Explore published research on epilepsy, including study methods and limitations.
Preclinical study showing whole cannabis extracts produced faster spasticity relief and more potent anticonvulsant effects than pure THC, with THC-free extracts also showing anticonvulsant activity.
Review of the endocannabinoid signaling system describes how it maintains physiological balance and identifies therapeutic potential for pain, epilepsy, spasticity, eating disorders, and inflammation.
Two epilepsy patients with seizures controlled by marijuana experienced dramatic seizure increases upon stopping, documented by continuous video-EEG monitoring.
Review identified five strategies for making cannabinoid medicines more effective while reducing psychoactive side effects, covering applications from pain to neurodegeneration.
Systematic review of 34 human studies found preliminary CBD benefits for anxiety, insomnia, and epilepsy, with complex THC interactions depending on delivery route.
Parent survey found 84% of children with treatment-resistant epilepsy had reduced seizures with CBD-enriched cannabis, after trying an average of 12 medications.
Expert review found clinical evidence for cannabinoids in MS spasticity, refractory pain, and nausea, with emerging evidence for epilepsy, dystonia, tics, and other neurological conditions.
Leading epilepsy researchers outlined the case for clinical trials of pure CBD in treatment-resistant epilepsy, citing strong preclinical evidence and apparent tolerability.
Landmark review found CBD showed anticonvulsant, anxiolytic, antipsychotic, and anti-addictive properties but lacked well-powered trials, setting the stage for the clinical program that led to FDA approval.
The AAN systematic review found oral cannabis extract effective for MS spasticity and pain, but ineffective for tremor and of unknown efficacy for epilepsy (pre-CBD trials).
Charlotte Figi: 50 seizures/day to 2-3/month on CBD cannabis extract. Single case that launched a movement, a drug approval, and a national policy shift.
Broad review of cannabinoid medicine covered therapeutic potential in MS spasticity, pain, nausea, epilepsy, psychosis, and addiction, contrasting THC and CBD pharmacology.
Review of CBD for epilepsy found strong preclinical support for endocannabinoid system involvement in seizure control and growing anecdotal evidence for CBD, but called for rigorous clinical trials.
Review of evidence across 13 state-approved medical marijuana conditions found insufficient evidence for most, with the strongest support for chronic pain and muscle spasticity.
Parent survey of 117 children with epilepsy reported 85% seizure reduction with CBD products, but the study authors explicitly warned of severe participation bias and lack of controls.
Among 75 children given cannabis extracts for epilepsy, parents reported 33% had seizures cut in half, with dramatic differences by syndrome type. But 44% had side effects including worsened seizures.
Blocking the enzyme that breaks down the endocannabinoid 2-AG delayed seizure development in a mouse epilepsy model, but had minimal effect once seizures were established.
The clinical program that turned CBD into the first FDA-approved cannabis-derived drug. Open-label trial: 214 patients, 36.5% seizure reduction. NEJM RCT: 120 Dravet patients, seizures dropped from 12.4 to 5.9/month vs placebo (p=0.01). Epidiolex approved June 2018.
A treatment-resistant epilepsy patient experienced dramatic seizure reduction with cannabis, and lab experiments suggest the rare cannabinoid CBDV may contribute through effects on the brain's inhibitory GABA system.
Clinical review finds insufficient evidence for medical cannabis in children overall, but acknowledges exceptional cases like refractory epilepsy may warrant carefully supervised, research-based use.
Multicenter Israeli study found 89% of 74 children with severe, treatment-resistant epilepsy (failed 7+ drugs) had seizure reduction with CBD-enriched cannabis oil, with 18% achieving 75-100% reduction.
Review of how GW Pharmaceuticals and the University of Mississippi produce consistent, medical-grade cannabis for clinical research, covering breeding, cultivation, and extraction.
Expert review confirming THC/CBD spray efficacy for MS spasticity after five years of clinical use and cataloging expanding research into cannabinoids for pain, Alzheimer's, Parkinson's, Huntington's, and epilepsy.
Review of randomized trials of plant-based cannabis (excluding synthetics) for psychiatric and neurologic conditions finding limited evidence across conditions, highlighting the gap between policy approval and clinical evidence.
Review of CBD for treatment-resistant epilepsy showing Phase 3 RCT evidence of efficacy for Dravet and Lennox-Gastaut syndromes, while highlighting the gap between pharmaceutical CBD and unvalidated dispensary products.
Review marking a turning point: three controlled trials confirmed CBD reduces seizures in Dravet and Lennox-Gastaut syndromes, but a drug interaction with clobazam complicates interpretation of how much benefit is directly from CBD.
