Pharmaceutical CBD achieves higher blood levels than artisanal CBD in children with epilepsy

In 42 children with drug-resistant epilepsy, pharmaceutical CBD (Epidiolex) achieved 2.4 times higher blood levels than artisanal CBD products, with higher levels linked to more side effects but no statistically significant difference in seizure reduction.

Cohen, Nathan T et al.·The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG·2022·Moderate EvidenceRetrospective Cohort
RTHC-03764Retrospective CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=42

What This Study Found

Mean serum CBD was 124 ng/mL for pharmaceutical CBD vs. 51.1 ng/mL for artisanal CBD (p=0.022). The pharmaceutical group had a median 50% seizure reduction vs. no change in the artisanal group, though this difference was not statistically significant (p=0.199). Higher CBD concentrations were associated with increased adverse effects.

Key Numbers

42 patients; pharmaceutical CBD: 124 ng/mL serum level; artisanal CBD: 51.1 ng/mL (p=0.022). Pharmaceutical group: median 50% seizure reduction. Artisanal group: no change (p=0.199).

How They Did This

Retrospective chart review of 42 patients with pharmacoresistant epilepsy treated with either artisanal CBD oil or pharmaceutical CBD (Epidiolex). Serum CBD concentrations, seizure frequency, and side effects tracked.

Why This Research Matters

Patients and families often choose artisanal CBD products for cost reasons, but this study shows pharmaceutical CBD achieves significantly higher blood levels, which may translate to better seizure control.

The Bigger Picture

The CBD product marketplace ranges from pharmaceutical-grade to unregulated artisanal products. This study provides one of the first direct comparisons of blood levels, offering data for the ongoing debate about product quality and interchangeability.

What This Study Doesn't Tell Us

Retrospective, non-randomized. Small sample size. Artisanal product composition and dosing not standardized. Seizure reduction difference was not statistically significant (may be underpowered). No blinding.

Questions This Raises

  • ?Would higher-dose artisanal CBD achieve equivalent blood levels?
  • ?Is the lack of significant seizure difference due to low power or true equivalence?
  • ?Should clinicians recommend pharmaceutical over artisanal CBD?

Trust & Context

Key Stat:
Pharmaceutical CBD: 124 ng/mL vs. artisanal: 51 ng/mL serum levels
Evidence Grade:
Retrospective comparison with significant bioavailability finding, but seizure outcomes were not statistically different.
Study Age:
Published in 2022.
Original Title:
Variability in Serum Concentrations and Clinical Response in Artisanal Versus Pharmaceutical Cannabidiol Treatment of Pediatric Pharmacoresistant Epilepsy.
Published In:
The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 27(6), 558-563 (2022)
Database ID:
RTHC-03764

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Are all CBD products equally effective for epilepsy?

This study suggests not. Pharmaceutical CBD (Epidiolex) achieved 2.4 times higher blood levels than artisanal CBD oils, with a trend toward better seizure control. However, the seizure reduction difference was not statistically significant in this small study.

Do higher CBD blood levels mean more side effects?

Yes. Patients with higher serum CBD concentrations (typically in the pharmaceutical group) reported more adverse effects, highlighting a trade-off between potentially better efficacy and increased side effects.

Read More on RethinkTHC

Cite This Study

RTHC-03764·https://rethinkthc.com/research/RTHC-03764

APA

Cohen, Nathan T; Bahar, Burak; Conry, Joan A; Schreiber, John M. (2022). Variability in Serum Concentrations and Clinical Response in Artisanal Versus Pharmaceutical Cannabidiol Treatment of Pediatric Pharmacoresistant Epilepsy.. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 27(6), 558-563. https://doi.org/10.5863/1551-6776-27.6.558

MLA

Cohen, Nathan T, et al. "Variability in Serum Concentrations and Clinical Response in Artisanal Versus Pharmaceutical Cannabidiol Treatment of Pediatric Pharmacoresistant Epilepsy.." The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2022. https://doi.org/10.5863/1551-6776-27.6.558

RethinkTHC

RethinkTHC Research Database. "Variability in Serum Concentrations and Clinical Response in..." RTHC-03764. Retrieved from https://rethinkthc.com/research/cohen-2022-variability-in-serum-concentrations

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.