Yes, CBD is used for seizures in one prescription form: Epidiolex, a purified CBD oral solution the FDA approved for seizures linked to Lennox-Gastaut syndrome, Dravet syndrome or tuberous sclerosis complex. Check the age range on the current FDA label. If you already take a seizure medicine, the rules that matter most are the monitoring in the prescribing information and your neurologist’s plan. Use this page as a starting point, and have a pharmacist check your exact medicines and labels before you decide anything.
Is CBD used for seizures?
Practical Neurology describes Epidiolex as the first FDA-approved CBD-based medication for epilepsy. Trials behind it are the strongest research. A 2018 Practical Neurology review reports that pharmaceutical-grade CBD reduced convulsive seizures compared with placebo in Dravet syndrome. Great Ormond Street Hospital reports seizures fell by nearly 40 per cent in children with Dravet syndrome compared with a dummy drug.
Those trials used one standardised pharmaceutical product. GOSH says the trials used the specific formulation pharmaceutically prepared, and that there is no evidence of benefit or risk for cannabis or hemp oils available for purchase. Retail CBD oils, gummies and capsules are not the same product as the trial medicine.
What is the prescribing information for Epidiolex?
The prescribing information is the FDA label. The copy cited by the 2018 Practical Neurology review is the 2018 Epidiolex package insert on the FDA site. Labels are updated, so check the current version on the FDA website or ask your pharmacist which version matches your prescription.
Which monitoring and label instructions apply?
The monitoring the 2018 review describes for pharmaceutical CBD is liver testing. It says the package insert recommends liver tests at months 1, 3 and 6 after starting, or monthly after dose changes or after adding another anti-seizure medicine that interacts with CBD. Your neurologist sets your own schedule.
| Item | What the source says | Source |
|---|---|---|
| Liver tests | Recommended at months 1, 3 and 6 after starting, then monthly after dose changes or after adding an interacting anti-seizure medicine | Practical Neurology 2018 review, citing the Epidiolex package insert |
| Valproate and clobazam | Liver risk appears more common with valproic acid products or clobazam, though elevated liver tests have also occurred without them | Practical Neurology 2018 review |
| Topiramate and rufinamide | Serum levels appear to rise when CBD is present | Practical Neurology 2018 review |
| Label accuracy of CBD extracts | In a study of 84 extracts, about 31 per cent were accurate, 42 per cent had more CBD than labelled, and 25 per cent had at least 10 per cent less | Practical Neurology 2018 review, citing Bonn-Miller et al., JAMA 2017 |
| Full-spectrum CBD products | May contain trace THC, according to Bluegrass Hemp Oil’s product information | Bluegrass Hemp Oil product page |
Read the product label for CBD amount, THC content and warnings, then take it to your pharmacist with your medicine list. Labels for retail products may not match what is inside, so the label alone cannot confirm what you would be taking.
Why should seizure medicines not be changed without the neurologist?
The Practical Neurology review says CBD is not a benign entity and that vigilance for interactions and side effects must be maintained. It warns that combining CBD with valproate or clobazam could lead to sedation, decreased efficacy and breakthrough seizures. It also describes CBD raising serum levels of topiramate and rufinamide. FDA consumer guidance on CBD warns that CBD can affect how other drugs work.
Starting, stopping or changing a seizure medicine changes the mix your neurologist is monitoring. Do not stop, start, reduce or change a seizure medicine on your own because of CBD information online. Ask your neurologist first.
Side effects of CBD oil
Practical Neurology reports somnolence, fatigue, diarrhea and reduced appetite in trials of pharmaceutical-grade CBD. A seller’s page (Bluegrass Hemp Oil) summarizes FDA safety information as including drowsiness, digestive symptoms and irritability. Practical Neurology also describes liver monitoring and interactions linked to liver enzymes, so liver tests and drug interactions belong in the same conversation with your neurologist.
For a side-by-side look at prescription CBD and retail products, see Hemp Gummies and Seizure Context: Epidiolex vs OTC CBD Products. For seizure-drug interactions, see Hemp Gummies and Prescription Medications.
Action and appointment checklist
- Write down every seizure medicine and every other medicine, supplement or CBD product, using the name on each label.
- Bring this exact medicine list to your treating clinician or neurologist. A pharmacist can check the label instructions for each medicine.
- Ask which liver tests you need and when, including whether your schedule changes if a medicine is added.
- Ask which of your current medicines could interact with CBD, and what signs would mean a problem.
- Ask whether CBD could add drowsiness with your medicines or with alcohol.
- Ask whether your product contains THC and whether that matters for your seizures.
- Ask your neurologist for your seizure action plan and which symptoms mean you should call the clinic.
- Do not stop, start, reduce or change a seizure medicine without your neurologist.
In an emergency, call 911. A guide to bringing the medicine list to your appointment is in Hemp Gummies and Medicines: An Interaction Question List for Your Pharmacist.
What the research cannot tell you yet
- The pharmaceutical trials used a standardised product, so they do not show how a retail CBD oil behaves. GOSH says there is no evidence relating to dose, safety or interaction for commercially available products.
- The Practical Neurology review says data are lacking for nonconvulsive seizures.
- The mechanism work is from rodent experiments. The BBR Foundation’s March 2023 summary of an NYU study describes experiments in rodents.
For current federal rules on cannabis-derived products, check the FDA’s cannabis regulation page directly. This is information, not legal advice.
By TakeHempGummies.com Consumer Research Desk
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.