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Start Low and Go Slow: The first step to finding your minimum effective dose is to establish a baseline dosage. Since many people report good results with CBD at low doses, we suggest you start with a minimal dose and slowly increase the dosage until you find results. Start with a small baseline dosage between 2-5mg, 2X or 3x daily (6-10mg total).
2. Will CBD Help with Epilepsy and Seizures? – What the Current Research Says
(Let’s get the legal stuff out of the way first)
It is important to recognize that everyone responds a little differently to CBD so there is no set dose for everyone or every condition. By following a stepwise dosing procedure you can find the most effective dosage of CBD for you.
The evidence base supporting the anti-convulsant effects of CBD is diverse and increasingly compelling. It ranges from anecdotal reports by patient and healthcare providers 4 ( https://www.ncbi.nlm.nih.gov/pubmed/25845492 ) to pre-clinical studies involving animals to randomized controlled trials involving humans. 5 ( https://www.ncbi.nlm.nih.gov/pubmed/24854329 ) Two open-label studies and one double-blind, placebo-controlled trial showed meaningful reductions in seizure frequency and severity, specifically seizures associated with Dravet and Lennox-Gastaut syndromes (Median seizure frequency decreased by 40% in one of the open-label studies 6 ( https://www.ncbi.nlm.nih.gov/pubmed/26724101 ) and 53% in the placebo-controlled trial). 7 ( https://www.ncbi.nlm.nih.gov/pubmed/28538134 ) A 2018 systematic review and meta-analysis including four trials involving 550 patients with Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) concluded that CBD contributed to a greater reduction in seizure frequency than conventional treatment alone. 8 ( https://www.ncbi.nlm.nih.gov/pubmed/30390221 )
Despite this change in the classification of hemp and hemp-derived CBD, the only CBD product that has been rigorously studied and approved to be used as a medical therapy for epilepsy is the drug Epidiolex. While more CBD products may come to market in the coming months, it is important to understand that not every CBD product is the same quality or uniform from batch to batch. Any drug or supplement that is being considered for use as a 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.
In this episode of Hallway Conversations, epilepsy.com Editor-In-Chief Dr. Joseph Sirven interviews Dr. Jose Cavazos MD, PhD, professor of neurology at the University of Texas Health Science Center in San Antonio. They discuss Dr. Cavazos’ experience serving as a panelist on the recent U.S. Food and Drug Administration (FDA) Peripheral and Central Nervous System Drug Advisory Committee review of Epidiolex ® for the treatment of Dravet and Lennox-Gastaut syndromes.
What do I need to know about hemp?
Results from 214 people who received Epidiolex (99% CBD) in an open-label study (without a placebo control) and who completed 12 weeks or more on the drug were published in 2015 in Lancet Neurology.
Cannabis is known by many names – the most common is marijuana. Cannabis is the Latin name used most often by botanists and pharmaceutical companies. The word marijuana usually refers to the leaves and female flowers of the cannabis plant. Medical cannabis is whole plant marijuana or chemicals in the plant used for medical purposes.
This study showed that the addition of CBD to a traditional seizure medication decreased the frequency of drop seizures significantly in children and adults with LGS.
metronidazole will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor.
Monitor Closely (1) tetracycline will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor.
cannabidiol will increase the level or effect of pantoprazole by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol.
Monitor Closely (1) erythromycin ethylsuccinate will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor.
Monitor Closely (1) cannabidiol, dacarbazine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.