Stopping Seizures With Cannabis: When Should Rescue Doses (THC) Be Given?

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A Parent of a child with severe Autism and Epilepsy asked today: "Mike, should the rescue dose of cannabis oil be given as my son starts seizing, or should I wait a few minutes?"

This was the start of a series of questions that I believe all need answers to. Parents and caregivers are rushing to aid the plant to bring those they love. When it comes to Epilepsy the answer to this question depends on the type of seizure, the severity of seizures, and their duration of them. In every case one question leads to another – this series of questions and answers are based on questions asked and responded to this morning by a parent whose child has been nonresponsive to CBD for seizures. Although the cannabinoid offered a tad of relief, it has given “less than 30%” additional seizure control as reported by the parent – and as she switches to a THC driven protocol during a medication wean from a drug that caused side effect issues vs. efficacy – her child is adjusting. This is why the headline specifically states THC as the rescue cannabinoid. Although there are manufacturers of CBD rescue inhalers and more, in this area of cannabinoid medicine as someone with extensive knowledge and severe epilepsy that I treat daily, I strongly feel there’s not much room for debate. Seizures kill and playing trial and error in rescue doses is beyond risky business.

“If he starts seizing it should be rescued as soon as it starts – if there are signs of Aura (a precursor or warning a seizure is coming) then a rescue should be given at that time. There should be no delay when an actual convulsive seizure starts, if there are rescue oils available they should be administered immediately upon the onset of seizure or onset of symptoms known to lead up to one. How I work with patients and parents is by explaining things as simple as possible. The brain becomes ‘Hot’ as I call it when we’ve had a lot of seizures or have had no break inactivity. You’ve explained your son has quite a few seizures with no breaks – literally seizing every day and night. Without a doubt, he’s continually running in that ‘Hot’ mode. I look at the oils as the coolant – every type of car (or person) needs a different ‘level’ of cooling. If you look at it that way once the brain has cooled the epileptiform waves slow and stop – and once they stop the brain literally can begin to forget them. Many don’t go this far down the seizure rabbit hole. Sure the sclerotic growth will be a focal point and cause the necessity for continued medication – plant medicine especially – but if we can cool our brains off for long enough they will start to forget to follow that pattern. Of course many would debate this or state it differently – but this is an easy way to understand it. We remember everything that happens to us both physically and physiologically. So, theoretically and scientifically speaking, when the brain is cool and calm it’s not memorizing patterns that cause seizures – because they aren’t in full force. This is why we do all we can in our home in stopping the seizure before it starts as it’s very imperative when this knowledge is absorbed.”

WATCH HOW FAST THC Rescues this young girl, she responded very poorly to CBD:

Thank you to the makers of Cannatol and Flowering Hope Foundation for the production of this video

Should I give a rescue dose when he's not even seizing?

“Yes, if you’re witnessing behavior or symptoms that you feel are leading to a seizure. There’s no reason to be holding onto the oils that will stop seizures, wait for them to happen, and then give the oil. It’s likely one of the biggest reasons we keep Genevieve on a THC/CBN regimen as it works and it’s also what most use to rescue. Since her brain is a precious commodity to us we felt that keeping her in a constant state of rescue was the smartest move. Then as she made monumental developmental gains on the cannabinoid that some researchers insist causes developmental loss, we kept her on the same oils that many use to rescue. When there was any type of hint of a seizure coming an increased dose was given to Genevieve. This allowed her to gain freedom from the continual seizures that tend to lead to even more seizures. Sleep deprivation and other issues now no longer cause the necessity for rescue doses, but with other patients, I see this need continually. It makes me often question whether the cannabinoid diet their on is sensible or not. Many will go with CBD as their staple cannabinoid and use THC for rescue – sometimes this needs to be questioned when in a state that allows for THC as the staple cannabinoid. The bottom line is seizures can kill, so we need to look at individual needs. Rescuing a child or adult from a situation that could cause a seizure is even more important than stopping the seizure that’s already happening. When you rescue a seizure in the midst of it you’re already there witnessing it – the biggest tragedies occur in Epilepsy when there’s nobody there to witness the event. For this reason, at any time you feel that a rescue dose is necessary – go with your gut and give it. “

How do I administer the rescue dose?

