CBD side effects: mostly mild, but dangerous when combined with certain epilepsy drugs

CBD is generally well-tolerated with mild side effects like sleepiness and diarrhea, but can cause severe, life-threatening reactions when combined with valproate or clobazam, two drugs commonly used in the epilepsy patients who take CBD.

Anciones, Carla et al.·Epileptic disorders : international epilepsy journal with videotape·2020·Strong EvidenceReview
RTHC-02385ReviewStrong Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Strong Evidence
Sample
Not reported

What This Study Found

Short-term CBD side effects are generally transitory, dose-dependent, and mild to moderate: somnolence, decreased appetite, and diarrhea. However, severe life-threatening reactions can occur, often related to uncontrolled combinations with valproate (hepatotoxicity risk) or clobazam (excessive sedation). These are widely used in Dravet and Lennox-Gastaut patients who are the target population for CBD.

Key Numbers

No specific incidence rates. Review noted dose-dependent effects and identified valproate and clobazam as primary interaction risks.

How They Did This

Brief review summarizing available data on short-term adverse events from clinical trials that led to Epidiolex FDA approval.

Why This Research Matters

The very patients most likely to benefit from CBD (those with severe epilepsy) are also taking the drugs most likely to cause dangerous interactions with CBD, making monitoring essential.

The Bigger Picture

The interaction concern highlights a broader issue: CBD is often perceived as universally safe because it is "natural," but it has real pharmacological interactions that can be serious.

What This Study Doesn't Tell Us

Brief review focused on short-term effects. Long-term safety data are lacking. Based primarily on clinical trial populations.

Questions This Raises

  • ?What is the long-term safety profile of CBD in children?
  • ?Can dosing adjustments of valproate and clobazam eliminate the interaction risk?

Trust & Context

Key Stat:
Life-threatening reactions possible with valproate or clobazam
Evidence Grade:
Based on clinical trial data from FDA approval process, the strongest available evidence.
Study Age:
2020 review.
Original Title:
Adverse effects of cannabinoids.
Published In:
Epileptic disorders : international epilepsy journal with videotape, 22(S1), 29-32 (2020)
Database ID:
RTHC-02385

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

Is CBD safe?

CBD is generally well-tolerated with mild side effects, but can cause severe reactions when combined with valproate (liver damage risk) or clobazam (excessive sedation), drugs commonly used in epilepsy patients.

What are the side effects of CBD?

Common side effects include sleepiness, decreased appetite, and diarrhea. These are typically dose-dependent and transitory. Serious effects occur mainly through drug interactions.

Read More on RethinkTHC

Cite This Study

RTHC-02385·https://rethinkthc.com/research/RTHC-02385

APA

Anciones, Carla; Gil-Nagel, Antonio. (2020). Adverse effects of cannabinoids.. Epileptic disorders : international epilepsy journal with videotape, 22(S1), 29-32. https://doi.org/10.1684/epd.2019.1125

MLA

Anciones, Carla, et al. "Adverse effects of cannabinoids.." Epileptic disorders : international epilepsy journal with videotape, 2020. https://doi.org/10.1684/epd.2019.1125

RethinkTHC

RethinkTHC Research Database. "Adverse effects of cannabinoids." RTHC-02385. Retrieved from https://rethinkthc.com/research/anciones-2020-adverse-effects-of-cannabinoids

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.