Cannabis-Based Treatment Guide
Epilepsy represents the strongest evidence base for cannabis medicine. CBD (cannabidiol) received FDA approval in 2018 as Epidiolex for Dravet syndrome and Lennox-Gastaut syndrome — the first plant-derived cannabis medicine approved by the FDA. Multiple RCTs demonstrate significant seizure reduction in treatment-resistant epilepsy.
Critical Warning: Epilepsy treatment must be managed by a neurologist. Never stop antiepileptic medications without medical supervision. CBD has significant drug interactions with common AEDs requiring dose adjustments and monitoring.
GPR55 Antagonism
CBD blocks GPR55 receptors, which when activated increase neuronal excitability. GPR55 antagonism reduces the hyperexcitability that drives seizures.
TRPV1 Desensitization
CBD activates and then desensitizes TRPV1 channels, reducing neuronal firing rates. TRPV1 overactivation contributes to seizure generation in several epilepsy syndromes.
Sodium Channel Modulation
CBD inhibits voltage-gated sodium channels (Nav1.1, Nav1.2), reducing the rapid firing of action potentials that characterizes seizure activity.
GABAergic Enhancement
CBD positively modulates GABA-A receptors, enhancing inhibitory neurotransmission and raising the seizure threshold.
Adenosine Reuptake Inhibition
CBD inhibits adenosine reuptake, increasing adenosine levels. Adenosine is a potent endogenous anticonvulsant that suppresses neuronal excitability.
Epidiolex (CBD oral solution) is FDA-approved for:
Epidiolex is the only FDA-approved cannabis-derived medication. It is a Schedule V controlled substance.