Comprehensive review finding that CBD and CBDV consistently reduce seizures in animal models, while THC-like CB1 agonists show complex, context-dependent effects that can be either anti- or pro-seizure.
Qualitative study of 25 parents using cannabis for pediatric epilepsy found they viewed themselves as scientific experimenters who wanted biomedical legitimacy, not alternative medicine rebels.
Australian survey of 976 epilepsy patients found 15% had tried cannabis, 90% of adults reported seizure reduction, and more failed medications predicted cannabis use.
Chart review of 119 pediatric epilepsy patients found 71% discontinued cannabis extracts, with only 13% achieving greater than 50% seizure reduction and perceived benefit the sole predictor of continued use.
Review of cannabis legalization's unintended pediatric consequences, covering prenatal exposure, accidental childhood ingestion, adolescent use, and the need for rigorous CBD epilepsy trials.
Systematic review of 22 studies found strongest pediatric evidence for chemotherapy-induced nausea, increasing evidence for epilepsy, and insufficient evidence for other conditions.
Profiling 94 phytocannabinoids across 36 strains showed that high-CBD extracts with equal CBD content produced different anticonvulsant effects, proving THC/CBD ratios alone are insufficient.
Conference report documents FDA approval of CBD oral solution for Lennox-Gastaut and Dravet syndromes, the first cannabis-derived FDA-approved medication.
Review confirms CBD efficacy for Dravet and Lennox-Gastaut syndromes but highlights practical challenges including drug interactions, variable absorption, and unclear mechanisms.
Comprehensive review cataloged six approved cannabinoid medications and evidence across pain, epilepsy, cancer, neurodegeneration, PTSD, anxiety, and addiction, spanning the full endocannabinoid system.
Review documents FDA-approved purified CBD (Epidiolex) significantly reducing seizures in Dravet and Lennox-Gastaut syndromes, with key drug interactions identified for clobazam and valproate.
Observational study found 56% of children with treatment-resistant epilepsy achieved 50%+ seizure reduction with CBD-enriched cannabis oil (20:1 ratio), with younger age and higher doses predicting better response.
Meta-analysis of 550 patients found CBD reduced seizures by ~20 percentage points in severe childhood epilepsies. The lower dose (10 mg/kg) was similarly effective but safer than the higher dose (20 mg/kg).
Open-label trial of 20 Dravet syndrome children found CBD/THC cannabis oil achieved 70.6% median seizure reduction and 63% responder rate, with significant quality of life improvement over 20 weeks.
Meta-analysis of 670 epilepsy patients found CBD-rich whole-plant extracts outperformed purified CBD (71% vs 46% improvement) at lower doses (6 vs 25 mg/kg/day) with fewer side effects, supporting the entourage effect.
Retrospective study of 108 children found artisanal CBD oil achieved >50% seizure reduction in 39%, with 10% seizure-free, 14% showing improved alertness, and minimal side effects.
CBD has proven benefit for Dravet and Lennox-Gastaut syndromes, and three other cannabinoids (CBDV, THCV, THCA) are in the epilepsy research pipeline.
Review traces the journey from anecdotal evidence to FDA approval of purified CBD (Epidiolex) for two severe childhood epilepsy syndromes, affecting the roughly one-third of epilepsy patients who are drug-resistant.
Review highlights that while CBD treats childhood epilepsy effectively, the endocannabinoid system plays critical roles in brain development, and long-term effects of modulating it in children remain unknown.
Systematic review of 36 studies confirmed CBD reduces seizures in treatment-resistant epilepsy (NNT=8 for 50% reduction), with 8.5% achieving complete seizure freedom, though serious adverse events increased.
Chemical analysis of cannabis extracts used by 41 Australian families for childhood epilepsy found wildly inconsistent cannabinoid content, with most samples low in CBD and high in THC, contrary to parents' beliefs.
Three randomized controlled trials showed CBD reduced seizures by 38-41% in severe childhood epilepsies, performing comparably to established anti-epileptic drugs with manageable side effects.
CBD and clobazam work better together through two mechanisms: CBD raises clobazam blood levels AND both drugs together directly enhance GABA receptor inhibition, providing genuine therapeutic synergy.
Epidiolex became the first CBD medication approved by a national regulator, earning FDA approval for Dravet and Lennox-Gastaut syndromes based on Phase III clinical trials.
A review found CBD shows therapeutic potential across autism, anxiety, psychosis, pain, epilepsy, and neurodegenerative diseases, with mainly diarrhea and somnolence as side effects.
