CBD reduced seizures in over half of children with drug-resistant epilepsy, with 55% still taking it at 18 months | Research

The takeaway

In 103 pediatric patients with drug-resistant epilepsy, 54% showed reduced seizures at one month, with sustained improvements in communication and alertness, and 55% retention at 18 months.

Pediatric neurologists, epilepsy specialists, caregivers of children with drug-resistant epilepsy

55% of patients were still taking CBD at 18 months, with off-label users showing higher retention

What the researchers found

54% of caregivers reported reduced seizure frequency at 1 month; 48% maintained improvement at 2-6 months; communication (60%), alertness (54%), and motor skills (44%) also improved; 55% retention at 18 months; off-label use had higher retention than approved indications.

Why it matters

Long-term retention data fills a critical gap in understanding whether CBD's initial benefits persist, and the finding that off-label use showed higher retention challenges restrictive prescribing practices.

The numbers in context

103 patients (mean age 11.2); 47% on-label (23 Dravet, 15 LGS, 10 TSC), 53% off-label; retention: 97% at 1 month, 90% at 2 months, 82% at 6 months, 66% at 12 months, 55% at 18 months; 62% positive overall caregiver impression at 1 month.

How the study worked

Prospective study of 103 consecutive pediatric patients starting CBD for drug-resistant epilepsy at a tertiary center (2019-2021); parental questionnaires at 1, 2, and 6 months; retention tracked at 18 months.

What this study cannot tell us

Single-center; no control group; caregiver-reported outcomes may introduce bias; dropout by 18 months means retention data may overestimate benefit in completers.

How to read the evidence

Prospective design with consecutive enrollment and long-term follow-up, though single-center and lack of control group limit causal conclusions.

When this study was published

Published 2025, enrollment 2019-2021

The bigger picture

Together with multicenter retrospective data, this prospective study strengthens the case that CBD benefits extend beyond its three approved epilepsy indications.

Questions still open

Why did off-label patients show higher retention? Do the non-seizure improvements (communication, alertness) represent direct CBD effects or secondary benefits of seizure reduction?

Common questions

How many patients stayed on CBD long-term?

55% were still taking CBD at 18 months. Retention decreased gradually from 97% at 1 month to 55% at 18 months.

Did CBD help with anything besides seizures?

Yes. Caregivers reported sustained improvements in communication (60%), alertness (54%), and motor skills (44%) at 2-6 months.

Read the original research

Assessing Real World Efficacy, Safety, and 18-Month Retention Rates of Cannabidiol in Individuals With Drug Resistant Epilepsies.

European journal of neurology, 32(9), e70304

View on PubMed ↗Publisher’s paper ↗

Citation

Chemaly, Nicole; Kuchenbuch, Mathieu; Losito, Emma; Kaminska, Anna; Coste-Zeitoun, Delphine; Barcia, Giulia; Desguerre, Isabelle; Hully, Marie; Nabbout, Rima. (2025). Assessing Real World Efficacy, Safety, and 18-Month Retention Rates of Cannabidiol in Individuals With Drug Resistant Epilepsies.. European journal of neurology, 32(9), e70304. https://doi.org/10.1111/ene.70304