Among 35 children with treatment-resistant epilepsy, 94% of those receiving CBD/THC combination therapy achieved 50%+ seizure reduction, compared to only 32% with CBD isolate and 18% with broad-spectrum CBD.
Read this if your child has treatment-resistant epilepsy and you want to understand the evidence for different cannabis-based treatments.
94.1% responseChildren on CBD/THC combination achieving 50%+ seizure reduction vs 31.6% on CBD alone
What the researchers found
In this UK Medical Cannabis Registry case series of 35 children with treatment-resistant epilepsy, 65.7% overall achieved at least 50% seizure reduction. The results were dramatically different by product type: 94.1% of patients on CBD/THC combination therapy achieved this threshold, compared to 31.6% on CBD isolate and only 17.6% on broad-spectrum CBD (p significant). Adverse events were mostly mild (34.2%) or moderate (28.6%).
Why it matters
While CBD alone (Epidiolex) is FDA-approved for certain epilepsies, this real-world data suggests that adding small amounts of THC may dramatically improve seizure control in treatment-resistant children. This challenges the CBD-only approach that dominates pediatric epilepsy treatment.
The numbers in context
- 35 children with treatment-resistant epilepsy
- Overall 50%+ seizure reduction: 65.7% (23/35)
- CBD/THC combination: 94.1% (16/17) achieved 50%+ reduction
- CBD isolate: 31.6% (6/19) achieved 50%+ reduction
- Broad-spectrum CBD: 17.6% (3/17) achieved 50%+ reduction
- Mild AEs: 34.2%; moderate AEs: 28.6%
How the study worked
Case series from the UK Medical Cannabis Registry. Children <18 years with treatment-resistant epilepsy. Prescribed CBD isolate, broad-spectrum CBD, or CBD/THC combination. Primary outcomes: 50%+ seizure reduction, IPES scores, adverse events.
Who was studied
35 children (<18 years) with treatment-resistant epilepsy from the UK Medical Cannabis Registry
What this study cannot tell us
Uncontrolled case series — no randomization or blinding. Patients were not randomly assigned to products, introducing selection bias. Very small sample sizes per group. Open-label design may influence reporting. Cannot determine if THC alone or the combination drives the effect.
How to read the evidence
Uncontrolled case series with small sample sizes. The dramatic difference between groups is striking but requires confirmation in controlled trials.
When this study was published
Published in 2023. Among the first real-world comparisons of different cannabis product types for pediatric epilepsy.
The bigger picture
The overwhelming superiority of CBD/THC combination in this small series, if confirmed in controlled trials, could fundamentally change pediatric epilepsy treatment. The reluctance to use THC in children is understandable, but treatment-resistant epilepsy carries enormous morbidity.
Questions still open
- Would a controlled trial confirm the superiority of CBD/THC over CBD alone?
- What is the optimal CBD:THC ratio for pediatric epilepsy?
- What are the long-term neurodevelopmental effects of THC exposure in epileptic children?
Read the original research
Clinical Outcome Data of Children Treated with Cannabis-Based Medicinal Products for Treatment Resistant Epilepsy-Analysis from the UK Medical Cannabis Registry.
Neuropediatrics, 54(3), 174-181
Citation
Erridge, Simon; Holvey, Carl; Coomber, Ross; Hoare, Jonathan; Khan, Shaheen; Platt, Michael W; Rucker, James J; Weatherall, Mark W; Beri, Sushil; Sodergren, Mikael H. (2023). Clinical Outcome Data of Children Treated with Cannabis-Based Medicinal Products for Treatment Resistant Epilepsy-Analysis from the UK Medical Cannabis Registry.. Neuropediatrics, 54(3), 174-181. https://doi.org/10.1055/a-2002-2119