Epidiolex (pure CBD) reduced severe seizures by 17-23% over placebo in children with Dravet and Lennox-Gastaut syndromes, with key drug interactions requiring careful management.
A cannabinoid and serotonin drug synergistically prevented seizures in rats when combined, though neither worked alone, revealing a novel CB1/5-HT2B anti-seizure interaction.
A review found growing evidence for cannabis-based treatments in CDKL5 Deficiency Disorder, including an open-label trial showing seizure reduction, building on proven CBD efficacy in similar severe epilepsies.
Systematic review of 23 studies finds moderate-certainty evidence that pharmaceutical CBD reduces seizure frequency by about 20% in children with drug-resistant epilepsy, with diarrhea as the main side effect.
Comprehensive review finding CBD has established efficacy for epilepsy, early clinical signals for anxiety and psychosis, and preclinical-only evidence for depression and Alzheimer's.
Comprehensive review of FDA-approved CBD for epilepsy details its efficacy in severe childhood epilepsies, complex pharmacokinetics including a 4x food effect, and important drug interaction with clobazam that may partly explain its benefits.
Lancet Neurology review finds strong RCT evidence for CBD in severe childhood epilepsies and some cannabis treatments for MS, but no demonstrated benefit for Huntington's, ADHD, or dementia.
Mouse study reveals cannabinoid receptor activation raises seizure thresholds partly by reducing hippocampal ATP and opening ATP-sensitive potassium channels, adding a new mechanism to cannabinoid anticonvulsant effects.
Oregon survey of 39 cannabis-using epilepsy patients found 87% used for seizures and 82% said it helped, but only 2 could specify their dose, highlighting the gap between self-medication and medical-grade use.
Prospective study found only 24% of children with refractory epilepsy responded to artisanal cannabis extracts, matching placebo rates from pharmaceutical CBD trials.
Review examines CBD as the first new class of antiepileptic drugs, with clinical evidence supporting its use as adjunctive treatment for Lennox-Gastaut and Dravet syndromes.
Expanded access program showed add-on CBD reduced major motor seizures by 50% at 12 weeks, sustained through 96 weeks, in patients with LGS or Dravet syndrome.
Systematic review of 35 CBD clinical studies finds effective doses from 1-50 mg/kg/day across 13 conditions, with epilepsy best supported and negative results potentially due to underdosing.
Phase II trial of CBD gelatin bead formulation (PTL-101) showed 82% seizure reduction in children with treatment-resistant epilepsy, with 56% achieving 50%+ improvement.
Review of cannabinoid-AED interactions shows enhanced seizure protection but also neurotoxicity with non-selective agonists; selective CB1 agonists may offer safer combinations.
Phase 1 trial shows CBD triples active clobazam metabolite levels, modestly increases stiripentol, and does not affect valproate, guiding dose adjustments for combination therapy.
In 29 children with severe epilepsy, purified CBD reduced seizures by 50% or more in 38% of patients, with mild side effects and no worsening in any patient.
CBD is FDA-approved for two childhood epilepsies but has significant drug interactions, liver risks with valproate, and regulatory challenges that affect patient access.
Over four years, CBD helped 27% of children with severe epilepsy (3 became seizure-free), but 81% had side effects and most discontinued.
Review of FDA-approved Epidiolex for childhood epilepsy details its seizure-reducing benefits alongside important drug interactions with clobazam and valproate.
CBD is mostly well-tolerated but can cause life-threatening reactions when combined with valproate or clobazam, commonly used in epilepsy patients who take CBD.
EEG brain network analysis distinguished CBD responders from non-responders in refractory epilepsy, with key differences in the beta frequency band.
In Dravet mice, acute low-dose THC plus CBD was anticonvulsant, but chronic combination unexpectedly increased seizure severity and mortality.
Simulations suggest CBD's seizure reduction in Lennox-Gastaut syndrome may be explained by its interaction with clobazam rather than direct anti-seizure effects.
Meta-analysis of pivotal trials found CBD has independent anti-seizure effects, though the benefit is amplified by interaction with clobazam.
A prospective study of 49 children with drug-resistant epilepsy in Argentina found 80% responded to add-on CBD therapy, with a median 66% seizure reduction and mild side effects.
A Nature Reviews Neurology article describes the expanded "endocannabinoidome" beyond CB1/CB2 and reviews its involvement in neurological diseases, noting approved therapies for MS and epilepsy and potential applications across neurodegeneration.
A review found purified CBD shows modest but significant seizure improvement in severe epilepsy, but important drug interactions, a 1-in-23 serious adverse event risk, and a wide gap between evidence and public belief complicate clinical use.
