The FDA has recently approved Epidiolex as the first CBD product for the treatment of epilepsy. However, this CBD product is different from the one that the majority of people use. The difference between Epidiolex and the CBD product you’re much more likely familiar with is Epidiolex is an isolate.
“What is CBD isolate?” Well, it’s just cannabidiol (CBD) by itself, but this isn’t the CBD product that grew to rapid popularity. Nor is it likely the CBD product you’ve heard about or taken before. It’s not even the one that has been helping the majority of epileptic patients. That would be full spectrum CBD, which contain hundreds of different compounds all found in hemp.
“So wait, my CBD isn’t just CBD?” Correct! Epidiolex is an isolate because it’s easier to get the first hemp CBD approved by the FDA when there is only one molecule in the product. However, this may be very ill-advised.
Why People Use Cannabis to Treat Epilepsy
Defined by sudden jerking and uncontrollable convulsions of the muscles, epilepsy occurs when a metaphorical floodgate of electrical activity unleashes itself inside the brain. It’s one of the most common neurological conditions, and there are potentially over 40 different types of seizures.
You want to pay close attention to the word “potentially” as we honestly don’t know how many types there are — often, we just focus on the main two. This makes treating seizures difficult for many, and they struggle to find a drug that works. This is then heightened by the way anticonvulsants are approved by the FDA. Approved under strict restrictions, conventional anticonvulsants all fairly identical with only slight deviations — so when one fails, it’s likely many others will.
There are some forms of epilepsy where nearly every drug fails to effectively manage them. In fact, there is only one drug that works. Enter cannabis.
Chemical compounds in cannabis called cannabinoids can help manage epilepsy by modulating cannabinoid receptors in the body. These cannabinoid receptors are naturally triggered by endocannabinoids we produce which are just neurotransmitters.
When activated, cannabinoid receptors release regulatory signals that stifle heighten states such as anxiety, pain, and neurological activity. Called the endocannabinoid system, it’s key to homeostasis — a process that stabilizes internal functions to optimize health despite outside stress factors.
There are over 113+ cannabinoids in cannabis, but the two most studied are THC and CBD.
- Tetrahydrocannabinol (THC) — Binds to CB1 receptors that regulate emotion, appetite, and sleep to name a few. Produces the high associated with marijuana variety of cannabis plants.
- Cannabidiol (CBD) — Cannot bind to CB1 receptors thus it’s non-psychoactive. Influences the activation of CB2 receptors which mainly regulates the immune and nervous systems. Hemp varieties of cannabis plants are bred to have a high percentage of CBD, with near non-existent levels of THC.
Isolate vs. full spectrum
The concern with Epidiolex is that it’s just CBD by itself. This doesn’t make it less safe to use or anything of that nature. To put it bluntly, when isolated CBD kind of sucks, in fact, the only reason full spectrum CBD products were originally called CBD is out of ignorance and lack of research at the time. However, much has changed since then.
Comprehensive research now shows us that there are two very important reasons we want full spectrum not isolate for medical conditions like epilepsy.
The Entourage Effect
You know how your doctor will advise you to eat fruits over drinking fruit juice? They tell you this because the skin and flesh of the fruit provide a lot of fiber and other compounds that help prevent all the sugar from spiking your insulin levels. Fruit juice is still better than not consuming any fruits though.
This is how you can think about the difference between isolate and full spectrum. CBD is just one of the hundreds of cannabinoids in hemp that all have different properties. Then you have hundreds more terpenes and flavonoids on top of that. All of them work together to benefit each other in several ways.
We then see this synergistic relationship extend itself when you consume cannabis — plant cannabinoids will protect and promote the positive effects of self-produced cannabinoids. This relationship is called the entourage effect.
The Entourage Effect in action:
- Blood-Brain Barrier — Perhaps the biggest issue with CBD isolate is that it’s poorly absorbed into the bloodstream and requires almost twice the dose as full spectrum. The terpenes — essential oils — along with cannabinoids like CBC will thin the blood-brain barrier so CBD and other cannabinoids can easily pass through.
- Inhibiting FAAH Enzymes — The molecule version of CBD will attach to FAAH enzymes that prematurely reuptake endocannabinoids in the body. This allows increases activity and allows more endocannabinoids to activate receptors in the body where they can promote better regulation and stability of health.
Some THC is Good
Full spectrum CBD oil will contain around 0.3% THC — marijuana averages around 15-20%. However, the more CBD present, the less psychoactive THC becomes. However, just because THC loses its psychoactive effects doesn’t mean we want it completely removed from the product.
THC is fantastic at controlling epilepsy, muscle spasms, and reducing hypersensitivity — it most likely has the strongest anticonvulsant properties of any cannabinoid in cannabis. Adults that don’t mind the high may still want to consider high amounts of THC or marijuana for managing seizures — especially if they have a rare form of epilepsy that’s poorly managed drugs by conventional drugs.
However, for children, pets, and those that don’t want to get high, full spectrum CBD is a wonderful alternative to marijuana. Even though it has just traces of THC that can’t cause a high, because of the entourage effect it will still play a vital role in CBD’s ability to reduce seizures.
Full spectrum CBD goes far in treating rare forms of epilepsy. In fact, this is why CBD became popular in the first place.
Using CBD to Treat Epilepsy
The research appears to be in agreement that when CBD is isolated from THC and the other cannabinoids, it only controls seizures about half as well. Epilepsy is not a one-size-fits-all disorder, and this is why we often see a cocktail of medications to control them. So it makes sense way full spectrum CBD beats CBD isolate for treatment of epilepsy.