Cannabis May Effectively Treat Drug-Resistant Epilepsy

Pharmaceutical-grade cannabidiol (CBD) may be effective for the treatment of drug-resistant pediatric epilepsy, according to findings from a recent systematic review.

For their review, the researchers compiled and evaluated evidence published through October 2017 for cannabinoids as adjunctive treatments for drug-resistant pediatric epilepsy. Data from 6 randomized controlled trials 30 observational studies were obtained from Medline, Embase and PsycINFO databases.
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The number of study withdrawals, adverse events, and serious adverse events were used to determine the tolerability and safety of CBD treatment in each study.

Ultimately, the researchers found that treatment with 20 mg/kg/day cannabidiol effectively reduced seizure frequency by 50% (relative risk [RR] 1.74), achieved complete seizure freedom (RR 6.17), and improved quality of life (RR 1.73) compared with placebo. They noted that the number needed to treat in order to experience a 50% seizure reduction was 8 per person.

Specifically, a 50% reduction in seizures was reported by 48.5% of participants in 17 observational studies, and 8.5% of participants in 14 observational studies reported being seizure-free. Improved quality of life was also reported in 12 observational studies.

However, the researchers noted that CBD use was associated with an increased risk of adverse events (RR 1.24) and serious adverse events (RR 2.55). Adverse events and serious adverse events were reported in 50.6% and 2.2% of participants, respectively, in 12 observational studies.

“Pharmaceutical-grade CBD as adjuvant treatment in pediatric-onset drug-resistant epilepsy may reduce seizure frequency,” the researchers concluded. “Existing [randomized controlled trial] evidence is mostly in pediatric samples with rare and severe epilepsy syndromes; [randomized controlled trials] examining other syndromes and cannabinoids are needed.”

—Christina Vogt

Reference:

Stockings E, Zagic D, Campbell G, et al. Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence [Published online March 6, 2018]. J Neurol Neurosurg Psychiatry. doi:10.1136/jnnp-2017-317168.