Thai CBD Oil Showed Sustained Seizure Reduction in Children With Drug-Resistant Epilepsy Over 12+ Months
In the first Thai multicenter study, CBD-enriched oil as add-on treatment achieved consistent seizure reduction in children with drug-resistant epilepsy over 12+ months, with most adverse events being mild.
Quick Facts
What This Study Found
Among 101 pediatric patients who had failed an average of 7 antiseizure medications, CBD-enriched oil at a median dose of 6 mg/kg/day produced consistent improvements in 50%+ seizure reduction rates at 3, 6, 9, 12 months and latest follow-up. Most seizure types responded positively except complex motor seizures. While 92% experienced adverse events, 95% were mild (somnolence, elevated liver enzymes, anorexia, irritability).
Key Numbers
101 patients, 42% male, median age 10 years. Median seizure frequency: 75/month at baseline. Failed average of 7 antiseizure medications. Median CBD dose: 6 mg/kg/day (range 1-15). Median follow-up: 15 months. Adverse events in 92%, mild in 95%. 33 discontinued (57% intolerable adverse events, 30% ineffectiveness, 12% noncompliance).
How They Did This
Prospective observational study across 19 Thai government hospitals (2021-2023). Enrolled 101 pediatric patients with drug-resistant epilepsy of various etiologies. Median follow-up: 15 months. Assessed seizure reduction, adverse events, and treatment discontinuation.
Why This Research Matters
This is the first multicenter evidence for CBD-enriched oil in pediatric epilepsy from Thailand, demonstrating that medical-grade CBD products developed outside Western pharmaceutical markets can be effective and tolerable for treatment-resistant cases.
The Bigger Picture
With Epidiolex setting the standard for CBD in epilepsy, this study shows that nationally developed CBD products can achieve similar outcomes at potentially lower costs, which matters for healthcare systems in developing countries.
What This Study Doesn't Tell Us
No randomized control group. Open-label design means placebo effects cannot be excluded. Variable etiologies make interpretation complex. 33 of 101 discontinued treatment. Adverse event rate was high (92%), though most were mild.
Questions This Raises
- ?How does the Thai CBD oil compare to Epidiolex in terms of purity and efficacy?
- ?Could the 33% discontinuation rate be reduced with better dosing protocols?
- ?Are the liver enzyme elevations clinically significant long-term?
Trust & Context
- Key Stat:
- Sustained seizure reduction over 12+ months in children who had failed an average of 7 antiseizure medications
- Evidence Grade:
- Moderate: multicenter prospective design with 15-month follow-up, but open-label without control group limits certainty.
- Study Age:
- 2025 study (2021-2023 enrollment).
- Original Title:
- National Multicenter Cohort Study: Adjunctive Cannabidiol-Enriched Cannabis Oil for Pediatric Drug-Resistant Epilepsy Treatment in Thailand.
- Published In:
- Pediatric neurology, 169, 59-68 (2025)
- Authors:
- Lusawat, Apasri, Khongkhatithum, Chaiyos, Suwannachote, Sirorat, Katanyuwong, Kamornwan, Fangsa-Ad, Thitiporn, Anurat, Kingthong, Pattharathitikul, Siriporn, Thongmak, Tipaporn, Thewamit, Rapeepat, Sudachan, Panisra, Rojanawatsirivej, Apimid, Thampratankul, Lunliya, Sattaporn, Chanikhan, Bunyatumma, Puangtong, Auvichayapat, Narong, Laohasaran, Salin, Anuroj, Krittawit, Kontun, Sineenart, Cheawcharnprapan, Krit, Paticheep, Sudathip, Paibool, Watuhatai, Thirapote, Pat, Sanguansermsri, Chinnuwat, Suwanpakdee, Piradee, Woravimolvanich, Ornpreeya, Watcharakuldilok, Piangor, Visudtibhan, Anannit
- Database ID:
- RTHC-06998
Evidence Hierarchy
Enrolls participants and follows them forward in time.
What do these levels mean? →Frequently Asked Questions
How severe was the epilepsy in these children?
Very severe. The median seizure frequency was 75 per month, and patients had failed an average of 7 different antiseizure medications before trying CBD.
Were there safety concerns?
92% experienced adverse events, but 95% were mild (sleepiness, elevated liver enzymes, decreased appetite, irritability). About one-third discontinued treatment, mostly due to side effects or lack of effectiveness.
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Cite This Study
https://rethinkthc.com/research/RTHC-06998APA
Lusawat, Apasri; Khongkhatithum, Chaiyos; Suwannachote, Sirorat; Katanyuwong, Kamornwan; Fangsa-Ad, Thitiporn; Anurat, Kingthong; Pattharathitikul, Siriporn; Thongmak, Tipaporn; Thewamit, Rapeepat; Sudachan, Panisra; Rojanawatsirivej, Apimid; Thampratankul, Lunliya; Sattaporn, Chanikhan; Bunyatumma, Puangtong; Auvichayapat, Narong; Laohasaran, Salin; Anuroj, Krittawit; Kontun, Sineenart; Cheawcharnprapan, Krit; Paticheep, Sudathip; Paibool, Watuhatai; Thirapote, Pat; Sanguansermsri, Chinnuwat; Suwanpakdee, Piradee; Woravimolvanich, Ornpreeya; Watcharakuldilok, Piangor; Visudtibhan, Anannit. (2025). National Multicenter Cohort Study: Adjunctive Cannabidiol-Enriched Cannabis Oil for Pediatric Drug-Resistant Epilepsy Treatment in Thailand.. Pediatric neurology, 169, 59-68. https://doi.org/10.1016/j.pediatrneurol.2025.04.015
MLA
Lusawat, Apasri, et al. "National Multicenter Cohort Study: Adjunctive Cannabidiol-Enriched Cannabis Oil for Pediatric Drug-Resistant Epilepsy Treatment in Thailand.." Pediatric neurology, 2025. https://doi.org/10.1016/j.pediatrneurol.2025.04.015
RethinkTHC
RethinkTHC Research Database. "National Multicenter Cohort Study: Adjunctive Cannabidiol-En..." RTHC-06998. Retrieved from https://rethinkthc.com/research/lusawat-2025-national-multicenter-cohort-study
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.