CBD Did Not Interfere With Diazepam Nasal Spray for Seizure Emergencies in Epilepsy Patients
In a phase 3 safety study of 163 epilepsy patients, concomitant CBD use did not worsen the safety or effectiveness of diazepam nasal spray for seizure clusters, with patients on purified CBD actually showing the lowest rates of drug-attributed adverse events.
Quick Facts
What This Study Found
Of 163 patients, 73% received no CBD, 14.1% received purified CBD (Epidiolex), and 12.9% received other CBD. While overall adverse event rates were higher in CBD users (90.9% vs 79.0%), the lowest rate of events attributed specifically to diazepam nasal spray was in the purified CBD group (13.0%). Use of second diazepam doses (effectiveness proxy) was lowest in the purified CBD group (8.2%) compared to no-CBD (11.6%) and other-CBD (20.3%).
Key Numbers
163 patients. No CBD: 73%. Purified CBD: 14.1%. Other CBD: 12.9%. Drug-attributed adverse events: purified CBD 13.0%, no CBD group higher. Second diazepam dose use: purified CBD 8.2%, no CBD 11.6%, other CBD 20.3%.
How They Did This
Post hoc analysis of a phase 3, 12-month safety study of diazepam nasal spray in patients aged 6-65 with seizure clusters. Concomitant CBD use recorded. Age- and weight-based diazepam dosing.
Why This Research Matters
Many epilepsy patients take both CBD products and rescue benzodiazepines. This study provides reassurance that CBD does not interfere with the safety or effectiveness of diazepam nasal spray, an important practical finding for clinical management.
The Bigger Picture
Drug interactions are a major concern in epilepsy management, where patients often take multiple medications. The finding that purified CBD may actually enhance diazepam nasal spray effectiveness (lower second-dose use) is intriguing and consistent with known CBD-clobazam interactions that can boost benzodiazepine levels.
What This Study Doesn't Tell Us
Post hoc analysis, not pre-specified. Small CBD subgroups. Patients on purified CBD tended to have more severe epilepsy syndromes. Cannot distinguish CBD effects from underlying disease severity differences. Other-CBD products were uncharacterized.
Questions This Raises
- ?Does CBD enhance diazepam effectiveness through pharmacokinetic interaction?
- ?Should epilepsy patients on CBD adjust their rescue benzodiazepine doses?
Trust & Context
- Key Stat:
- Purified CBD users had the lowest rate of diazepam-attributed adverse events (13%)
- Evidence Grade:
- Post hoc analysis of a phase 3 study with small CBD subgroups, providing safety reassurance but not definitive drug interaction data.
- Study Age:
- Published 2023.
- Original Title:
- Concomitant cannabidiol does not impact safety and effectiveness of diazepam nasal spray for seizure clusters: Post hoc analysis of a phase 3 safety study.
- Published In:
- Epilepsy & behavior : E&B, 144, 109248 (2023)
- Authors:
- Peters, Jurriaan M, Puri, Vinay, Segal, Eric(3), Misra, Sunita N, Rabinowicz, Adrian L, Carrazana, Enrique
- Database ID:
- RTHC-04848
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
Can you take CBD with seizure rescue medications?
This study found CBD did not interfere with diazepam nasal spray safety or effectiveness. Patients on purified CBD actually needed second doses less often.
Does CBD interact with benzodiazepines?
While CBD can interact with benzodiazepines through liver enzymes, this study found no negative safety signals when CBD was used alongside diazepam nasal spray for seizure emergencies.
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Cite This Study
https://rethinkthc.com/research/RTHC-04848APA
Peters, Jurriaan M; Puri, Vinay; Segal, Eric; Misra, Sunita N; Rabinowicz, Adrian L; Carrazana, Enrique. (2023). Concomitant cannabidiol does not impact safety and effectiveness of diazepam nasal spray for seizure clusters: Post hoc analysis of a phase 3 safety study.. Epilepsy & behavior : E&B, 144, 109248. https://doi.org/10.1016/j.yebeh.2023.109248
MLA
Peters, Jurriaan M, et al. "Concomitant cannabidiol does not impact safety and effectiveness of diazepam nasal spray for seizure clusters: Post hoc analysis of a phase 3 safety study.." Epilepsy & behavior : E&B, 2023. https://doi.org/10.1016/j.yebeh.2023.109248
RethinkTHC
RethinkTHC Research Database. "Concomitant cannabidiol does not impact safety and effective..." RTHC-04848. Retrieved from https://rethinkthc.com/research/peters-2023-concomitant-cannabidiol-does-not
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.