We live in a modern, busy world, where external stimuli constantly bombard us. Street noises steal our attention, and our eyes delight with the city flashing lights while our central nervous system harmoniously coordinates all these signals into sounds and visions that make sense to us.
Usually, neurons communicate through electrical impulses to respond to a stimulus. Still, this symphony of standard brain signals can be interrupted by a storm of uncontrolled electrical impulses, causing a seizure.
According to epilepsy action, 65 million people worldwide have epilepsy, from which over 600,000 live in the UK. Around 87 people in England are diagnosed with epilepsy every day and what is even more concerning is that one in four newly diagnosed people is over the age of 65. While many of these individuals can control their seizures with medications, within 30- 40 per cent have what’s called drug-resistant or medically refractory epilepsy. This critical population doesn’t respond to standard anti-seizure medications, representing more than a challenge for specialist doctors.
In front of this growing reality, the UK government rescheduled cannabis-based medicines. Since 2018, patients can legally access CBD, a non-psychoactive cannabinoid that has gained popularity for its multiple therapeutic properties. In 2019, the National Institute for Health and Care Excellence (NICE) published the new cannabis-based medicines guidance, replacing the previous interim guidance of the British Paediatric Neurology Association (BPNA) and the Association of British Neurologists (ABN).
We are now moving towards removing the barriers that prevented people from benefiting from cannabis-based drugs, bringing hope to those who have severe, treatment-resistant epilepsy. Follow us through this article to learn everything you need to know about CBD oil for epilepsy.
What is Epilepsy?
According to the UK’s National Health Service (NHS), Epilepsy is the fourth most common neurological condition that affects the brain and causes frequent seizures.
We understand seizure as a burst of abnormal electrical activity that interrupts regular brain signals. Doctors classify these into two main types: Generalized seizures, which affect the whole brain, and Focal (partial) seizures, in which abnormal electrical brain function occurs in one or more areas of one side of the brain.
Usually, connections between nerve cells in the brain can be interrupted under conditions like an imbalance of nerve-signalling brain chemicals (neurotransmitters), brain tumours, stroke, and brain damage from illness or brain injury. Among other common causes, we find high fever, high or low blood sugar, lack of oxygen to the brain, and drug abuse or alcohol misuse.
Nevertheless, the exact cause of the convulsion is unknown to most patients. Johns Hopkins Medicine diagnoses epilepsy when a person has two or more seizures with no known cause. Depending on which part of the brain the seizure has taken place, a wide range of cerebral functions can be temporarily affected, causing possible symptoms such as:
- uncontrollable jerking and shaking movements of the arms and legs (fit)
- Stiffening of the body
- Nodding your head rhythmically while losing awareness or consciousness.
- Periods of rapid eye blinking and staring blankly into space
- Strange sensations: a “rising” feeling in the tummy, unusual smells or tastes, or a tingling feeling in your arms or legs
- Confusion and temporary memory loss
- Breathing problems or stopping breathing
- Not responding to noise or words for brief periods
- Loss of bowel or bladder control
This chronic neurological disorder can affect people of all ages, especially during childhood or in people over 60. Some people can identify things or situations that can provoke seizures.
Specialist doctors prescribe anti-epileptic drugs to manage several types of epilepsy. Alternatively, they recommend following a special ketogenic diet, a vagus nerve stimulator, or surgery to help control or reduce how often seizures occur. Most cases get slowly better over time with treatment.
Side Effects of Epilepsy Drugs
The first-line treatment for epilepsy is anti-seizure medication. These medications can reduce the frequency or the severity of seizures when taken correctly. We absorb them through the digestive tract, from where they travel the bloodstream to the brain. Once there, anti seizures regulate neurotransmitters while reducing the electrical activity.
Depending on the type of seizures you have, your doctor can prescribe a single drug or a combination of drugs. Your healthcare provider might warn you about its potential side effects like fatigue, dizziness, skin rash, poor coordination, and memory problems. Although rare, serious side effects of epilepsy drugs may include depression and inflammation of the liver or other organs.
On the other hand, it’s vital to mention that epilepsy deaths have increased by 70%. According to the new figures from Public Health England (PHE), people with the condition now die on average eight years earlier than the rest of the population.
Not only could Carbamazepine alter cardiac autonomic function, but it also potentially increases the risk for sudden unexpected death in epilepsy (SUDEP). Some studies have reported that carbamazepine use, toxicity, and frequent, rapid changes in carbamazepine levels may be associated with SUDEP. However, this evidence is tenuous and more research is needed to associate the use of carbamazepine or any other individual anti-epileptic drug and SUDEP.
For these reasons and more, people worldwide are looking for safe, natural treatments to help them control seizures’ frequency without dealing with side effects that seriously affect their quality of life. Keep reading down below to find out why CBD oil for epilepsy might be the answer.
