In addition to medication, devices, and surgery, epilepsy can be treated through alternative treatments like CBD or music therapy.
Traditionally, epilepsy and seizures are treated through medication, devices, surgery, change in diet, or a combination of those options. Occasionally, traditional therapies alone may not be enough to reach seizure freedom. A healthcare provider may suggest using alternative or complementary therapies in addition to conventional treatments to help manage your epilepsy.
On this page, we introduce you to two alternative therapies for epilepsy. If you are thinking of using alternative therapies for epilepsy treatment, please discuss these treatments with your neurologist or healthcare provider to find out which therapies are safe and potentially helpful for you.
CBD is an abbreviation for cannabidiol, a type of biologically active substance known as cannabinoids found in the Cannabis sativa plant. While the plant’s flower buds contain high amounts of cannabinoids, including CBD, the plant itself contains more than 80 cannabinoids. When consumed, the chemical compounds may bind with the cannabinoid receptors in the brain and body and cause a range of effects.
In recent years, CBD has gained popularity due to its ability to offer health benefits without the psychoactive properties (i.e., the “high” feeling) of its well-known sibling, a cannabinoid called tetrahydrocannabinol (THC). While CBD is marketed as a health product or food supplement, these CBD products are not controlled as medicines approved by the US Food and Drug Administration (FDA). Some CBD formulations have been developed under FDA guidance and have been studied in clinical trials for treating epilepsy, mood disorders, anxiety, and pain.
Cannabis, marijuana, and hemp are some of the common names for the Cannabis sativa plant, whereas CBD is a substance (cannabinoid) found in the plant. While marijuana and hemp are names for the same plant species, there are critical differences that determine their legality. Federal law states cannabis can only be considered hemp if it contains less than 0.3% of THC by weight. Hemp is legal to sell and use, whereas any cannabis that contains more than 0.3% THC by weight is considered marijuana and is therefore illegal at the federal level.
As of 2021, 48 states and the District of Columbia have legalized marijuana for medicinal use, with or without THC limits. In addition, 18 states and the District of Columbia have legalized marijuana for recreational use.
The FDA has approved only one CBD product for medicinal usage, the prescription drug Epidiolex® (cannabidiol). It has been approved to treat seizures associated with Lennox-Gastaut syndrome (LGS), Dravet syndrome (DS), and Tuberous Sclerosis Complex (TSC) in patients one year of age and older. If you currently take CBD or are thinking about taking CBD for epilepsy treatment, be sure to discuss this with your neurologist or healthcare provider, who can guide you to determine which products are safe or unsafe for you to use.
No other CBD products have been evaluated to see if they are safe to use or effective at treating epilepsy. In addition, factors like the proper dosage, interactions with other drugs or food, use by specific groups such as pregnant people, or product consistency from bottle to bottle with CBD are unknown. Marijuana and other CBD-containing products should be used with care and awareness for all these reasons. Your healthcare provider can help you decide if Epidiolex is appropriate for you.
FDA-approved medications are tested in several rounds of clinical trials that determine if the risks are outweighed by the benefits of an approved drug for a specific group of people. Epidiolex was studied in several clinical trials before the FDA approved it as a medication for several severe childhood epilepsies, but like many medications, it can still interact with other medications and have harmful side effects.
Relatively speaking, there is minimal data or information about over-the-counter CBD, including its effects on the body. The FDA states that consumers should be aware of the potential risks associated with using over-the-counter CBD products, including liver injury, drug interactions, increased drowsiness, and damage to fertility in male patients.
CBD products available as dietary supplements and purchased without a prescription are not tested nor regulated as strictly as pharmaceutical products and could be impure. The products may contain excessive amounts of THC or impurities such as heavy metals, pesticides, or plasticizers (an ingredient used to increase the flexibility of plastic).
There are risks associated with all medicines. You should consider carefully before exposing yourself to any product which may have potential risks, be of unknown quality, and have unproven benefits.
Music therapy is the incorporation of music into medical treatment. Besides having calming or energizing effects for some, music has affected the electrical signals inside the brain. Researchers have proposed that when music stimulates different brain regions, it simultaneously decreases the frequency of abnormal brain signals, which are measured through electroencephalography (EEG). Brain scans have shown that, unlike nonmusical sounds, each component of music (such as rhythm, pitch, and melody) activates a different part of the brain.
Patients with various medical conditions have benefitted from music therapy, and many researchers have studied its impact on patients with epilepsy. While the effects of music on epilepsy control were not consistent, there have been examples of clinical trials in which patients experienced seizures less frequently when treated with music therapy. Other benefits found in music therapy were psychological, such as decreased irritability, tearfulness, and aggression, as well as improved sleep patterns.
In one of the earliest studies on music therapy for epilepsy, the researchers chose Mozart’s sonata for two pianos in D major (also known as K. 448) as the music for patients. When the music was found to reduce abnormal brain signals in patients in status epilepticus. The term “Mozart Effect” was coined to describe the phenomenon. Since then, many studies have used the same sonata, K. 448, to investigate the connection between music and seizure control. Some elements of the sonata, including its unpredictable rhythm, have been linked to its effectiveness in decreasing abnormal brain signals in patients with epilepsy. However, music written in different styles and composers could potentially be useful for the same purpose.
Dawit S, Crepeau AZ. When Drugs Do Not Work: Alternatives to Antiseizure Medications. Curr Neurol Neurosci Rep. 2020 Jul 9;20(9):37. doi: 10.1007/s11910-020-01061-3. PMID: 32648170.
Rafiee M, Istasy M, Valiante TA. Music in epilepsy: Predicting the effects of the unpredictable. Epilepsy Behav. 2021 Sep;122:108164. doi: 10.1016/j.yebeh.2021.108164. Epub 2021 Jul 10. PMID: 34256336.