One of the really big issues around CBD and it’s ability to reduce seizures is the fact that it’s always taken with other antiseizure medications (ASMs) in studies. Now, on the surface, this isn’t a problem for most ASMs, until you realize that CBD has a very potent effect on CYP enzymes, which many ASMs are metabolized by. As a result, the increased bioavailability of antiseizure medications is seen when CBD is administered. Does this have an impact on seizure outcomes? Are we inappropriately assuming CBD has a direct antiseizure effect? Unfortunately many of these studies can’t address that question.