Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Tetrahydrocannabinol (THC) is one of the primary psychoactive constituents of cannabis. While cannabinoids have been explored for epilepsy management, most scientific validation and regulatory approvals center on cannabidiol (CBD), a non-psychoactive cannabinoid. The evidence supporting the use of THC specifically for epilepsy is limited and less compelling. Clinical trials and systematic reviews have shown that CBD can reduce seizure frequency in certain types of epilepsy (notably Dravet syndrome and Lennox-Gastaut syndrome), leading to FDA approval of Epidiolex, a purified CBD product. In contrast, THC’s role is less clear—human studies are sparse, and most available data come from animal models or anecdotal reports. Concerns about THC’s psychoactive side effects, possible pro-convulsant actions at higher doses, and risk of cognitive and psychiatric adverse effects limit its clinical application for epilepsy. Some early reports and small case series suggest potential benefit, but these are insufficient for strong clinical recommendations. Major epilepsy and neurology guidelines do not recommend THC for epilepsy due to lack of robust evidence. In summary, while cannabis has a traditional history of use for seizures, the scientific evidence for THC’s efficacy is weak, especially compared to CBD. Most medical guidance supports the use of purified CBD, not THC, for epilepsy management.

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