CBD oil reduced seizures by more than half in four of eight infants with treatment-resistant West syndrome | Research

The takeaway

In eight infants with West syndrome who had failed all other treatments, CBD-enriched cannabis oil reduced seizures by more than 50% in four patients, with mild and transient side effects.

Parents of children with treatment-resistant epilepsy, pediatric neurologists, epilepsy researchers

50% of patients achieved more than 50% seizure reduction

What the researchers found

Of 8 children with treatment-resistant West syndrome treated with CBD:THC (25:1 ratio), 2 had 75-99% seizure reduction, 2 had 50-74% reduction, 3 had less than 50% reduction, and 1 had no change. EEG abnormalities improved in 7 of 8 patients. Side effects were mild: somnolence (1), nausea/vomiting (1), irritability (1).

Why it matters

West syndrome is a devastating infantile epilepsy with limited treatment options. When standard medications and ketogenic diet fail, families have few alternatives. This data suggests CBD may offer meaningful seizure reduction for some of these patients.

The numbers in context

8 patients; ages 16-22 months; CBD:THC ratio 25:1; median CBD dose 12 mg/kg/day; mean baseline 63 seizures/day; 50% had >50% seizure reduction; 6-13 months follow-up

How the study worked

Retrospective analysis of 8 patients (6 female, 2 male) with West syndrome refractory to antiseizure medications and ketogenic diet, treated with CBD-enriched cannabis oil (25:1 CBD:THC) at a single center from May 2020 to March 2021.

What this study cannot tell us

Very small case series (8 patients), no control group, retrospective design, single center, variable follow-up periods, concurrent antiseizure medications continued.

How to read the evidence

Very small retrospective case series without controls

When this study was published

Published in 2021. CBD for infantile epilepsy syndromes beyond FDA-approved indications continues to be studied.

The bigger picture

This adds to growing evidence that CBD can help treatment-resistant epilepsy syndromes beyond Dravet and Lennox-Gastaut, which are the only FDA-approved indications.

Questions still open

Would a controlled trial confirm these findings? Is the 25:1 CBD:THC ratio optimal? What predicts which West syndrome patients will respond to CBD?

Common questions

Can CBD help with West syndrome?

In this small study of 8 treatment-resistant infants, half achieved more than 50% seizure reduction with CBD oil. Side effects were mild. However, a controlled trial is needed to confirm these findings.

What dose of CBD was used?

The median dose was 12 mg/kg/day of a CBD-enriched cannabis oil with a 25:1 CBD to THC ratio. Doses ranged from 2 to 25 mg/kg/day, starting at 2 mg/kg/day and titrating upward.

Read the original research

Cannabidiol-enriched medical cannabis as add-on therapy in children with treatment-resistant West syndrome: A study of eight patients.

Seizure, 92, 238-243

View on PubMed ↗Publisher’s paper ↗

Citation

Caraballo, Roberto; Valenzuela, Gabriela Reyes. (2021). Cannabidiol-enriched medical cannabis as add-on therapy in children with treatment-resistant West syndrome: A study of eight patients.. Seizure, 92, 238-243. https://doi.org/10.1016/j.seizure.2021.10.002