CBD for Epilepsy
CBD, also known as Cannabidiol, is a naturally-occurring cannabis compound known for having a myriad of therapeutic effects. Unlike THC, CBD is not euphoric or impairing. It interacts with receptors in your endocannabinoid system, regulating body functions including appetite, sleep, and pain while boosting your immune system response.
Usually, people often take it to manage chronic pain or reduce their anxiety symptoms, but studies have shown that Cannabidiol has antiseizure properties. Although little is known about how CBD eases seizures, scientists believe that might come from its neuroprotective, anti-inflammatory effects and its ability to reduce neuron excitability.
A 2017 study based on animal model data demonstrated that this neuroactive Cannabis-derivative has positive effects against a broad spectrum of seizures. Furthermore, clinical trials evidenced that when combined with clobazam, an anti-seizure medication, cannabidiol reduces the frequency of the main types of seizures. Nevertheless, more research is needed to study the longer-term effectiveness of cannabidiol with clobazam.
While other anti-epileptic drugs cannot control seizures associated with Dravet and Lennox-Gastaut syndromes or tuberous sclerosis complex, CBD has shown safety and efficacy in dropping convulsive and non-convulsive seizure frequency. Contrary to anti-seizure medications, the most common side effects of CBD include sleepiness, diarrhoea, fatigue, and decreased appetite.
Thus, in 2018, the FDA in the United States approved using a prescription drug CBD called Epidiolex to treat these rare forms of epilepsy in patients one year of age and older. This relatively new drug represents a legal option for children with these severe types of epilepsy. NICE guidelines indicate that patients will be considered for Epidyolex with clobazam where other treatments have not worked.
Can CBD Oil Cure Epilepsy
Unfortunately, there’s no cure for epilepsy. Still, most people are able to have everyday lives with the help of CBD. Evidence from laboratory studies, anecdotal reports, and small clinical trials support CBD’s effectiveness in controlling seizures. Even with the most severe treatment-resistant epilepsy, CBD has reduced the frequency of convulsive seizures by at least 30% after six months of treatment.
Meindert Boysen, director of the Centre for Health Technology Evaluation at NICE, claimed, “The often distressing and life-limiting nature of these very difficult to control epilepsies mean that we should all welcome new treatment options.” CBD doesn’t heal epilepsy, but it surely can manage this common neurological disorder and restore the quality of life of those who experience constant seizures without causing severe adverse effects.
Dosage of CBD Oil for Epilepsy
Epidolex is the only NICE-approved, purified prescription cannabidiol indicated to treat seizures in patients two years and older. The recommended starting dose of the plant-derived drug is 2.5 mg/kg taken by mouth, twice per day. After a week, the dose can be increased to 5 mg/kg twice per day. Eventually, it can increase to a maximum of 10 mg/kg twice per day, depending on an individual’s response and tolerability.
However, Epidiolex can be expensive, and many insurance providers don’t cover it. For this reason, some people opt for artisanal or store-bought CBD. Apart from oil, other common ways to use CBD for epilepsy are through tinctures and gummies.
The New England Journal of Medicine published a study in 2018 demonstrating the efficacy and safety of cannabidiol added to a regimen of conventional antiepileptic medication to treat drop seizures in patients with severe Lennox-Gastaut syndrome. Clinical trials showed that combining 10mg to 20mg of CBD per kilogram of body weight per day along with their anti-epileptic treatment had greater reductions in drop seizures.
Nevertheless, the American Academy of Neurology warns that some people have reported more seizures after taking artisanal CBD oil. Currently, several CBD oils are running in the market without presenting proper third-party lab testing. Research proclaims that these extracts may have varying levels of THC. Scientists have pointed out this psychoactive compound as having pro convulsant properties that can trigger seizures.
According to a comparative study, patients with refractory epilepsy have reported improvement using CBD-rich extracts. Thanks to the synergistic effects of CBD with other phytocompounds (Entourage effect), Full-spectrum oils seem to present a better therapeutic profile at a lower average dose (6.0 mg/kg/day) than purified CBD. Adding Columbia Care Platinum Full Spectrum CBD Oil directly under the tongue offers the greatest therapeutic potential of the plant, aids in potency, and guarantees 0% THC. Besides CBD, it includes other natural cannabis ingredients that, when combined, magnify and enhance the benefits of CBD oil for epilepsy.
Since higher doses are related to sleepiness, decreased appetite, diarrhoea, and elevated liver aminotransferase concentrations, you should always talk to your doctor first to analyse the minimum effective dose for your particular epilepsy type.
Finally, it’s important to highlight that CBD interacts with different medications, making it more or less effective and increasing your risk of liver damage. Do not replace your traditional medicine for CBD unless your healthcare provider tells you. Your doctor can help you monitor your seizure frequency and determine if CBD is right for you.