“There are many different ways people will administer THC oil as a ‘rescue’ in the middle of a grand mal seizure – because the individual is convulsing a rescue dose should be pre-loaded and ready. Many people will use straight cannabis oil that some call “RSO” for rescue – but it’s very sticky and very thick. Others will use C02 and other types of extracts that can also be extremely thick and don’t absorb well in the mouth or in the bloodstream. Those types of oils will work best if adhered to lips and upon gums – but that can be difficult to do in a severe convulsive seizure. One of the biggest issues with these oils is the lack of flow from the oral dispenser. For this reason, it’s a good idea to infuse these thick viscous extracts into coconut oil and prefill 1ml oral syringes for the purpose of using them as rescue doses. When it’s done in this manner the oil will push out of the oral syringe easily even in cold weather – otherwise, you could be trying to rescue someone from a seizure and be holding an oral syringe with oil that’s so thick it won’t push out. When you have your rescue dose already filled and ready it stops the losses when the panic of a seizure occurs – it stops excessive doses from being given and allows for one quick push of a single ML at whatever strength you’ve determined to be the “rescue”. When making these life-saving doses keep in mind that it flows best and absorbs best when it’s an even ratio of cannabis oil to coconut oil or a 50/50 mix. Don’t feel as if you’re not going to give your loved one enough – you’re actually giving them more due to the increased and quick absorption that occurs when it’s mixed this way.”

These are pre-loaded rescue doses, ready to give. The cannabis oil has been mixed with coconut oil to allow it to flow out of the oral syringe quickly and absorb in the mouth of the seizure patient.

Why does my son need rescue doses - what do you think sets him off?

“It’s hard to say what his seizure triggers are – this is something that can be figured out by keeping a seizure log to see what happens before all seizures. When my brain is hot any trigger will set it off, when it’s cool I can literally watch fireworks while sitting next to someone with a blaring boom box while trying to hold a conversation as well while also looking at my cell phone messages. No worries, no static. At times, due to the stress I likely put on myself, I will get Non-Convulsive Status – and I talk about this often. It’s a state where the brain only is seizing and the body is not. People can’t see the seizure but can hear irritability, or hear someone who just isn’t acting right but it’s not a convulsion – and it takes an extremely well-trained eye to catch it on EEG if it even shows. The untrained eye just judges the person with Epilepsy not realizing they’re having an issue that could last for hours – the only way to do that is to slow down that ‘hot brain’. THC/CBN to me is my coolant. Slowing down the electrical impulses with seizure disorders related to head injuries or scar tissue is not so simple as the tissue holds onto the electrical charge. I relate to this well due to the overwhelming amount of scar tissue from the racing wreck – although it’s not an organic growth it’s the same thing – literally a web-like scar tissue near the temporal lobes that interrupts signaling. Although I have a severe generalized diagnosis, the scar tissue makes the seizures of now (if I have any at all) much more like someone with Temporal Lobe Epilepsy or MTLE. it’s one reason I want to see video of people when they’re having seizures to help determine protocol – it tells me a ton without any words.

The number one goal is to try to ‘stop the seizure before it happens’ – remember you’re at war against a neurological killer and these are preemptive strikes. The theory of application of THC/CBN is the same with pharma in depressing the CNS but without the side effects of synthetics and the unknown additives. The thing about CBD is that it can stimulate just as much as it can depress the central nervous system – so can THC and so can some terpenes which are where strains can come into play. With about 25% of users, I work with (to use a ballpark estimate) CBD will increase CNS activity – I’m one of them. 30-50mg of CBD and I feel like I drank a triple espresso from Starbucks – which I love. But does my Epilepsy diagnosis love that? It seems to like the energy and seems to like the feeling but eventually, it’s edgy and uncomfortable (like I had too much coffee feeling) and I need THC to offset the feeling. I look at kids as little people that don’t quite know what they need yet – so when a child is given CBD it’s what mommy said to take – they take it. Do they complain when they don’t feel ‘the way they want to’? No, kids run around with runny noses and chapped lips with no problem – it’s the adult that’s sensitive to everything so if you think about it – it’s the adult that’s going to really let you know what works/doesn’t work as their so vocal and there’s no mommy to answer to. In the world of severe epilepsy, I know very few adults who are content with CBD alone – I’m talking about those that have the word ‘Severe’ in front of their Intractable or Refractory diagnosis – it’s important to remember there are over 40 different types of seizures and 100’s of diagnostics that can cause them.”

Both Genevieve and I have Severe Epilepsy Diagnostics

What should I do, I'm getting so much conflicting advice?

“Keeping options open – keeping the paths to freedom open as there could be 100’s of them and not just one – is so important. As you continue your journey you learn more and more – and the most important thing you learn is to listen to nobody but your gut. Don’t even listen to me – analyze me – but don’t take my word as that of a God. I’m a mere man that can screw up as any other could. Question everything and gain the answers that you are comfortable with.

Ultimately, if at all possible, a patient will choose the protocol that works best. Not someone giving advice. This is why it’s so difficult for parents as kids can’t give too much input back – so the input is coming from 1000 different people with 1000 different opinions. Your opinion is the #1 for your child or loved one you’re treating with cannabis and extracts. By asking questions, reading articles, and learning all you can what happens is over time you will be able to come to your own conclusions, develop your own theories, and make your own medicine. Empowering yourself as a parent or patient in that manner changes your life, it opens doors to healing that simply are not at a clinic, doctor’s office, or any other place in which your healthcare insurance pays the bill.”