizures worse? Indeed, is CBD oil good for epilepsy or might it worsen the condition?
Thankfully, both clinical trials and data from Epidyolex use have shown improvement in the frequency and severity of epileptic seizures.
Researchers are still trying to understand how CBD works in easing these forms of epilepsy. Their work is complicated by the fact that epilepsy is a little-understood condition, while we still need a better grasp on the mechanisms used by CBD to interact on the brain and its neurotransmitters.
What is epilepsy?
Epilepsy affects more than 50 million across the world and is the most common neurological disease.
It is a disorder of the central nervous system whereby there are random and erratic electric discharges in the brain cells. These cause sufferers to lose consciousness and experience body convulsions.
Symptoms of epilepsy
There are various types of seizures, depending on the brain parts that are affected from the irregular electric discharges.
Seizures can affect both sides of the brain, in which case they are called generalized seizures, while focal seizures only affect one part of the brain.
Some people may lose consciousness while others may be just confused. Some start flailing their arms and legs, while in some milder cases people just stare for a prolonged period of time. During an epileptic seizure, people may collapse on the ground and injure themselves.
It is generally accepted that people suffering from epilepsy experience the same type of epileptic seizures during their episodes.
Most seizures last from mere seconds to up to two minutes. The frequency of seizures varies wildly: some people may suffer a couple of seizures a year while others may experience dozens of seizures each day.
With frequent seizures drastically reducing a person’s quality of life, the question, ‘how does CBD help seizures?’ becomes crucial. But to answer that, we first need to decipher the causes of epilepsy.
Causes of epilepsy
The causes of epilepsy are generally unclear.
We do know that it can occur after head trauma, prenatal injury or lack of oxygen during birth, brain conditions, or infectious diseases. However, in two-thirds of epilepsy cases, the origin of the condition is unidentified.
How does CBD help seizures?
In research and clinical trials, CBD decreased the frequency and severity of epileptic seizures.
According to the trials done by GW Pharmaceuticals:
- 47% of patients experienced a ≥50% reduction in seizures after 12 weeks of treatment.
- The positive clinical effects were maintained for 36 weeks of treatment.
- There was a median reduction in total seizures of 45% across all patients.
- Only 4% of patients had to withdraw due to side-effects.
How does CBD oil stop seizures?
CBD has been known to interact with our endocannabinoid system (ECS).
Our endocannabinoid system consists of at least two human cannabinoids produced by our own body. These human cannabinoids are called anandamide and 2-AG.
Interestingly, 2-AG is particularly close in its function and composition to CBD. This was an initial clue for researchers to look into the possibility that CBD could interact with our ECS, since there was such similarity in the chemical compounds.
How does the human endocannabinoid system work?
The goal of the ECS is to maintain our homeostasis—the natural balance of our body.
Our ECS regulates various functions such as reproduction, mood, sleep patterns, appetite, motion, temperature perception, inflammation, immune response, and pain perception among others.
Once a section of our body loses its balance, our ECS either corrects the problem on its own or alerts us to fix it. For instance, when we feel hungry, it’s our ECS alerting us to eat something in order to fill our hunger.
Our ECS is found throughout our body, including the brain, so researchers turned to the possibility that CBD could help with epilepsy through our ECS. But how does CBD help seizures?
How does CBD work with epilepsy?
There is still a lot of speculation regarding the mechanics at work with CBD. A lot remains unknown and the scientific community is still trying to understand the exact interaction between our ECS and CBD.
But initial results are positive as there seems to be a general scientific agreement that CBD is beneficial in treating epilepsy. There also seems to be proof that CBD is effective in treating central nervous system disorders.
What remains to be seen is how CBD interacts with the brain to abate the severity and frequency of seizures. Therefore, the question ‘how does CBD help seizures?’ is still somewhat unanswered.
CBD as an anti-inflammatory
The possible anti-inflammatory qualities of CBD may have an effect on brain inflammation involved in epilepsy.
Specifically, CBD could be decreasing the neuro-inflammation that has been documented in cases of epilepsy, thus reducing its severity and frequency. Ongoing research on the subject of the anti-inflammatory effects of CBD is promising.
