Issues and promise in clinical studies of botanicals with anticonvulsant potential

•There are no high quality clinical trials of botanicals.•Well-designed trials of cannabinoids for epilepsy are recruiting subjects.•Identifying the best botanical candidates may facilitate future trials.

Botanicals are increasingly used by people with epilepsy worldwide. However, despite abundant preclinical data on the anticonvulsant properties of many herbal remedies, there are very few human studies assessing safety and efficacy of these products in epilepsy. Additionally, the methodology of most of these studies only marginally meets the requirements of evidence-based medicine. Although the currently available evidence for the use of cannabinoids in epilepsy is similarly lacking, several carefully designed and well controlled industry-sponsored clinical trials of cannabis derivatives are planned to be completed in the next couple of years, providing the needed reliable data for the use of these products. The choice of the best botanical candidates with anticonvulsant properties and their assessment in well-designed clinical trials may significantly improve our ability to effectively and safely treat patients with epilepsy.This article is part of a Special Issue entitled “Botanicals for Epilepsy”.