A multicenter study of 125 children found slow CBD titration achieved 38% with 50%+ seizure reduction at 6 months with better tolerability than previous faster protocols. Clobazam did not add efficacy but increased some side effects.
A meta-analysis of 4 RCTs confirmed CBD significantly reduces seizures both with and without clobazam, though the effect was somewhat larger with clobazam. Side effects like somnolence were increased with the combination.
Qualitative study found parents of children with drug-resistant epilepsy in Canada face neurologist resistance, lack of insurance coverage, and costs up to $2,000/month when accessing medical cannabis.
Systematic review of 35 studies found cannabidiol likely reduces seizure frequency in children with drug-resistant epilepsy, though it did not achieve seizure freedom more than placebo and increased GI side effects.
Systematic review of 10 studies found cannabinoids may improve behavioral symptoms, sleep, and hyperactivity in autism, while reducing seizures in those with comorbid epilepsy, though evidence on core ASD symptoms is limited.
Mouse study found CB1 receptor activation and endocannabinoid boosting raised seizure thresholds in Toxoplasma-infected mice, while CB1 blockade worsened seizure vulnerability.
Pilot study of 10 young epilepsy patients found a THC/CBD cannabis preparation was generally safe, with blood levels correlating to dose, supporting the feasibility of therapeutic drug monitoring.
Mouse study found CBD's anti-seizure effects were abolished in mice lacking the TRPV1 receptor, strongly implicating this receptor in CBD's mechanism of action against seizures.
First Korean study of CBD for childhood epilepsy found about one-third of Lennox-Gastaut and Dravet syndrome patients achieved 50%+ seizure reduction at 3 months, with mostly mild side effects.
Meta-analysis of 3 RCTs (359 patients) found CBD increased 50% seizure reduction by 69% in Dravet syndrome, with notable side effects including somnolence and liver enzyme changes.
Meta-analysis of 4 RCTs (714 patients) showed CBD reduced seizures in Dravet and Lennox-Gastaut syndrome regardless of whether patients were also taking clobazam.
Review of pharmaceutical CBD for epilepsy synthesized 4 pivotal RCTs showing significant seizure reduction in DS and LGS, with important drug interactions via CYP2C19.
Georgia expanded access program found sustained seizure reduction over 36 months in 45 children with treatment-resistant epilepsy on CBD, with adverse events decreasing over time.
Researchers discovered CBD inhibits methionine synthesis through one-carbon metabolism, a new mechanism validated in Dravet syndrome mouse and rat seizure models.
In 3 infants with rare KCNT1 epilepsy, CBD showed limited benefit: 2 had no response, 1 had reduced seizure intensity and possible developmental progress.
A 15-year-old with autism showed unexpected improvements in core social deficits, anxiety, and sleep on low-dose CBD extract originally prescribed for epilepsy.
A 9-year-old with Lennox-Gastaut syndrome achieved complete seizure control and dramatic EEG normalization on CBD, an improvement not previously described.
Case report of lithium toxicity developing weeks after adding CBD, revealing a previously unknown drug interaction in a patient who subsequently became seizure-free on CBD alone.
Survey of 451 healthcare professionals found over 80% support medical cannabis but 40-50% lack knowledge of cannabinoid pharmacology and clinical applications.
A randomized trial found that abruptly stopping 1,500 mg/day CBD after four weeks produced virtually no withdrawal symptoms in healthy volunteers.
An open-label study of 38 children with treatment-resistant epilepsy found no cognitive decline after one year of add-on CBD treatment, with some trends toward improvement.
Implantable polymer microdepots provided sustained release of full-spectrum cannabis extract for 14+ days in mice, reducing seizure incidence by 40% and improving survival by 50% compared to a single injection.
A CB2 inverse agonist given after prolonged seizures were stopped prevented brain inflammation, reduced neuronal death, and improved behavior in mice, suggesting a potential post-seizure neuroprotective therapy.
Cannabinoids stopped cocaine-induced seizures in mice by restoring glycine receptor function, working independently of CB1 and CB2 receptors through a novel molecular mechanism.
CBGA showed anticonvulsant effects in Dravet syndrome mice and potentiated clobazam, but was proconvulsant in another seizure model and at high doses, revealing a complex therapeutic profile.
CBD's proven success treating severe epilepsy has opened the door to investigating its potential for depression, anxiety, PTSD, addiction, and autism. Preclinical and early clinical data show promise across multiple neuropsychiatric conditions.
Eight infants with treatment-resistant West syndrome received CBD-enriched cannabis oil. Four achieved more than 50% seizure reduction, with EEG improvements in seven of eight. Side effects were mild and temporary.