CBD interacts with GABA activity in the brain
Another possibility is that CBD affects GABA activity. GABA is a neurotransmitter that sends chemical messages throughout the nervous system and the brain. Since epilepsy is a problem related to the nervous system, there has been ongoing research regarding the involvement of GABA in epilepsy.
GABA is responsible for controlling the communication between brain cells. Specifically, GABA is an inhibitory neurotransmitter that stops the over-excitation of brain cells.
In simple words, GABA reduces the electrical activity in the brain. CBD appears to be interacting with GABA receptors by boosting their calming effects.
Therefore, CBD could be helpful during seizures by decreasing the electrical activity in the brain through the GABA receptors.
CBD and other brain receptors
One potential way to answer the question ‘how does CBD help with seizures?’ is that studies have shown an interaction between CBD interacts and many brain receptors. For instance, CBD binds with receptor TRPV1, which is responsible for temperature regulation and inflammation.
Research around epilepsy has shown that seizures in children under the age of size often occur during episodes of fever and high body temperatures. There is speculation that increased body temperatures have a connection with epilepsy, although there is no medical proof yet.
Furthermore, research into epilepsy has shown that increased levels of the TRPV1 receptor activate epileptic seizures. CBD appears to be regulating the activity of the TRPV1 receptor. Therefore, CBD could be helpful in regulating body temperature and thus decreasing the frequency of seizures.
CBD could be neuroprotective
Inflammation and oxidative stress may damage brain neurons that are tasked with processing electrical signals throughout the brain. Irregular electric signals being the main cause of epilepsy, researchers have investigated whether CBD could act as an anti-oxidant of brain neuros and cells. A study on piglets showed preliminary promising results.
Further studies have shown that CBD has a neuroprotective effect on the brain. This could mean that CBD works in the brain by reducing neuron inflammation and cell oxidation.
CBD as an anticonvulsant
A major symptom of epileptic seizures is the accompanying body convulsions that cause the whole body to convulse uncontrollably. There has been some research regarding the anticonvulsant qualities attributed to CBD.
Further studies on epileptic rats showed that CBD is indeed an anticonvulsant.
Common side-effects from Epidyolex
It is generally thought that CBD has fewer and less important side-effects than other anti-epileptic medication. However, in some cases, these side-effects were significant.
In children being treated with CBD for their epilepsy, some of them suffered adverse side-effects.
The manufacturers of Epidyolex point to some frequent side-effects such as vomiting, diarrhoea, decreased appetite, drowsiness, and fatigue. It would appear that the side-effects subside after taking Epidyolex for a few weeks. In some cases, children were taken off CBD due to the severity of the side-effects.
Also, it is unclear whether CBD has a long-term effect on the brain of the children using Epidyolex. Quite simply, we need to wait for a few decades before we can answer this question.
However, most researchers and doctors agree that CBD displays fewer severe side-effects, is non-addictive and non-psychotic.
Research has shown that:
“In the randomized controlled trials conducted to date, the tolerability profile of CDB was relatively benign, with somnolence, decreased appetite and gastrointestinal symptoms being the most common treatment-emergent adverse events.”
A further study showed that:
“In general, the often described favorable safety profile of CBD in humans was confirmed and extended by the reviewed research.[…] CBD has a better side effect profile.”
CBD and anti-epileptic medication
There are still concerns regarding the interaction of CBD with other anti-epileptic medication.
CBD seems to raise the blood levels of certain medications while decreasing the blood levels of some others. It also seems to increase liver enzymes.
Children and people already taking anti-epileptic medication should consult with their doctor before experimenting with CBD. Epidyolex can only be subscribed by a doctor, who will certainly know what other medication the patient is taking.
How does CBD help seizures: Conclusion
So, how does CBD help seizures?
Epilepsy is a health issue where CBD has been shown to be beneficial. That is the reason why the NHS and the FDA have approved Epidyolex as a CBD medication for treating rare forms of epilepsy in children.
It is still unclear how CBD interacts with the body. There is speculation regarding the anticonvulsant, anti-inflammatory, and anti-oxidant qualities of CBD. All these and many more potential qualities are being investigated to better understand the mechanisms at work.
It should be noted that Epidyolex has some side-effects, although these are not as adverse as those of other anti-epileptic medication.
People should be aware that CBD interacts with anti-epileptic medication and they should always consult with their doctor before introducing CBD to their treatment.