Best Cannabinoids for Epilepsy

Managing epilepsy can be challenging, with treatments ranging from medications to surgery in severe cases. For many who haven’t found relief through traditional methods, cannabis may be a promising alternative. 

However, the wide variety of cannabis strains and cannabinoid concentrations can be confusing, especially for new patients. Finding the best cannabinoids for epilepsy and the right balance of them may help manage symptoms more effectively.

Which Cannabinoids Help Most With Epilepsy?

Current research suggests that certain cannabinoids, notably cannabidiol (CBD) and cannabidivarin (CBDV), are effective in managing epilepsy. 

CBD has received FDA approval through the drug Epidiolex for the treatment of severe epilepsy syndromes like Lennox-Gastaut and Dravet. Epidiolex is currently the only prescription CBD medicine approved by the FDA.

Studies have shown that CBD can significantly reduce seizure frequency, especially in individuals with treatment-resistant forms of epilepsy. For example, an open-label trial found that CBD doses ranging from 2 to 50 mg/kg/day significantly reduced seizure frequencies when used as a supplementary treatment.^1,2

CBDV also shows promise, reducing focal seizures by as much as 40.5% in clinical trials. However, the study noted a high placebo effect, suggesting that patient expectations may affect perceptions of CBDV’s effectiveness. Despite this, CBDV was found to be generally well-tolerated.

Anecdotal evidence from patients supports these findings, with many reporting effective relief from epilepsy symptoms when using cannabis, especially high-CBD strains. This aligns with the growing body of clinical evidence supporting the therapeutic benefits of cannabinoids for epilepsy.

Which Cannabinoid Concentrations and Ratios Help Most With Epilepsy?

Identifying the right concentrations and ratios of cannabinoids for epilepsy can lead to better symptom management. Current research strongly supports CBD as a major player in reducing seizure frequencies, especially in treatment-resistant epilepsy.

Clinical studies and real-world medical use show that higher concentrations of CBD may be effective in managing seizures. 

Epidiolex, the only FDA-approved CBD drug for specific epilepsy types, starts at a low dose of 2.5 mg/kg twice daily. Depending on how well a patient tolerates and responds, the dose can be gradually increased weekly by 5 mg/kg/day, up to 20 mg/kg/day. Starting with a low dose and gradually increasing it may help maximize benefits while minimizing side effects. 

Unlike THC, which can lead to intense experiences such as greening out, high doses of CBD for epilepsy are generally well-tolerated. However, they can still cause side effects such as fatigue or changes in appetite.

The specific ratios and concentrations necessary vary depending on individual patient needs and the specifics of their condition. It’s advised to monitor responses to CBD and make adjustments as needed.

CBD should be administered regularly to maintain stable absorption rates and consistent results. For patients with dietary restrictions, such as a ketogenic diet, CBD oil can be compatible and should be taken consistently to maintain its efficacy.

How to Choose Strains for Epilepsy Based on Cannabinoid Content

Choosing the right cannabis strains for managing epilepsy involves more than just picking a name. It requires a thoughtful look at the cannabinoids each cultivar contains. 

Here’s how to choose the best strains and cannabinoids for epilepsy.

An important factor to look for is the cannabinoid profile. Strains high in CBD are often preferred for their potent anti-seizure properties and lower risk of intoxicating effects, making them suitable for regular use. Also, while some may prefer indica or sativa strains, these classifications aren’t reliable indicators of effects due to varying chemical profiles. 

To find strains with the optimal cannabinoid ratios, check the certificate of analysis (COA), which provides information about the cannabinoid levels and, sometimes, terpenes. Alternatively, if you have strain names available, NuggMD’s strain directory offers insight into cannabinoid ratios.

Beyond CBD and THC, other minor cannabinoids like CBDV have also shown potential in managing epilepsy through the entourage effect. Strains that include minor cannabinoids may offer additional health benefits. 

Some users report that terpenes like linalool provide additional calming and anti-inflammatory effects. Strains rich in certain terpenes may complement the seizure-reducing properties of cannabinoids, according to anecdotal evidence.

Keep an eye on how your body reacts to different strains over time since tolerance and effectiveness can change. Careful monitoring helps guide any needed adjustments to the cannabinoid mix or switching to a new cultivar.

Consultation with healthcare providers who are knowledgeable about cannabis use in epilepsy is advised. They can help find a cultivar that is well-matched to the individual’s treatment plan and health considerations.

The 5 Best Strains for Epilepsy Based on Cannabinoid Content

Below are five strains with cannabinoid ratios that may be beneficial for managing epilepsy.

Remedy

This strain showcases a CBD-dominant profile with ratios often reaching 13% CBD to 1% THC. Derived from Cannatonic and Afghan Skunk, Remedy is prized for its medicinal properties, including potentially reducing pain, anxiety, and seizure frequencies.

Cannatonic

With up to 9% CBD and around 4% THC, Cannatonic provides a balanced profile that helps with soothing symptoms without a strong high. It may be well-suited for patients looking for pain and stress relief alongside seizure control.

Charlotte's Web

This strain has a reputation for its effectiveness in pediatric epilepsy treatment, featuring approximately 12% CBD and less than 1% THC. It provides a focus-enhancing, non-intoxicating effect suitable for daytime use.

ACDC

ACDC is known for its high CBD content, typically around 13%, and minimal THC levels close to 1%. A phenotype of Cannatonic, it may offer relief from seizures without the intoxicating effects often associated with higher THC levels.

Granddaddy Purple

Although it is higher in THC at about 20%, Granddaddy Purple is included for its potent effects in managing muscle spasms and stress. Due to its strength, it should be used cautiously, especially by those who find therapeutic benefits in THC’s effects alongside CBD.

References

1. Peng J, Fan M, An C, Ni F, Huang W, Luo J. A narrative review of molecular mechanism and therapeutic effect of cannabidiol (CBD). Basic & Clinical Pharmacology & Toxicology. 2022;130(4):439-456. doi:https://doi.org/10.1111/bcpt.13710
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2. Brodie MJ, Czapinski P, Pazdera L, et al. A Phase 2 Randomized Controlled Trial of the Efficacy and Safety of Cannabidivarin as Add-on Therapy in Participants with Inadequately Controlled Focal Seizures. Cannabis and Cannabinoid Research. 2021;6(6):528-536. doi:https://doi.org/10.1089/can.2020.0075 ↩︎

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.