Case series of six children in Italian palliative care found medical cannabis reduced seizure frequency and pain over one year with only mild, transient side effects.
Systematic review of 12 economic evaluations found medicinal cannabis may be cost-effective for MS spasticity and Dravet syndrome, but results varied widely by product, indication, and setting.
CBD is approved for three epilepsy syndromes based on multiple RCTs, but its interaction with clobazam (boosting active metabolite levels) makes it difficult to isolate CBD's independent antiseizure contribution.
Mouse study found the omega-3 endocannabinoid DHEA was more potent than DHA in raising seizure thresholds, acting through CB1 receptors, while the EPA-derived EPEA had no effect.
Interviews with 10 parents revealed families pursued medical cannabis for children with cancer or epilepsy out of desperation, relying on social media and peers rather than healthcare providers for information.
Review of 30 studies found CBD interacts with at least 15 anti-seizure medications through pharmacokinetic mechanisms and 3 through pharmacodynamic mechanisms, primarily via the cytochrome P450 system.
Stabilized CBDa hemp extracts showed seizure protection comparable to CBD in rats, with the multi-cannabinoid extract outperforming purified CBDa, supporting the entourage effect.
Meta-analysis of 714 patients across 4 RCTs found CBD reduced seizures by about 30% in Dravet and Lennox-Gastaut syndromes, with 37-44% reduction when combined with clobazam.
Italian expanded access program found purified CBD achieved 50%+ seizure reduction in 40% of 82 patients with highly treatment-resistant Dravet or Lennox-Gastaut syndrome who had failed a median of 8 prior drugs.
Prospective study of 35 children with drug-resistant epilepsy found CBD cut abnormal brain discharges nearly in half and improved sleep microstructure in 85% of those with initial sleep abnormalities.
Systematic review of 42 studies found purified CBD effective for epilepsy beyond its approved indications, with preliminary evidence for CDKL5, Dup15q, Doose, and other rare syndromes.
Real-world study of 18 adults with Dravet syndrome found CBD reduced seizures by over 30% in 17.6%, but adverse effects were universal and led to discontinuation in some patients.
Study of 418 epilepsy patients found artisanal CBD users reported better quality of life, fewer psychiatric symptoms, and reduced healthcare utilization compared to non-users, though seizure control was similar.
Landmark RCT of 224 patients found CBD significantly reduced TSC-associated seizures by about 49%, with the lower dose (25 mg/kg/day) as effective as the higher dose but with fewer side effects.
Prospective study of 92 epilepsy patients found 25% developed tolerance to CBD-enriched oil after a mean of 7.3 months, though 54% achieved meaningful seizure reduction overall.
Danish study of 78 children with severe epilepsy found CBD reduced seizures by 50%+ in 31% at 3 months, with Dravet/Lennox-Gastaut patients responding best (70%). Response declined to 20% at 24 months.
A review of CBD science following Malawi's cannabis legalization highlights epilepsy treatment, neuroprotective potential, and a novel proposal for malaria-related brain injury.
A meta-analysis of 152 RCTs found CBD has high-grade evidence for epilepsy, while dronabinol and nabiximols show moderate evidence for pain, spasticity, and other conditions.
A 20-month study of 59 children with drug-resistant epilepsy found CBD-enriched cannabis reduced seizures by 71% on average, with 12% achieving seizure freedom.
Pharmaceutical CBD achieved 2.4x higher blood levels than artisanal CBD in children with epilepsy, with more side effects but a trend toward better seizure control.
After 30 years of research, only two formal medical cannabis indications are supported by evidence: CBD for rare childhood epilepsy and CBD/THC for MS spasticity.
CBD reduced seizures by 50%+ in 27% of 41 children with severe epilepsy, but quality of life and adaptive behavior did not improve over six months.
Standardized CBD oil reduced seizures by 50%+ in 73% of treatment-resistant epilepsy patients and achieved seizure freedom in 19% over 40 months, with few side effects.
Epidiolex (pharmaceutical CBD) is the only cannabis-derived drug with FDA and EMA approval for epilepsy, specifically proven for Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex.
Critical review of 69 articles confirmed CBD is effective for Lennox-Gastaut, Dravet, and tuberous sclerosis complex seizures in children, with a good safety profile despite frequent mild side effects.
In epileptic rats, THC doubled seizure activity while CBD halved it — and smoked high-THC cannabis increased seizures too, highlighting the importance of cannabinoid ratios.
Meta-analysis of 6 trials with 1,034 patients confirmed CBD reduces seizure frequency by 33% in Dravet syndrome, Lennox-Gastaut, and tuberous sclerosis complex.
