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Study breakdown

CBD and THC Together May Fight Seizures Better Than Either Alone

evidenceAnimal study
The takeaway

Both CBD and THC reduced seizures in a mouse model of generalized epilepsy, and adding a low, non-therapeutic dose of THC to CBD modestly improved CBD's effectiveness.

Read this if you have epilepsy and are interested in whether THC-containing cannabis products might add benefit to CBD treatment.

15:1 ratio

CBD:THC ratio that improved seizure protection over CBD alone in mouse model

What the researchers found

In the mouse maximal electroshock seizure (MES) model, THC alone had an ED50 of 52 mg/kg (therapeutic index 1.7), while CBD alone had an ED50 of 190 mg/kg (therapeutic index 2.4). When combined at a 15:1 CBD:THC ratio, the ED50 dropped to 130 mg/kg CBD + 8.6 mg/kg THC, indicating a modest improvement. The benefit of adding THC to CBD was less dramatic than what the same research group previously observed in the amygdala-kindling model of focal seizures.

Why it matters

Most cannabis-based seizure medications focus on CBD alone. This study provides preclinical evidence that small amounts of THC could enhance CBD's anti-seizure effects, though the benefit may depend on seizure type.

The numbers in context

- THC alone ED50: 52 mg/kg, therapeutic index 1.7

- CBD alone ED50: 190 mg/kg, therapeutic index 2.4

- CBD+THC (15:1) ED50: 130 mg/kg + 8.6 mg/kg

- Combination benefit less dramatic than in focal seizure model

How the study worked

Male CF-1 mice received intraperitoneal injections of CBD, THC, or combinations. MES test conducted 2 hours post-CBD and 1 hour post-THC injection. Wide dose ranges tested for dose-response curves. Toxicity assessed via behavioral rating scale.

Who was studied

Male CF-1 mice

What this study cannot tell us

Mouse MES model may not fully predict human seizure responses. Intraperitoneal injection route differs from oral administration used clinically. Only one CBD:THC ratio (15:1) was tested in combination. Single sex (male mice only).

How to read the evidence

Preclinical animal study with well-established seizure model. Provides mechanistic evidence but requires human studies before clinical application.

When this study was published

Published in 2023. Builds on the research team's prior work with the amygdala-kindling model.

The bigger picture

The FDA-approved CBD medication Epidiolex has transformed epilepsy treatment, but response rates are not universal. Exploring whether THC can enhance CBD's effects at sub-psychoactive doses could improve outcomes for patients with treatment-resistant epilepsy.

Questions still open

  • Would other CBD:THC ratios produce better results for generalized seizures?
  • Does the seizure type (focal vs generalized) determine whether THC enhances CBD's effects?
  • Could sub-psychoactive THC doses improve outcomes for patients already taking Epidiolex?

Read the original research

The effects of cannabidiol and Δ9-tetrahydrocannabinol, alone and in combination, in the maximal electroshock seizure model.

Epilepsy research, 190, 107087

Citation

Dlugosz, Lukasz; Zhou, Han Zhong; Scott, Brian Wayne; Burnham, McIntyre. (2023). The effects of cannabidiol and Δ9-tetrahydrocannabinol, alone and in combination, in the maximal electroshock seizure model.. Epilepsy research, 190, 107087. https://doi.org/10.1016/j.eplepsyres.2023.107087