Long-term CBD-enriched cannabis reduced seizures by 71% in children with drug-resistant epileptic encephalopathies | Research

The takeaway

In 59 children with drug-resistant epileptic encephalopathies treated with CBD-enriched cannabis for a median of 20 months, 78% achieved at least 50% seizure reduction and 12% became seizure-free.

Pediatric neurologists, families of children with drug-resistant epilepsy, and medical cannabis researchers.

78% achieved ≥50% seizure reduction over 20 months

What the researchers found

After a median 20 months of treatment, 78% of children had ≥50% seizure reduction and 47.5% had >75% reduction. Seven patients (11.9%) achieved seizure freedom. Median seizures decreased from 305/month to 90/month (71% median reduction, p<0.0001). Adverse effects were mostly mild to moderate. Treatment was discontinued in 28.8% due to lack of response, increased seizures, intolerance, or poor compliance.

Why it matters

This is one of the longer follow-up studies of CBD for pediatric drug-resistant epilepsy, showing that benefits are sustained over time and not just a short-term effect.

The numbers in context

59 patients; mean age 10.5 years; median follow-up 20 months; 78% achieved ≥50% seizure reduction; 47.5% achieved >75% reduction; 11.9% seizure-free; median seizures 305/month to 90/month; 28.8% discontinued.

How the study worked

Prospective cohort study of 59 children (age 2-17, mean 10.5 years) with drug-resistant developmental and epileptic encephalopathies receiving CBD-enriched medical cannabis oil as add-on therapy. Median follow-up of 20 months (range 12-32).

What this study cannot tell us

Open-label without placebo control. Single center. Heterogeneous epilepsy types. Cannot separate CBD effects from other cannabis components. Nearly 30% discontinued treatment. No cognitive or quality-of-life outcome measures reported.

How to read the evidence

Prospective cohort with extended follow-up, but open-label design and no placebo control limit causal claims.

When this study was published

Published in 2022 with enrollment from 2018-2020.

The bigger picture

While pharmaceutical CBD (Epidiolex) has shown efficacy in controlled trials for specific epilepsy syndromes, this study suggests CBD-enriched cannabis oil may benefit a broader range of drug-resistant epileptic encephalopathies over extended treatment periods.

Questions still open

Which specific epileptic encephalopathy subtypes respond best? How do these results compare to pharmaceutical CBD (Epidiolex)? What predicts which patients will respond vs. discontinue?

Common questions

How much did seizures decrease with CBD treatment?

Median seizures dropped from 305 per month to 90 per month, a 71% reduction. Nearly 12% of children became completely seizure-free, and 78% had at least a 50% reduction.

Were there side effects from long-term CBD use in children?

Adverse effects were mostly mild to moderate. However, about 29% of patients stopped treatment due to lack of response, increased seizures, intolerance, or poor compliance, showing that CBD does not work for everyone.

Read the original research

Long-term use of cannabidiol-enriched medical cannabis in a prospective cohort of children with drug-resistant developmental and epileptic encephalopathy.

Seizure, 95, 56-63

View on PubMed ↗Publisher’s paper ↗

Citation

Caraballo, Roberto; Reyes, Gabriela; Demirdjian, Graciela; Huaman, Marina; Gutierrez, Robinson. (2022). Long-term use of cannabidiol-enriched medical cannabis in a prospective cohort of children with drug-resistant developmental and epileptic encephalopathy.. Seizure, 95, 56-63. https://doi.org/10.1016/j.seizure.2022.01.001