Reality Check: Long-Term CBD Use for Childhood Seizures

For families living with pediatric epilepsy every day can feel unpredictable. Seizures can disrupt learning, sleep, emotional development, and overall quality of life, while parents often face the exhausting challenge of trying multiple medications with limited success. Although anti-seizure drugs help many children, a significant number continue to experience seizures despite treatment.

That reality is one reason cannabidiol (CBD) has gained so much attention in recent years. Unlike THC, CBD is non-intoxicating and has become one of the most researched cannabis-derived compounds in neurology. Now, a prospective study published in Epilepsy & Behavior adds to growing evidence that purified CBD may help some children with difficult-to-treat epilepsy, while also revealing the limitations and challenges of long-term treatment. Let’s dive into the research and what it could mean for the future of seizure management.

Why Pediatric Epilepsy Research Matters

Epilepsy affects an estimated 50 million people worldwide, making it one of the most common neurological disorders globally. In children, epilepsy can be especially devastating because the brain is still developing. Frequent seizures may interfere with cognitive function, memory, behavior, emotional regulation, and social development.

Even more concerning is the prevalence of drug-resistant epilepsy (DRE). Researchers estimate that more than one-third of children with epilepsy continue to experience seizures despite trying at least two anti-seizure medications.

Because of these challenges, researchers continue searching for therapies that may reduce seizure frequency while improving long-term tolerability and daily functioning, and CBD has emerged as one of the most promising candidates in that search.

CBD and Epidiolex Already Changed Treatment

CBD is not entirely new to epilepsy care. In fact, the FDA-approved CBD medication Epidiolex is already prescribed for several severe seizure disorders, including Lennox-Gastaut syndrome and Dravet syndrome. These conditions are rare but often severe forms of childhood epilepsy that can cause frequent, difficult-to-control seizures beginning early in life.

Clinical trials involving Epidiolex demonstrated that purified CBD could significantly reduce seizure frequency in some patients, helping establish CBD as a legitimate medical treatment rather than simply an alternative wellness product. However, most previous research focused specifically on those approved seizure syndromes. The recent 2026 study is important because it explored whether CBD may also benefit children with a broader range of epilepsy types outside of those FDA-approved indications. That broader investigation could help expand understanding of which patients may benefit most from CBD therapy in real-world clinical settings.

What the New CBD Study Examined

The study¹, titled Effectiveness and tolerability of cannabidiol in paediatric epilepsy: a one-year multisite prospective study, followed 103 pediatric epilepsy patients across multiple sites in Australia. Participants received purified cannabidiol through a compassionate access program, meaning the treatment was made available to children with severe epilepsy who needed additional therapeutic options.

Researchers tracked patients over 12 months and collected information on:

• Seizure frequency
• Emergency room visits
• Hospitalizations
• Medication use
• Status epilepticus episodes
• Side effects and adverse events
• Overall epilepsy severity

This was a prospective study, meaning researchers followed patients forward in time instead of relying only on past records. That design generally provides stronger real-world evidence regarding treatment outcomes and tolerability.

CBD Showed Meaningful Improvements for Some Children

Among children who continued CBD treatment, researchers observed several encouraging trends. At the 12-month mark, approximately 40% of continuing patients were rated as at least “much improved” on the Clinical Global Impression Improvement scale. Researchers also reported sustained reductions in:

• Overall epilepsy severity
• Seizure frequency
• Hospital visits
• Emergency department visits
• Status epilepticus episodes
• Use of additional medications

These findings suggest CBD may provide benefits that extend beyond seizure reduction alone. Improvements in hospitalizations and emergency visits may also indicate better overall disease management and potentially improved daily quality of life.

Another notable finding was that benefits appeared to extend beyond only Dravet syndrome and Lennox-Gastaut syndrome. Some children with other forms of epilepsy also appeared to respond positively. That broader response is particularly important because treatment options for rare or treatment-resistant epilepsy syndromes are often limited.

Long-Term CBD Use Had Limitations

Despite promising results, the study also highlighted significant limitations. Nearly 46% of patients who began treatment discontinued CBD before reaching the 12-month mark. The most common reasons included:

• Lack of effectiveness
• Side effects or adverse events
• Tolerability concerns

This high discontinuation rate reinforces an important reality in epilepsy treatment: just because a therapy works for one individual, it does not mean it will work for everyone. While some children experienced meaningful improvements, others saw little benefit. Researchers emphasized that predicting which patients will respond to CBD remains difficult.

Additionally, adverse reactions were reported in 31% of patients, although most were described as mild to moderate.

In many cases, side effects can be managed through dosage adjustments or monitoring, but they may still impact long-term adherence. The findings also highlight the importance of medical supervision when using CBD therapeutically, especially in children taking multiple anti-seizure medications, as CBD can interact with certain medications and may alter how the body processes them.

Why Real-World CBD Data Is Valuable

Controlled clinical trials remain the gold standard in medicine, but real-world observational studies provide another important layer of evidence. Clinical trials often involve carefully selected participants under highly controlled conditions. In contrast, real-world studies examine how treatments perform in more diverse patient populations facing everyday medical complexities. That matters because pediatric epilepsy is highly individualized. Children may have different seizure types, genetic conditions, medication combinations, and neurological challenges.

The Australian study helps bridge the gap between controlled trials and real-world clinical practice by showing how CBD performs across a broader population of children with severe epilepsy. Researchers concluded that CBD treatment was associated with sustained improvements in many patients but also emphasized the need for further studies to better identify which children are most likely to benefit.

The Future of CBD in Epilepsy Care

Research into CBD and epilepsy is still evolving. Scientists continue exploring which epilepsy syndromes respond best to CBD, optimal dosing strategies, long-term safety, drug interaction risks, and biomarkers that may predict response. Future studies may also help determine whether earlier CBD intervention could improve outcomes in some patients before epilepsy becomes more severe or drug-resistant. At the same time, researchers caution against viewing CBD as a cure-all. The treatment landscape for epilepsy remains complex, and individualized care is still essential.

For families navigating severe pediatric epilepsy, the expanding body of CBD research offers optimism, as even modest reductions in seizures can dramatically improve a child’s safety, development, and quality of life.

While this latest study confirms CBD’s potential, it also reminds us that epilepsy treatment is rarely simple. The future likely lies not in one universal therapy, but in more personalized approaches that help identify the right treatment for the right patient at the right time.

References:

^{1. Andreas Halman, Jeremy L. Freeman, Michael Fahey, Richard Chenhall, Daniel Perkins, Effectiveness and tolerability of cannabidiol in paediatric epilepsy: a one-year multisite prospective study, Epilepsy & Behavior, Volume 182, 2026, 111095, ISSN 1525-5050, https://doi.org/10.1016/j.yebeh.2026.111095}