CBD and Epilepsy: A Brain Composed of Cannabis Leaves

CBD and Epilepsy: What the Latest Research Reveals

Mira Elwood in Health & Wellness December 2025 • 4 min read.

"A comprehensive look at the efficacy, safety, and drug interactions of cannabidiol (CBD) in treating refractory epilepsy, offering insights for patients and clinicians."

Epilepsy, a neurological disorder characterized by recurrent seizures, affects millions worldwide. For approximately one-third of these individuals, seizures remain uncontrolled despite trying multiple anti-epileptic drugs (AEDs). This condition, known as treatment-resistant epilepsy (TRE), significantly impacts quality of life, increasing morbidity and mortality.

In recent years, cannabidiol (CBD), a non-psychoactive compound found in the cannabis plant, has garnered significant attention as a potential treatment for epilepsy, particularly TRE. Unlike its counterpart, tetrahydrocannabinol (THC), CBD does not produce the 'high' associated with cannabis use, making it an attractive option for patients and parents seeking alternative therapies.

Fueled by anecdotal evidence and increasing media coverage, interest in CBD has surged. However, it's crucial to differentiate between hype and scientifically-backed evidence. This article sifts through the latest research, examining the efficacy, safety, and potential drug interactions of CBD in treating epilepsy, providing a balanced and informed perspective.

CBD for Treatment-Resistant Epilepsy: What the Studies Say

CBD and Epilepsy: A Brain Composed of Cannabis Leaves

One of the most significant studies on CBD for TRE was an open-label interventional trial published in The Lancet Neurology in 2016. Led by Orrin Devinsky and colleagues, the study enrolled 214 patients aged 1-30 years with severe, intractable, childhood-onset, treatment-resistant epilepsy. Participants received oral CBD at a starting dose of 2-5 mg/kg per day, gradually increased to a maximum of 25 mg/kg or 50 mg/kg per day, depending on the study site.

The primary objective was to assess the safety and tolerability of CBD, with the primary efficacy endpoint being the median percentage change in the frequency of motor seizures after 12 weeks. The results showed that:

Adverse events were common, reported in 79% of patients, including somnolence (25%), decreased appetite (19%), diarrhea (19%), and fatigue (13%).
Serious adverse events occurred in 30% of patients, though only 12% were considered possibly related to CBD.
The median monthly frequency of motor seizures decreased by 36.5% over the 12-week treatment period.

While the study lacked a placebo control, the findings suggested that CBD might reduce seizure frequency and have an acceptable safety profile in children and young adults with highly treatment-resistant epilepsy. The researchers emphasized the need for randomized controlled trials to further characterize the safety and efficacy of CBD.

The Future of CBD in Epilepsy Treatment

The research on CBD for epilepsy is still evolving, but the initial findings are promising. While CBD is not a cure for epilepsy, it may offer a valuable option for individuals with treatment-resistant seizures. As more rigorous studies are conducted, we will gain a better understanding of the optimal use of CBD, its potential benefits and risks, and its place in the comprehensive management of epilepsy.

About this Article -

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Everything You Need To Know

What is Treatment-Resistant Epilepsy (TRE), and why is it significant?

Treatment-Resistant Epilepsy (TRE) refers to a condition where seizures persist despite trying multiple anti-epileptic drugs (AEDs). This affects approximately one-third of individuals with epilepsy. TRE significantly impacts quality of life and increases morbidity and mortality. This makes the search for alternative treatments, such as cannabidiol (CBD), critical for these patients.

How does Cannabidiol (CBD) differ from Tetrahydrocannabinol (THC), and why is this difference important for epilepsy treatment?

Cannabidiol (CBD) is a non-psychoactive compound found in the cannabis plant, unlike Tetrahydrocannabinol (THC). THC produces the 'high' associated with cannabis use. The absence of psychoactive effects makes CBD a more appealing option for patients, particularly children and young adults with epilepsy, and for their parents, who are seeking alternative therapies without the mind-altering effects. This distinction is crucial in the context of epilepsy treatment, where the goal is seizure control without impairing cognitive function or causing unwanted side effects.

What were the key findings of The Lancet Neurology study regarding CBD for Treatment-Resistant Epilepsy?

The open-label interventional trial published in *The Lancet Neurology* enrolled 214 patients aged 1-30 years with severe, intractable, childhood-onset, treatment-resistant epilepsy. The study used oral CBD, with dosages up to 25 mg/kg or 50 mg/kg per day. The results indicated that the median monthly frequency of motor seizures decreased by 36.5% over 12 weeks. Adverse events were common, with somnolence, decreased appetite, diarrhea, and fatigue being the most frequent. Serious adverse events were observed in 30% of patients, though most were not considered CBD-related. While lacking a placebo control, the findings suggested that CBD might reduce seizure frequency and have an acceptable safety profile.

What are the potential side effects of using CBD for epilepsy, as indicated by the research?

The research indicates that adverse events associated with CBD use are common. In the *The Lancet Neurology* study, 79% of patients reported adverse events. These included somnolence (25%), decreased appetite (19%), diarrhea (19%), and fatigue (13%). Serious adverse events occurred in 30% of the patients. It's important to note that, while adverse events were frequent, not all were directly attributed to CBD. Patients and clinicians should carefully weigh the potential benefits against these risks when considering CBD treatment.

What is the future of CBD in treating epilepsy, according to the available evidence?

The research on CBD for epilepsy is still evolving, but initial findings are promising. While CBD is not a cure, it may offer a valuable option for individuals with treatment-resistant seizures. As more rigorous studies are conducted, we will gain a better understanding of the optimal use of CBD, its potential benefits and risks, and its place in the comprehensive management of epilepsy. Further research is needed to fully characterize the safety and efficacy of CBD and to determine its optimal use in the treatment of epilepsy, including dosage, long-term effects, and potential drug interactions.