56% of children with treatment-resistant epilepsy had at least 50% seizure reduction with CBD-enriched cannabis oil | Research

The takeaway

An observational study of 57 children and young adults with treatment-resistant epilepsy found that 56% achieved at least 50% seizure reduction with CBD-enriched cannabis oil (20:1 CBD:THC), with younger age and higher doses linked to better response, though 46% reported adverse reactions.

Read this if your child has treatment-resistant epilepsy and you are considering CBD-based treatment.

56% achieved 50%+ seizure reduction; 46% reported adverse reactions

What the researchers found

Researchers followed 57 patients aged 1-20 years with epilepsy of various causes who were treated with CBD-enriched cannabis oil (CBD:THC ratio of 20:1) for at least 3 months, with a median follow-up of 18 months.

Of 46 patients included in efficacy analysis, 26 (56%) achieved at least 50% reduction in mean monthly seizure frequency.

Response rates did not differ significantly by epilepsy type or cannabis strain used. However, younger age at treatment onset and higher CBD doses (>11 mg/kg/day) were associated with better response.

The average CBD dose was 11.4 mg/kg/day. Adverse reactions were reported in 46% of patients and were the main reason for treatment cessation.

The results are based on parental reports of seizure frequency, and the authors emphasized the need for randomized controlled trials to assess true efficacy.

Why it matters

This study provides real-world data on CBD-enriched cannabis for a broader range of pediatric epilepsy types than the FDA-approved indications (Dravet and Lennox-Gastaut syndromes). The high adverse reaction rate (46%) and the finding that it was the main reason for treatment cessation provide important safety data for clinicians and families.

The numbers in context

57 patients, 46 in efficacy analysis. 56% achieved 50%+ seizure reduction. Average CBD dose 11.4 mg/kg/day. CBD:THC ratio 20:1. Median follow-up 18 months. Adverse reactions in 46%. Younger age and higher doses predicted better response.

How the study worked

Observational, longitudinal study of 57 patients (age 1-20) with various epilepsy etiologies treated with CBD:THC 20:1 cannabis oil extract for at least 3 months. Median follow-up 18 months. 46 patients included in efficacy analysis. Response defined as 50% or greater reduction in monthly seizure frequency.

What this study cannot tell us

Observational design without placebo control means response rates may include placebo effects. Seizure frequency based on parental report, not EEG monitoring. No randomization. Adverse event rate may reflect the specific product used. 11 patients were excluded from efficacy analysis, potentially biasing results.

How to read the evidence

Longitudinal observational study with reasonable follow-up provides moderate evidence, limited by absence of placebo control and reliance on parental seizure reports.

When this study was published

Published in 2018. FDA-approved CBD (Epidiolex) has since become available, and additional clinical data has emerged.

The bigger picture

This study adds to the growing evidence base for CBD in pediatric epilepsy beyond the specific syndromes studied in randomized trials. The predictors of response (younger age, higher dose) provide clinically useful guidance, while the high adverse event rate underscores the importance of medical supervision.

Questions still open

Would a placebo-controlled trial confirm the 56% response rate? What is the optimal CBD:THC ratio for seizure control? Why does younger age predict better response? Are the adverse reactions dose-dependent?

Common questions

Did CBD-enriched cannabis oil help children with seizures?

56% of the 46 children analyzed had at least a 50% reduction in monthly seizure frequency. The response did not depend on epilepsy type but was better in younger children and those receiving higher CBD doses.

Were there side effects?

Yes. 46% of patients reported adverse reactions, and adverse effects were the most common reason for stopping treatment. The specific adverse reactions were not detailed in the abstract.

Read the original research

Efficacy of CBD-enriched medical cannabis for treatment of refractory epilepsy in children and adolescents - An observational, longitudinal study.

Brain & development, 40(7), 544-551

View on PubMed ↗Publisher’s paper ↗

Citation

Hausman-Kedem, Moran; Menascu, Shay; Kramer, Uri. (2018). Efficacy of CBD-enriched medical cannabis for treatment of refractory epilepsy in children and adolescents - An observational, longitudinal study.. Brain & development, 40(7), 544-551. https://doi.org/10.1016/j.braindev.2018.03.013