Synopsis

Source of validity: Scientific
Rating (out of 5): 5

Phytocannabinoids, particularly cannabidiol (CBD), have strong scientific evidence supporting their use in certain forms of epilepsy. The most compelling data comes from randomized, double-blind, placebo-controlled clinical trials investigating the efficacy of CBD in treating refractory epilepsy syndromes such as Dravet syndrome and Lennox-Gastaut syndrome. In 2018, the U.S. FDA approved Epidiolex, a purified CBD preparation, for these indications based on these trials, which demonstrated significant reductions in seizure frequency compared to placebo. The mechanism of action is not fully elucidated but is believed to involve modulation of endocannabinoid signaling, inhibition of excitatory neurotransmission, and anti-inflammatory effects.

Historically, cannabis extracts have been used anecdotally for epilepsy since the 19th century, but rigorous scientific research has only emerged in recent decades. The current clinical guidelines endorse CBD as an adjunctive therapy for specific, severe epilepsies, particularly in patients who have not responded to conventional treatments. However, whole-plant cannabis and other phytocannabinoids such as THC lack sufficient evidence for safety and efficacy in epilepsy, and may even have pro-convulsant effects in some cases.

In summary, there is robust scientific validation for the use of purified CBD in certain treatment-resistant epilepsies, with regulatory approval reflecting the strength of the evidence. Use of other phytocannabinoids or non-standardized cannabis preparations is not supported by comparable scientific data at this time.

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