CBD added to standard medications reduced seizures in 80% of children with drug-resistant epilepsy | Research

The takeaway

In a prospective study of 49 children with drug-resistant epileptic encephalopathies, 80% responded to adjunctive CBD treatment, with a median 66% reduction in monthly seizure frequency.

Parents of children with epilepsy, neurologists, medical cannabis researchers

80% of children responded; median seizure reduction was 66%

What the researchers found

Of 49 children followed for 3-12 months, 80% responded to CBD add-on therapy. Seizure reduction of at least 25% occurred in 77.6%, at least 50% in 73.5%, and at least 75% in 49%. Mean monthly seizure frequency dropped from 959 to 381 (median decrease 66%, p < 0.001). The most common adverse effect was drowsiness (32%), often resolved by adjusting clobazam dose.

Why it matters

Children with drug-resistant epileptic encephalopathies have few treatment options. Real-world effectiveness data from diverse clinical settings supplements evidence from controlled trials.

The numbers in context

49 children analyzed; mean age 10.5 years; median age at first seizure 7 months. 80% responders. 73.5% achieved 50%+ seizure reduction. 49% achieved 75%+ reduction. Median seizure frequency decrease: 66%. Drowsiness in 32%.

How the study worked

Prospective cohort study at a single pediatric hospital in Buenos Aires, Argentina. 50 patients with drug-resistant epileptic encephalopathies enrolled between October 2018 and October 2019. CBD oil added to standard antiseizure medications. Mean follow-up: 8.5 months.

What this study cannot tell us

Open-label, single-center, no control group; relatively small sample; interim analysis with variable follow-up periods; the drowsiness-clobazam interaction suggests some benefit may come from altered clobazam metabolism.

How to read the evidence

Prospective single-center cohort without a control group; results are consistent with but less rigorous than randomized controlled trials.

When this study was published

Published in 2020.

The bigger picture

This study from Argentina adds to growing real-world evidence supporting CBD as an adjunctive therapy for severe childhood epilepsy, consistent with the randomized trial data that led to FDA approval of Epidiolex.

Questions still open

How much of the seizure reduction is from CBD directly vs. its interaction with clobazam? Will the benefits persist long-term beyond 12 months?

Common questions

What types of epilepsy were treated?

The study included children with various drug-resistant epileptic encephalopathies, which are severe forms of epilepsy that have not responded to standard medications. The mean age was 10.5 years with seizure onset typically in infancy.

Were there serious side effects?

All adverse effects were mild or moderate. The most common was drowsiness (32% of patients), which often resolved when the clobazam dose was adjusted. No patients discontinued due to adverse effects.

Read the original research

Effectiveness of cannabidiol in a prospective cohort of children with drug-resistant epileptic encephalopathy in Argentina.

Seizure, 80, 75-80

View on PubMed ↗Publisher’s paper ↗

Citation

Caraballo, Roberto; Demirdjian, Graciela; Reyes, Gabriela; Huaman, Marina; Gutierrez, Robinson. (2020). Effectiveness of cannabidiol in a prospective cohort of children with drug-resistant epileptic encephalopathy in Argentina.. Seizure, 80, 75-80. https://doi.org/10.1016/j.seizure.2020.06.005