Retrospective study of 114 children with drug-resistant epilepsy found 73% improved with CBD-enriched oil, with 59% achieving over 50% seizure reduction over at least one year.
Spanish expanded access program of 102 patients found CBD reduced seizures by 48%, with 45% achieving over 50% reduction at 6 months in highly refractory epilepsy.
In adolescent rats, synthetic cannabinoid WIN 55,212-2 prevented medium-severity convulsions in both sexes and increased hippocampal CaMKII signaling.
Real-world European data showed plant-derived CBD without clobazam reduced seizures by 50%+ in 30% of LGS patients at 12 months, with 63% still taking it at one year.
An open-label study found CBD-rich cannabis oil reduced seizures from 11 to 2.5 per month in adults with drug-resistant focal epilepsy, with 80% achieving 50%+ reduction.
Only 9 RCTs exist for CBD across all neurodevelopmental disorders, with inconsistent results.
Phase 3 analysis found CBD did not worsen safety or effectiveness of diazepam nasal spray for seizure clusters, with purified CBD patients showing the lowest drug-attributed adverse event rates.
Review of CBD (Epidiolex) clinical evidence shows efficacy for seizures in Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex, with unresolved dosing and interaction challenges.
Study revealed CBD prevents seizures by blocking a lipid (LPI) that simultaneously boosts excitatory and weakens inhibitory signaling in the hippocampus through GPR55 receptors.
Meta-analysis of 6 RCTs confirms CBD (Epidiolex) significantly reduces seizures in Dravet, Lennox-Gastaut, and tuberous sclerosis complex, with notable side effects.
Real-world study found prescribed CBD reduced seizures in a substantial proportion of epilepsy patients over 12 months with mostly mild side effects.
Review of 10 clinical trials confirms CBD reduces seizures in pediatric Dravet syndrome with manageable side effects and notable clobazam interactions.
Survey of 498 caregivers found CBD improved seizures in 85% of severe epilepsy patients, plus alertness, cognition, and emotional functioning even in some without seizure improvement.
Real-world study of 91 adults found CBD showed similar effectiveness for drug-resistant epilepsy whether used for approved conditions or off-label, with clobazam co-prescription strongly predicting who responded.
Comprehensive review maps cannabinoid drug interactions across epilepsy, cancer, MS, and pain — CYP450 inhibition by CBD and THC can significantly alter blood levels of co-administered medications.
JAMA Pediatrics meta-analysis of 23 RCTs with 3,612 young patients found medical cannabinoids associated with 3x more treatment withdrawals, 5.7x higher liver enzyme elevations, and 2.3x more drowsiness versus placebo.
A woman with a rare genetic epilepsy experienced major improvements in seizures, sleep, mood, language, and motor skills after starting off-label CBD treatment.
While CBD works for several genetic epilepsies, evidence for CDKL5 Deficiency Disorder remains largely anecdotal.
Pharmaceutical CBD helped about 25-29% of adults with various drug-resistant epilepsies in French epilepsy centers, with no difference in response between epilepsy types.
Purified CBD as add-on therapy achieved >50% spasm reduction in 68% of 28 infants with treatment-resistant epileptic spasms, with particularly strong responses in Down syndrome patients.
Five of 6 patients with drug-resistant epilepsy from rare GPI-anchored protein deficiencies achieved >=50% seizure reduction with add-on CBD over a median 27-month treatment period.
Dutch economic analysis found pharmaceutical CBD is cost-effective for Lennox-Gastaut syndrome (21,493 euros/QALY) and cost-saving for Dravet syndrome, supporting reimbursement decisions.
Multicenter Israeli study found purified CBD reduced seizures in 92% of 139 children with drug-resistant epilepsy, with 41% achieving >50% reduction and prior CBD oil response predicting success.
Expert panel developed practical consensus guidelines for optimizing Epidiolex dosing in rare epilepsies, emphasizing individualized titration, drug interaction management, and distinguishing from non-approved CBD products.
Chronic nicotine pouch exposure worsened seizures and brain inflammation in mice, but inhaled CBD reversed these effects by restoring brain waste clearance and reducing inflammatory markers.
Retrospective study of 15 children with drug-resistant epilepsy found CBD reduced seizures in 11 (2 seizure-free), with improved social participation and a good safety profile, including off-label use.
Five-year monitoring of 38 children on pharmaceutical CBD found zero detectable THC in blood at any timepoint, with CBD levels rising predictably with dose.
