Medical Marijuana
What is medical cannabis?
Medical cannabis is more commonly known as medical marijuana. “Cannabis” is the name of the plant, and “marijuana” usually refers to parts of the cannabis plant. Medical cannabis is marijuana from the whole plant or chemicals in the plant, used for medical purposes.
There are two major ingredients from cannabis:
- Tetrahydrocannabinol, or THC- causes the psychoactive effects of "getting high"
- Cannabidiol, or CBD- does not cause psychoactive effects but has shown some positive effects on certain body systems. This is the part that has been effective in reducing seizures in some people with epilepsy.
Does cannabis help seizures?
Research studies have now shown strong evidence that pharmaceutical-grade CBD can reduce seizures in people with:
- Dravet syndrome
- Lennox-Gastaut syndrome
- Tuberous sclerosis complex
Pharmaceutical-grade CBD
It is important to know that the studies were performed using pharmaceutical-grade CBD, not artisanal CBD. Pharmaceutical-grade CBD is carefully regulated, meaning it has a consistent amount of CBD in each dose and does not contain other impurities. There is significantly less information on artisanal marijuana, which may have less consistent doses and potentially harmful impurities.
Epidiolex (Cannabidiol, CBD) is a pharmaceutical-grade, plant-based CBD approved by the FDA for treatment of Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex. It may also be used off-label for other types of epilepsies, although insurance may not cover this.
Does cannabis have side effects?
Pharmaceutical-grade cannabis has been well studied in clinical trials and overall is well tolerated. In general, marijuana or cannabis can have side effects depending on how it is used. For example, if smoked, the negative effect of smoking on a person’s lungs and heart also applies to marijuana.
It is important to know that even though marijuana is a plant, it breaks down in a person’s liver like many medicines. People mistakenly believe that marijuana is completely safe because it is a plant or oil from a plant. However, medication interactions can occur.
What do I need to know about hemp?
Hemp is a variety of the Cannabis sativa plant that has lower levels of THC and higher levels of CBD. As of 2018, Hemp and CBD made from hemp are legalized. Still, it is important to understand that not every CBD product is the same quality or uniform from batch to batch. Any drug or supplement being considered for use as medical treatment should first be discussed with your doctor. The potential for benefit as well as the interaction with other seizure medications and possible side effects require careful review with your doctor.
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Subscribe to Our NewsletterShould I worry about drug interactions?
Some drug-to-drug interactions have been seen during studies of CBD in epilepsy syndromes. More research continues to be done examining these interactions. We know from studies that have been done:
Valproic Acid
People who had increases in their liver enzymes to a level three times or more than normal were also on valproic acid (VPA), a commonly used anti-seizure medication. The levels of VPA were not increased when taken with CBD. It is thought that a part or byproduct of VPA may interact with CBD when it is broken down. This may put some people at increased risk for liver issues.
Clobazam
As clobazam (Onfi) is broken down, a major component of the drug appears to interact with CBD in some people. This may be the cause of tiredness that is seen in some people who are on both CBD and Onfi.
Providers do not need a special license or certificate to prescribe Epidiolex. Epidiolex is the first and only plant-based treatment derived from cannabis for use as a treatment for seizures with FDA approval. Other formulations of medical cannabis have not been approved by the FDA.
Traveling with CBD Products
When flying, products that contain no more than 0.3 percent THC on a dry weight basis or that are approved by FDA, such as Epidiolex, are allowed. The rule for liquids in carry-on bags is less than 3.4 ounces/100mL, but TSA allows larger amounts of medically necessary liquids if you declare them to security officers at the checkpoint for inspection.
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Travelling with MedicationsIs medical cannabis an option when all other seizure medications fail?
When conventional treatments do not work to control seizures, as is the case for roughly 30% of people with epilepsy, it is not unreasonable to consider CBD oil. However, this should only be considered after a thorough evaluation at a specialized epilepsy center to look at whether all possible treatments (including FDA-approved new and add-on medicines, dietary therapy, devices, and surgery) have been reasonably tried.
The Epilepsy Foundation urges anyone exploring any treatment for their epilepsy, as permitted under their state law, to work with their treating provider to make the best decisions for their own care.
Learn about the Epilepsy Foundation's state and federal advocacy efforts on medical cannabis research and access.
Resources
Epilepsy Centers
Epilepsy centers provide you with a team of specialists to help you diagnose your epilepsy and explore treatment options.
Epilepsy Medication
Find in-depth information on anti-seizure medications so you know what to ask your doctor.
Epilepsy and Seizures Helpline
Call our Epilepsy and Seizures Helpline and talk with an epilepsy information specialist or submit a question online.
Tools & Resources
Get information, tips, and more to help you manage your epilepsy.
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