CBD Oil (Cannabidiol)
Specifically for Epilepsy
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Why it works for Epilepsy:
How it works (best current understanding): CBD doesn’t act like typical anti-seizure drugs and it doesn’t meaningfully activate CB1 “cannabis” receptors. Converging preclinical and translational data suggest a multimodal mechanism that reduces neuronal hyperexcitability via:
- Antagonism of GPR55 (a GPCR that modulates intracellular calcium),
- Desensitization of TRPV1 channels, and
- Increasing extracellular adenosine by inhibiting adenosine reuptake (ENT1) → more inhibitory A1 receptor signaling. epilepsybehavior.com
Major reviews (WHO; Epilepsy & Behavior; Lancet Neurology) reach similar conclusions: precise human mechanism isn’t fully nailed down, but is distinct from other ASMs and consistent with the clinical anti-seizure effect. WHO CDN
How to use for Epilepsy:
Who it’s for (on-label): adjunctive treatment of seizures in Dravet syndrome (DS), Lennox–Gastaut syndrome (LGS), and tuberous sclerosis complex (TSC) (age ≥1 year). (In Australia: EPIDYOLEX is registered on the ARTG.) FDA Access Data
Formulation & strength: Oral solution, 100 mg/mL. Use the provided 1 mL or 5 mL oral syringes (no kitchen spoons). Discard any remaining solution 12 weeks after first opening. FDA Access Data
Dosing (by body weight):
- LGS or DS: start 2.5 mg/kg twice daily (total 5 mg/kg/day) × 1 week → increase to 5 mg/kg twice daily (10 mg/kg/day). If needed/tolerated, you may increase weekly to 10 mg/kg twice daily (20 mg/kg/day). FDA Access Data
- TSC: start 2.5 mg/kg twice daily → increase weekly to 12.5 mg/kg twice daily (25 mg/kg/day) as tolerated. FDA Access Data
- Hepatic impairment: lower starting/maintenance doses are recommended; see label table. FDA Access Data
Administration tips:
- Take consistently with or without food (meals alter exposure; consistency reduces variability). FDA Access Data
- If stopping, taper to avoid seizure worsening/status epilepticus. FDA Access Data
Monitoring:
- Check ALT/AST & bilirubin at baseline, then at 1, 3, and 6 months, and periodically thereafter, and within 1 month after changing dose or adding interacting meds. Monitor more closely if on valproate or if baseline LFTs are elevated. FDA Access Data
Guideline/context links:
- FDA Full Prescribing Information (US) – dosing/monitoring, interactions, clinical trials. FDA Access Data
- EU SmPC (EPIDYOLEX) – similar dosing; maximum 25 mg/kg/day where indicated. pp.jazzpharma.com
- Australia: ARTG entry & TGA guidance; consumer and clinician resources. Therapeutic Goods Administration (TGA)
Scientific Evidence for Epilepsy:
Randomized, double-blind, placebo-controlled trials (pivotal):
- Dravet syndrome (NEJM 2017): CBD 20 mg/kg/day reduced median convulsive-seizure frequency ~39% vs ~13% with placebo. New England Journal of Medicine
- Lennox–Gastaut (NEJM 2018): CBD (10 or 20 mg/kg/day) cut drop seizures ~37–42% vs ~17% with placebo; responder rates significantly higher. New England Journal of Medicine
- Tuberous sclerosis complex (JAMA Neurology 2020): CBD 25 or 50 mg/kg/day (25 mg/kg/day is the approved maintenance) reduced seizures vs placebo; safety favored 25 mg/kg/day. ORCA
Specific Warnings for Epilepsy:
Common adverse effects: Somnolence/sedation, decreased appetite/weight loss, diarrhea, vomiting, fatigue/pyrexia—generally dose-related and more frequent at 20–25 mg/kg/day. FDA Access Data
Liver risk (important): CBD can cause dose-related ALT/AST elevations, especially with valproate (and to a lesser extent clobazam). Follow the LFT schedule above; interrupt or stop per label thresholds (e.g., ALT/AST >3×ULN with bilirubin >2×ULN). FDA Access Data
Drug interactions to know:
- Clobazam: CBD raises N-desmethylclobazam (~3-fold) via CYP2C19 inhibition → more sedation; often requires clobazam dose reduction. FDA Access Data
- Valproate: Higher risk of transaminase elevations (and occasional hyperammonemia/thrombocytopenia) when combined; monitor closely. FDA Access Data
- Enzyme inducers (e.g., rifampin) lower CBD levels; strong CYP3A4/2C19 inhibitors/inducers can alter exposure. FDA Access Data
- Other CNS depressants (including alcohol): additive sedation—avoid driving/machinery until you know your response. FDA Access Data
- Everolimus (TSC): CBD can ~2.5× increase everolimus exposure; therapeutic drug monitoring may be needed. FDA Access Data
Pregnancy/lactation: Data remain limited; discuss risks/benefits with a specialist and register with pregnancy exposure registries where available. (See label Section 8.*.) FDA Access Data
Suicidality warning (class for ASMs): Monitor mood/behavioral changes. FDA Access Data
Product quality (why not “CBD oils” from shops): Multiple surveys show mislabeling of CBD content and potential contaminants/THC in over-the-counter products; the FDA has issued numerous warning letters. If you’re treating epilepsy, use the regulated prescription product. Johns Hopkins Medicine
General Information (All Ailments)
What It Is
CBD oil, short for Cannabidiol oil, is a natural extract derived from the Cannabis sativa plant. Unlike THC (tetrahydrocannabinol) — the psychoactive compound responsible for the “high” associated with marijuana — CBD is non-intoxicating. This means it does not produce euphoria or alter perception.