Multicenter study of 266 patients with 77 different genetic epilepsies found nearly half achieved 50%+ seizure reduction with CBD, with comparable effectiveness between approved and off-label uses.
Mouse study found CBD dampens seizure-like hippocampal activity spread by boosting fast-acting inhibitory PV interneurons through GPR55 receptor signaling.
Prospective study of 103 children with drug-resistant epilepsy found over half responded to CBD, with sustained seizure and non-seizure benefits and 55% retention at 18 months.
Parents are increasingly giving children unregulated CBD products despite FDA approval only for specific epilepsy — with concerns about product quality, drug interactions, and absent pediatric evidence.
Among 63,713 insured epilepsy patients, 1.1% had cannabis use disorder. Young adults 18-24 were at 5x the risk.
Nanoemulsion-delivered CBD, THC, and their combinations reduced seizures and brain oxidative stress in mice, with low-dose combinations matching the anticonvulsant drug valproic acid in delaying seizure progression.
Two patients with life-threatening status epilepticus that failed standard treatments achieved seizure resolution after adding highly purified CBD via nasogastric tube, with continued benefit at 6 months and no adverse events.
A UK early access program found pharmaceutical CBD reduced motor seizures by a median 60% at 12 months in 26 children with Lennox-Gastaut or Dravet syndrome, with 67% achieving at least 50% improvement.
Among 50 children with drug-resistant epilepsy treated with CBD for at least six months, 56% had meaningful seizure reduction and 16% became seizure-free.
Researchers created CBD-like molecules from spearmint compounds that showed stronger anti-seizure effects than natural CBD in mouse models of epilepsy.
Off-label CBD treatment across 108 patients with various refractory epilepsies achieved 38.9% responder rate at three months, with tolerability similar to approved indications.
Zebrafish epilepsy model found cannabis extracts matched pure CBD for seizure reduction despite containing much less CBD, supporting an entourage effect.
About 30% of epilepsy patients resist standard drugs—and the evidence for CBD and THC as anticonvulsants keeps growing, though access remains limited.
Analysis of 130 cannabinoid-related seizure reports found 68% of individuals had pre-existing risk factors, with drug interactions the most common contributor.
A Thai multicenter study found CBD-enriched oil reduced seizures in children who had failed an average of 7 medications, with benefits sustained over 12+ months and mostly mild side effects.
CBD reduced seizures and brain damage in rats with post-traumatic epilepsy by targeting the TRPV1 channel, suggesting a potential preventive treatment for epilepsy after brain injury.
A novel drug delivery technology dramatically improved CBD absorption and brain levels in rats, showing anti-seizure effects at potentially lower doses than Epidiolex.
Review maps endocannabinoid system dysregulation in childhood epilepsy and outlines emerging treatment strategies beyond CBD, including allosteric modulators and enzyme inhibitors.
A practical clinical guide to prescribing pharmaceutical CBD for drug-resistant epilepsy—covering dosing strategies, drug interactions, and the 'start low, go slow' approach.
Long-term study found CBD reduced seizures by 45-87% through nearly 3 years in 140 patients with treatment-resistant focal epilepsies, regardless of epilepsy type.
Survey of 243 caregivers found CBD with clobazam improved seizures (87%), cognition (84%), and communication (76-81%) in patients with severe epilepsy.
In 107 patients with severe epilepsy syndromes, 69% achieved at least 50% seizure reduction with CBD—with genetic causes and LGS/TSC showing the best outcomes.
CBD fights seizures through multiple mechanisms including neuroinflammation reduction, modulation of several receptor systems, and oxidative stress reduction.
Neonatal rat study found CBD significantly enhanced phenobarbital's antiseizure effects, supporting potential combination therapy for newborn seizures.
Multicenter study of 551 children found purified CBD reduced seizures by 50%+ in half of patients with drug-resistant epilepsy, with 14% becoming seizure-free and benefits sustained over 2+ years.
First reported case of status epilepticus in a toddler from confirmed cannabis edible ingestion, requiring intubation and five-day hospitalization before full neurologic recovery.
A systematic review of 14 studies (682 children) found that pharmaceutical CBD achieved clinically meaningful seizure reduction in children with severe, treatment-resistant epilepsies, with mostly mild and reversible side effects.
Review of CBD for drug-resistant childhood epilepsy documents regulatory approval in the US, Europe, and India for Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex, with evidence of seizure reduction and generally favorable safety.
Survey of 126 Australian epilepsy patients and caregivers found nearly half used illicit cannabis despite legal options, with cost (69%) and THC driving restrictions as primary barriers to legal access.
