CBD guides: Could CBD help with epilepsy?

It is estimated that 600,000 people currently live with epilepsy in the UK. We examine if CBD could help with managing the symptoms

When it comes to epilepsy, could CBD or medical cannabis help?

What is epilepsy?

Epilepsy is a common condition that affects the brain causing frequent seizures. A seizure is a burst of electrical activity in the brain that temporarily affects how it works.

Symptoms can include uncontrollable shaking, losing awareness, stiffness, unusual smells or tastes as well as tingling sensations in the arms or legs.

There are a number of different treatments that can help to control seizures or lessen their frequency. This can include medication, surgery, ketogenic diets or even cannabis. Speaking to your GP or specialist is the best way to determine if a medication could work for you.

There are different types of childhood epilepsy such as Dravet syndrome, West syndrome and Lennox-Gastaut syndrome. These are particular treatment-resistant forms of epilepsy. It is thought that there are over 60,000 children living with epilepsy in the UK. It is estimated that 23,000 of whom do not respond to treatment.

Are there different types of epilepsy?

There are different types of epilepsy including:

• Focal onset epilepsy involves focal seizures that start on one side of the brain
• Complex focal seizures that cause confusion but may not result in loss of consciousness.
• A complex focal seizure causes altered consciousness, but not necessarily the complete loss of consciousness.
• Generalised epilepsy involves generalized onset seizures. These seizures begin on both sides of the brain and cause impaired consciousness or loss of consciousness

Generalised epilepsy may include different types of seizures such as:

•  Absence seizures can cause confusion, memory loss and slight muscle twitching. It normally lasts for about 15 seconds
• Myoclonic seizures are usually brief and a patient can have multiple myoclonic seizures in short periods of time.
• Generalized tonic-clonic (GTC) seizures where a patient experiences muscle stiffening, jerking and loss of consciousness.

A seizure can also be tonic without the clonic phase meaning a person may stay conscious during this time. Generalised and focal epilepsy can also occur together.

Can CBD oil help with seizures?

CBD’s effectiveness for seizures is currently an ongoing area of research. There are some studies into the effect it might have on seizures. However, this is usually in animal studies with high-grade pharmaceutical products rather than generally available products.

It is thought to work by interacting with our endocannabinoid system. The endocannabinoid system contains receptors and neurotransmitters throughout the body. These receptors help to regulate the body keeping it in a state of balance. CBD may be able to interact with these receptors although it is not fully understood how. The antiseizure effects may be a result of CBD’s ability to reduce neuron excitability by acting on the receptors, GRP55 and TRPV1.

Epilepsy studies

A review published in the Journal of Clinical Neurophysiology reported that isolated or CBD-infused herbal extract may help to decrease seizure frequency in treatment-resistant epilepsy.

One study from 2018 revealed that CBD may help people with CDKL5 deficiency disorder, Aicardi, Doose and Dup15q syndromes. A group of 55 participants experienced an average of 59.4 seizures a month but after 12 weeks of treatment, this was reduced to 22.5.  The improvement continued over 48 weeks of the study.

In one trial researchers gave 148 patients with tuberous sclerosis, different doses of Epidolex per day or a placebo. Those in the Epidolex group reported a 48 per cent improvement compared to the placebo group at 24 per cent.

Read more: Further evidence for cannabis-based medicines in epilepsy treatment

CBD with other cannabinoids

Researchers at the University of Sydney have been examining the potential of three cannabinoids to treat Dravet syndrome. This new study explored whether CBGA, or its precursor olivetolic acid could have better brain penetration and help to control seizures. While CBGA shows promise in helping to reduce the frequency of seizures, it is limited due to its poor brain penetration abilities and also, its chemical instability.

Researchers aimed to discover if a more stable version of CBGA (CBGA methyl ester) could offer more success. The results showed that the more stable version of CBGA had limited brain penetration at 13 per cent. This was notably superior in relation to CBGA at two per cent. While the olivetolic acid also showed poor brain penetration at one per cent, it did have a modest anticonvulsant effect.

Is medical cannabis legal for epilepsy?

Medical cannabis products are available for epilepsy but they have to be obtained through a medical cannabis clinic. They are normally prescribed when a patient has experienced all other treatments available. It is very difficult to get medical cannabis through the NHS, so a patient would need to go to a private clinic instead.

One study published in the BMJ Paediatrics Open found that children given whole-plant medicinal cannabis experienced an 86 per cent reduction in seizures. The children were recruited from MedCann and End Our Pain and had previously failed to respond to Epidyolex which is prescribed on the NHS.

Always talk to your GP or health professional before making any changes to your treatment or medical care.