Cannabidiol Use in Refractory Epilepsy

Marcia L. Buck, PharmD, FCCP, FPPAG, BCPPS


Pediatr Pharm. 2018;24(11) 

In This Article

Structure and Mechanism of Action

Cannabidiol is a component of the plant Cannabis sativa L.[2–4] It was isolated by Mechoulam and Shvo in 1963. Mechoulam and Carlini published the first study of its use in the treatment of refractory seizures in 1978.[5,6] Unlike tetrahydrocannabinol (THC), CBD has little binding affinity for cannabinoid receptors (CB1 and CB2). It acts as a negative allosteric modulator of CB1 and has activity at serotonin (5-HT1A), transient receptor potential cation channel subfamily V (TRPV1), and adenosine (A2AAR) receptors, in addition to acting as a positive allosteric modulator of GABA-A receptors. These mechanisms appear to produce its antiseizure, anti-anxiety, and analgesic effects.[4]