Study reveals CBD's anticonvulsant mechanism works through enhancing DEC2's suppression of the SCN2A sodium channel, reducing neuronal excitability and seizure susceptibility in laboratory models.
Post hoc analysis of two phase 3 CBD trials found that a 31% reduction in drop seizures, not the traditional 50%, was the threshold for caregiver-perceived meaningful improvement in Lennox-Gastaut syndrome.
German multicenter chart review of 202 epilepsy patients found adjunctive CBD achieved 43-44% responder rates at 3 and 12 months, with seizure days dropping from 30 to 18 per month and 67% remaining on treatment at 1 year.
German real-world study of 126 patients found CBD plus clobazam achieved 48% seizure response at 3 months for LGS/DS, with 63% tonic-clonic response and 70% treatment retention at 1 year.
A review of 142 pediatric medical cannabis patients found 73% parent satisfaction, with epilepsy patients showing the most measurable benefit (34% seizure reduction >50%).
CBD reduced seizures and extended survival in mice with a rare childhood epilepsy (DEE1), working through anti-inflammatory pathways and ion channel modulation.
CBD (Epidiolex) reduced seizures in 67% of 27 patients with Rett syndrome or CDKL5 deficiency, with caregivers reporting improvements in attention, sleep, and motor function over 14 months.
A global ILAE survey of 86 countries found that even where CBD is approved for epilepsy, most countries report it unaffordable (72%) and hard to access (56%), while unregulated products fill the gap worldwide.
Cannabis-like compounds magnolol and amorfrutin 2 from non-cannabis plants show antiseizure effects in Dravet and Lennox-Gastaut mouse models through T-type calcium channel inhibition.
Review detailing how the endocannabinoid system regulates both neuronal excitability and neuroinflammation in epilepsy, highlighting dual therapeutic mechanisms.
Review of cannabinoid therapies for rare and less-common disorders including unusual epilepsies, movement disorders, and skin diseases, with focus on advanced drug delivery strategies.
Systematic review of 57 studies and 971 patients found prescription CBD (Epidiolex) reduced seizures across 37 different rare epilepsy types beyond its three approved conditions, with some patients achieving seizure freedom.
Computational study modeled CBD's interactions with five brain receptor types involved in seizures, finding multi-target binding that may explain its broad anti-epileptic activity.
A study of 53 children found that CBD (Epidyolex) reduced drug-resistant epileptic spasms by ≥50% in nearly 60% of patients, with the best results in children with Down syndrome and cortical malformations.
A rigorous crossover trial found CBD had no effect on brain excitability or sedation at either low or high doses, suggesting its anti-epileptic benefits may come from drug interactions rather than direct activity.
Epilepsy monitoring unit data shows cannabis users have shorter stays and higher event capture rates, but significantly more depression, anxiety, and abuse histories than non-users.
LGS diagnoses in the US jumped ~60% after the 2018 FDA approval of CBD for the condition, then returned to baseline, suggesting treatment availability may have influenced diagnostic practices.
Review mapped how cannabinoids interfere with drug metabolism through CYP450 enzymes, potentially altering effectiveness of antidepressants, blood thinners, opioids, and more.
Review found hemp-derived compounds from seeds, leaves, and flowers show neuroprotective potential across epilepsy, Alzheimer's, Parkinson's, and MS — mostly in preclinical studies.
Study finds cannabis and linden tree extracts together produce synergistic neuroprotection, fully restoring cell viability and shifting brain immune cells to anti-inflammatory states.
Retrospective study of 29 pediatric patients with intractable epilepsy found CBD therapy had 86%+ retention at 2 years, with nearly 80% achieving at least 50% seizure reduction across diverse genetic and non-genetic causes.
Combining CBD with the non-psychoactive cannabinoid CBG cut the anti-seizure CBD dose by over 50% in mice — the first detailed dose-response data for this combination.
Phase 3 RCT in The Lancet: CBD reduced Lennox-Gastaut drop seizures by 43.9% vs 21.8% placebo (p=0.0135). The second RCT that led to Epidiolex becoming the first FDA-approved cannabis drug.
The first CBD epilepsy trial (1980): 10% of CBD patients still seizing vs 90% placebo. Published by Carlini and Mechoulam, ignored for 40 years, vindicated by Epidiolex trials in 2017-2018.
Small dose-ranging trial (34 Dravet patients, ages 4-10) that identified the CBD-clobazam interaction explaining somnolence, confirmed the CBD-valproate liver signal, and showed dose-proportional pharmacokinetics.
NEJM RCT: CBD reduced seizures 39% vs 13% placebo in Dravet syndrome. Led to Epidiolex FDA approval — first cannabis-derived drug.