CBD oil is typically produced by extracting CBD from the hemp variety of cannabis, which is naturally low in THC. The extract is then diluted with a carrier oil, such as coconut oil (MCT oil) or hemp seed oil, to improve bioavailability and ease of use.
CBD products come in various forms, including:
- Oils and tinctures (taken under the tongue)
- Capsules and soft gels
- Edibles (like gummies)
- Topical creams and balms
- Vape liquids
How It Works
CBD interacts with the body through the endocannabinoid system (ECS) — a complex network of receptors, enzymes, and signaling molecules that help maintain homeostasis, or internal balance.
The ECS regulates many vital functions, such as:
- Pain perception
- Mood and stress response
- Sleep cycles
- Immune system activity
- Appetite and metabolism
CBD primarily influences two types of receptors:
- CB1 receptors, located mostly in the brain and central nervous system.
- CB2 receptors, found mainly in immune cells and peripheral tissues.
Instead of directly binding to these receptors (as THC does), CBD modulates them, enhancing or inhibiting their activity indirectly. Additionally, CBD affects serotonin (5-HT1A) receptors, vanilloid (TRPV1) receptors, and GABA signaling — all of which contribute to its potential effects on anxiety, pain, and inflammation.
CBD also helps prevent the breakdown of anandamide, a naturally occurring endocannabinoid often called the “bliss molecule.” This prolongs its calming and mood-stabilizing effects in the body.
Why It’s Important
CBD oil has gained significant attention due to its therapeutic potential across a wide range of conditions — without the intoxicating effects of THC. Although research is still evolving, studies and anecdotal evidence suggest that CBD may:
- Reduce anxiety and stress: By interacting with serotonin receptors, CBD can help promote calmness and emotional balance.
- Alleviate pain and inflammation: CBD may support chronic pain management (such as arthritis, neuropathic pain, or muscle soreness) by influencing inflammatory pathways.
- Improve sleep quality: Many users report better sleep, likely due to reduced anxiety and pain.
- Support neurological health: CBD is being studied for conditions such as epilepsy, multiple sclerosis, and Parkinson’s disease. In fact, Epidiolex, a prescription form of CBD, is FDA-approved for certain severe forms of epilepsy.
- Promote skin health: Its anti-inflammatory and antioxidant properties make it a common ingredient in skincare formulations.
The importance of CBD oil lies in its potential as a natural, low-risk therapeutic option for people seeking alternatives to pharmaceutical drugs for managing pain, anxiety, or sleep disturbances.
Considerations
Despite its popularity and promising effects, CBD oil is not a one-size-fits-all solution. Important factors to consider include:
- Legal Status: The legality of CBD varies by country and even by state. In many regions, hemp-derived CBD (with less than 0.3% THC) is legal, while cannabis-derived CBD may not be. Always verify local laws before purchasing or using CBD products.
- Quality and Purity: Because the CBD market is largely unregulated, product quality varies widely. It’s essential to choose products that provide third-party lab testing results verifying CBD content, purity, and absence of contaminants like pesticides or heavy metals.
- Dosage and Individual Response: The effective dosage depends on factors such as body weight, metabolism, and the condition being treated. Starting with a low dose and gradually increasing is generally recommended.
- Possible Side Effects: While CBD is generally well-tolerated, some users experience mild side effects like dry mouth, dizziness, drowsiness, or changes in appetite.
- Drug Interactions: CBD can affect how the liver metabolizes certain medications (via the cytochrome P450 enzyme system). Those taking prescription drugs should consult a healthcare professional before use.
- Product Type and Administration: The method of consumption affects absorption rate and duration. For example, tinctures act faster than edibles, while topical products target localized areas.
Helps with these conditions
CBD Oil (Cannabidiol) is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Anxiety
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Insomnia
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Arthritis
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Nerve Pain (Neuropathy)
Multitarget actions relevant to neuropathic pain. CBD has low direct affinity for CB1/CB2 but modulates them allosterically and, more importantly for...
Epilepsy
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Helps With These Conditions
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