Adults only (18+)

Introduction

For individuals living with epilepsy, seizure disorders or their caregivers, the idea of using cannabidiol (CBD) as a means to reduce seizures can feel hopeful and promising. This article is written for those exploring that possibility and seeking a clear, reliable overview of what the current UK research and guidance suggest. It aims to provide plain English, evidencebased information about what CBD oil may offer for seizures, where the limitations lie, and what safe, responsible use might look like. It is not a substitute for medical advice or specialist consultation. If you or someone you care for is considering CBD oil in relation to seizures, you should always engage with a specialist neurologist or epilepsy clinician.

What is CBD and how does it relate to seizures?

Cannabidiol, or CBD, is one of many compounds found in the cannabis plant. Unlike tetrahydrocannabinol (THC) it does not produce a “high” in the way recreational cannabis does. Over the past decade researchers have studied whether CBD might help in the treatment of seizures by modulating brain activity, reducing excitability or stabilising neural networks. In the UK, a crucial distinction must be recognised: the type of CBD studied in clinical trials for epilepsy is a highly purified, pharmaceuticalgrade product, not the overthecounter wellness oils sold in health shops. Only one such medicine is currently licensed for specific seizure syndromes. This means when we talk about CBD oil in the context of seizures, we are dealing with treatments that require specialist prescription, regulation, monitoring and integration with other antiepileptic therapies. Without that context the term “CBD oil” can be misleading.

What the UK evidence and guidelines indicate

In the UK context a number of regulatory and professional bodies have issued guidance on the use of cannabisbased medicinal products, including those containing CBD, for epilepsy. The charity for people with epilepsy points out that CBD is the only cannabisderived medicine currently approved for epilepsy in the UK under very specific conditions. The guideline body National Institute for Health and Care Excellence (NICE) has published recommendations in relation to severe treatmentresistant epilepsy and cannabisbased medicinal products. According to NHS England, cannabisbased medicinal products are not first line and should only be considered when other treatments have failed. The guidance also emphasises that overthe-counter CBD oils are not approved for epilepsy treatment and their efficacy or safety remains unproven. In simple terms, in the UK you cannot assume that any CBD oil will help seizures. Prescription CBD for epilepsy is tightly regulated, involves specialists, and applies only when other options have been tried.

What the research has found: benefits, limitations and what is unknown

When reviewing research on CBD in the context of seizures, several key themes stand out. First, in the licensed areas, notably the syndromes Dravet syndrome and Lennox–Gastaut syndrome, CBD has shown benefit when used alongside other antiseizure medications. Trials indicate reductions in seizure frequency for some patients compared to placebo. At the same time these results are moderate rather than dramatic. In many cases seizures continue albeit at a lower frequency. Evidence outside these syndromes is far more limited. Professional guidance stresses that for most types of epilepsy the data are weaker, and longterm effects remain less certain. Safety and monitoring are additional critical factors. CBD interacts with other antiepileptic drugs through the liver enzyme system, can cause sideeffects, and requires specialist oversight rather than selfmedication. Overall the research suggests that CBD oil in its licensed pharmaceutical form is a valuable tool in certain hardtotreat epilepsy cases, but it is not a universal cure or readily available over the counter.

Mechanisms of action: simplified explanation

Although the precise mechanisms through which cannabidiol may reduce seizures are not fully understood, many researchers believe CBD interacts with multiple neural signalling pathways. It appears to affect the balance between excitatory and inhibitory neurotransmitters, modulate ion channel activity, and possibly reduce neuronal hyperexcitability that triggers seizures. In clinical practice what matters is that CBD is used as part of a broader treatment plan rather than in isolation, since epilepsy often involves complex pathways and systems.

Safety, interactions and regulation in the UK context

In the UK the regulatory and safety framework for CBD in seizure treatment is stringent. The licensed product for epilepsy is treated as a prescription medicine. The regulator emphasises that unlicensed CBD oils may vary in content, may contain unwanted substances including THC or contaminants, and have not been properly tested for treating seizures. Professional guidance warns against parents giving children nonlicensed CBD oils for epilepsy because of these risks. Moreover drugdrug interactions are a real concern. CBD can raise the levels of active metabolites of other medications such as clobazam, and combining it with certain antiepileptics may affect liver enzymes. NICE guidance includes recommendations for monitoring, specialist prescription and states that cannabisbased medicinal products should only be considered when other treatments have not succeeded. Legally, specialist physicians are the only ones able to prescribe the licensed CBD product for epilepsy in the UK. Products available without prescription are categorised as food supplements rather than medicines and cannot legally be marketed with medicinal claims for epilepsy. This regulatory clarity establishes the boundary between researchbacked therapy and general wellness use.

Practical implications for patients and carers

If you or someone you care for is exploring CBD oil in the context of seizures, several practical points are important. CBD is an adjunctive therapy rather than a substitute for standard antiseizure treatments. That means current medications should continue unless explicitly advised otherwise by a specialist. The formulation that has shown benefit is a pharmaceuticalgrade CBD product used in trials, which is not the same as overthe-counter wellness oils. Monitoring is essential, including baseline measures of seizure frequency, medication levels, liver function tests, and awareness of sideeffects. Expectations should be realistic. Reductions in seizure frequency may occur, but complete seizure freedom is not guaranteed and varies widely. Open dialogue with a neurologist or epilepsy specialist is critical to address drug interactions, possible sideeffects, the specific indication for your case, and adjustments if the treatment does not meet expected benefits. Long-term data is still emerging, so ongoing specialist review is important.

Comparison and alternatives

Comparing CBD oil with other epilepsy treatments shows its position as an adjunct rather than a replacement. Standard antiseizure medications have been evaluated over decades with large trials, long-term follow-up, and known side-effect profiles. CBD is newer, with its strongest evidence in specific rare syndromes. For other types of epilepsy, alternatives remain important, such as other drug classes, dietary therapies like ketogenic diet or low glycaemic index approaches, neural stimulation devices, or surgery in selected cases. CBD is one of several tools rather than a sole solution, and it is considered when standard therapies have been exhausted or seizures remain uncontrolled.

Addressing FAQs and misconceptions

A common misconception is that any CBD oil will stop seizures. Only the pharmaceuticalgrade CBD product used under specialist supervision has evidence for benefit in specific epilepsy syndromes. Overthe-counter products vary in composition and are not supported by research. Another misconception is that CBD is riskfree. It can cause sideeffects and interact with other medications, requiring careful monitoring. Some parents ask if CBD allows them to avoid other treatments or surgery. In most cases, other therapies are still required. THC-containing cannabis is not recommended because it may worsen seizures in some cases and has insufficient evidence for safe use in epilepsy.

Key take-aways

Research supports the use of CBD oil in its licensed pharmaceutical form for certain rare, treatmentresistant epilepsy syndromes when standard treatments have failed. Evidence outside those syndromes remains incomplete. Overthe-counter CBD oils are not supported for seizure control in the UK. Safety, monitoring, drug interactions, and realistic expectations are essential. Decisions regarding CBD oil should be made with a specialist and integrated into a broader epilepsy management plan.

Conclusion

CBD oil occupies a promising but carefully circumscribed role in the treatment of epilepsy. The research shows benefit in specific severe syndromes when standard therapies have not succeeded, but it is not a universal remedy. Licensed pharmaceutical CBD products are distinct from overthe-counter oils and must be used under specialist supervision. With informed understanding, realistic expectations, ongoing monitoring, and integration into established treatment plans, CBD oil may provide an additional tool in seizure management. It is essential to proceed thoughtfully, focusing on evidence, safety, and professional oversight to maximise potential benefit while minimising risk.