Over the past few years, increasing public and political pressure has supported legalization of medical marijuana. One of the main thrusts in this effort has related to the treatment of refractory epilepsy—especially in children with Dravet syndrome—using cannabidiol (CBD). Despite initiatives in numerous states to at least legalize possession of CBD oil for treating epilepsy, little published evidence is available to prove or disprove the efficacy and safety of CBD in patients with epilepsy. This review highlights some of the basic science theory behind the use of CBD, summarizes published data on clinical use of CBD for epilepsy, and highlights issues related to the use of currently available CBD products.
Cunha et al. reported a 2-phase pilot study of CBD versus placebo in normal volunteers and patients with refractory secondarily generalized epilepsy (14). In the first phase, 8 normal volunteers received CBD or placebo in a doubled-blind fashion, at a dose of 3 mg/kg for 30 days. The second phase was also double-blinded in 15 patients with epilepsy receiving 200 to 300 mg daily of CBD or placebo for 135 days. Patients continued baseline AED. All subjects tolerated CBD well, with no serious adverse events. Four of the epilepsy patients receiving CBD were “almost free of convulsive crisis” for the duration of the study. Three other patients receiving CBD had a partial reduction in seizures, and 1 subject had no response. Of the 7 patients receiving placebo, seizure frequency was unchanged in 6, and 1 had clear improvement in seizure control.
Roger, I’m not 100% certain on this, but I’m pretty confident that the difference here (and what makes it legal for people to sell it on Amazon) is that they are ONLY selling Hemp derived CBD vs. Cannabis derived CBD. Hence the “hemp extract” which is why the Farm Bill passing was such a big deal. As far as I’m aware, you can get CBD from both cannabis and hemp, but the hemp is legal federally. The bigger problem that I see is how misleading all of the amazon products are though because of these amazon regulations. All of the bottles I’ve seen only show the amount of “Hemp seed extract” (ex-2,500 mg Hemp Oil Extract) which is just like buying 2,500 mg of orange juice when I’m looking for vitamin c!
Rather, what most of these oils appear to be are extracts of the hemp seed. As we mentioned earlier, CBD oil can be made from either hemp or marijuana cannabis plants. No matter which plant they come from, however, they must be made using the flowers, leaves, stem and stalks of the plant, as these are the parts where the CBD compound is actually located.
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