Can CBD Help with Tough Cases of Epilepsy? Here’s What the Science Says

Epilepsy can profoundly impact the lives of those diagnosed, especially when standard treatments fail to control seizures effectively. Approximately 20% of epilepsy patients suffer from what's known as pharmacoresistant epilepsy, meaning their seizures go on despite using (sometimes multiple) anti-seizure medications. For these patients, as well as their families, exploring alternative options and additions to support their current treatment regime becomes crucial. One natural supplement increasingly studied by researchers for its potential benefits in epilepsy treatment (especially rare forms like Dravet syndrome and Lennox-Gastaut syndrome) is CBD - short for cannabidiol - a natural extract from the hemp or cannabis plant. 

Understanding Pharmacoresistant Epilepsy

Epilepsy is a chronic neurological condition characterized by seizures that are caused by unusual electrical activity in the brain. These Seizures can vary widely, from brief, barely noticeable episodes to prolonged convulsions that significantly impact the daily life of those affected. While most people with epilepsy manage their condition effectively with conventional treatments, a substantial minority continues to experience frequent, uncontrolled seizures, significantly impacting their overall well-being and quality of life. This persistent form is called "pharmacoresistant epilepsy".

What Makes Epilepsy Resistant to Medication?

Doctors refer to epilepsy as pharmacoresistant when the seizures do not respond sufficiently to treatment with at least two different appropriately chosen anti-seizure medications at high enough doses. The reasons behind this pharmacoresistance are complex and may include genetic factors, differences in drug metabolism, or structural differences in the brain of those affected. Unfortunately, this persistence of seizures not only affects the patient's physical health - but it can also lead to psychological distress, decreased independence, and an overall reduction in quality of life.

CBD Explained: What Exactly is Cannabidiol?

Cannabidiol - more commonly known as CBD - is one of over 100 compounds called cannabinoids, or phytocannabinoids, found in the cannabis plant. Unlike its more famous counterpart THC (tetrahydrocannabinol), CBD does not produce delirious effects or a "high". Instead, CBD may help through its calming properties and potential therapeutic effects, which researchers are nowadays exploring in various health conditions. This includes anxiety, pain management - and epilepsy!

How Do CBD and Cannabis Work in Epilepsy?

CBD and other cannabis-based products interact with the body's endocannabinoid system (ECS). The ECS is a complex network of receptors involved in regulating various bodily processes, including mood, pain perception, and neurological functions. In the case of epilepsy, more research is needed to uncover CBD's precise mechanism. Still, research results so far suggest it may influence neuronal activity and reduce excitability in brain cells, which might explain why it's potentially lowering seizure frequency.

What Recent Studies Tell Us About Cannabis Products to Treat Epilepsy

A comprehensive scientific review in 2025, known as a meta-analysis, has combined data from multiple high-quality clinical trials examining CBD's effectiveness, particularly in pharmacoresistant epilepsy. The results provide strong evidence that CBD may significantly help reduce seizure frequency:

• Significant seizure reduction: On average, patients treated with CBD experienced a roughly 41% reduction in seizures compared to only an 18% reduction in placebo groups.

• Improved seizure control: Several patients saw remarkable improvements, with some even achieving complete seizure freedom during the study periods.

Use of CBD: Dosage Matters

The studies analyzed compared various doses of CBD, typically focusing on 10 mg/kg/day and 20 mg/kg/day (note: these doses are significantly higher than common recreational doses and should only be applied under medical supervision). The higher doses occasionally led to better seizure control, but results varied significantly:

• Higher doses: While potentially more effective, the higher doses often resulted in increased side effects, including fatigue, decreased appetite, and gastrointestinal discomfort.

• Lower doses: Many patients benefited substantially even at lower doses, highlighting the importance of individualized treatment and careful dose management under medical supervision.

Potential Side Effects and Safety Considerations for CBD Products

CBD is generally considered safe and effective but can cause some side effects, especially at higher doses or when used alongside other medications. These include:

• Somnolence (sleepiness): Around 25% of patients reported feeling excessively sleepy.

• Reduced appetite: Approximately 20% experienced decreased hunger or changes in appetite.

• Digestive issues: Some patients reported mild diarrhea or gastrointestinal discomfort.

Liver health is another important consideration, as really high doses of CBD used to treat seizures can impact liver enzymes involved in metabolising various medications. A regular monitoring of liver function is recommended, particularly during the initial months of CBD treatment for epilepsy.

It's important to note that while clinical trials offer valuable insights, personal experiences with CBD can vary widely. For some, it has brought substantial improvements in seizure control and quality of life, while others experienced less noticeable effects. This variability emphasises how important it is to have personalised medical guidance when considering CBD for epilepsy treatment.

Accessibility of Cannabis-based Medicines for Epilepsy

Access to CBD varies significantly depending on regional laws and healthcare systems. For example, in many countries, CBD products are widely available as supplements and wellness products. However, medical-grade CBD specifically formulated for epilepsy treatment - like Epidyolex - may require prescriptions and professional oversight. It might also not be covered through public health insurance, complicating access for many patients. This highlights the ongoing need for policy discussions and improved accessibility to ensure that those who might benefit from CBD can reliably access it.

What Should Patients and Families Consider?

If you or a family member has pharmacoresistant epilepsy, considering CBD might offer hope. However, several key points should guide your decision:

• Medical supervision: Always discuss with your healthcare provider before starting CBD, especially when taking other epilepsy medications.

• Quality of products: Ensure you choose high-quality, lab-tested CBD products to guarantee safety and effectiveness.

• Monitoring and adjustment: Regular medical follow-ups and careful dose adjustments are crucial to safely and effectively using CBD epilepsy medicines.
  
  

Final Thoughts: Hope with Caution

Despite promising results, further research remains essential to fully understand the long-term efficacy and safety of CBD and other cannabis-based medicinal products in the treatment of epilepsy. Key questions researchers continue to explore include optimal dosing, long-term effects, potential interactions with other medications, and predicting who might benefit most from CBD treatment.

All things considered, CBD represents an encouraging potential treatment option for patients with pharmacoresistant epilepsy, that could improve seizure control and enhance quality of life. While the science is promising, it also highlights the importance of a careful, informed approach - always prioritising safety, quality, and professional guidance.

Curious to learn more? Reach out with any questions - our team is here to help!

Sources

[1] Oliveira, Vinícius & Almeida, Natália & Radmann, Guilherme & Santos, Bruno Fernandes. (2025). The efficacy of cannabidiol for seizures reduction in pharmacoresistant epilepsy: a systematic review and meta-analysis. Acta Epileptologica. 7. 10.1186/s42494-024-00191-2.