Artisanal CBD preparations reduced seizures by 50% or more in 39% of children with epilepsy, with increased alertness in 14% | Research

The takeaway

A retrospective study of 108 children with epilepsy found that artisanal CBD oil preparations achieved greater than 50% seizure reduction in 39% of patients (10% seizure-free), with increased alertness and improved verbal interactions in 14%, and sedation as the main side effect in less than 4%.

Pediatric neurologists considering CBD for refractory epilepsy; parents using or considering artisanal CBD products; epilepsy researchers.

39% had >50% seizure reduction; 14% showed improved alertness and verbal interactions

What the researchers found

Researchers reviewed records of 108 pediatric epilepsy patients using artisanal CBD oil preparations at a tertiary medical center.

39% of patients achieved greater than 50% seizure reduction, with 10% becoming seizure-free.

No patients achieved CBD monotherapy, but AED weaning became possible in 22% of patients.

Patients also taking clobazam had a slightly higher response rate (44% vs 33% without clobazam), but this difference was not statistically significant.

Sedation was the most common side effect, occurring in less than 4% of patients, all of whom were also taking clobazam.

Notably, 14% of patients showed increased alertness and improved verbal interactions, a positive cognitive effect.

Benefits were more marked in the CBD-alone group compared to CBD + clobazam, but this difference was also not statistically significant.

Why it matters

While pharmaceutical CBD (Epidiolex) data gets the most attention, most families using CBD for epilepsy are using artisanal preparations from dispensaries. This real-world data from a tertiary center shows that artisanal products can be effective, with response rates comparable to clobazam and with a favorable side effect profile.

The numbers in context

108 patients. 39% achieved >50% seizure reduction. 10% seizure-free. AED weaning possible in 22%. Sedation in <4% (all on clobazam). 14% showed increased alertness/verbal interactions. Clobazam subgroup: 44% vs 33% response (not significant).

How the study worked

Retrospective study of 108 pediatric epilepsy patients using artisanal CBD preparations. Medical record review. Subgroup comparison by clobazam use. Comparison of CBD responder rate to clobazam responder rate in overlapping cohort.

What this study cannot tell us

Retrospective design. Artisanal products are not standardized (varying CBD content, purity, and other cannabinoid levels). No placebo control. Observer/caregiver bias in reporting seizure counts. Small numbers in subgroup analyses.

How to read the evidence

Moderate. Real-world data from a tertiary center with adequate sample, but retrospective design and unstandardized artisanal products limit conclusions.

When this study was published

Published in 2018, before FDA approval of Epidiolex. Artisanal CBD use for epilepsy continues alongside pharmaceutical options.

The bigger picture

The 14% of patients showing improved alertness and verbal interactions is particularly interesting because it suggests CBD may have positive cognitive effects beyond seizure control, which could matter enormously for quality of life in children with epilepsy.

Questions still open

How do artisanal CBD products compare to pharmaceutical CBD in a controlled trial? What explains the improved alertness in some patients? Are specific artisanal formulations more effective than others?

Common questions

Are artisanal CBD products as good as Epidiolex?

This study found response rates (39% with >50% improvement) that are broadly comparable to pharmaceutical CBD trials. However, artisanal products are not standardized, so CBD content, purity, and the presence of other cannabinoids varies. This makes dosing less precise and quality less guaranteed.

Why did some children become more alert on CBD?

The 14% who showed increased alertness and improved verbal interactions may have benefited from better seizure control (fewer subclinical seizures), reduction of sedating AEDs, or direct cognitive effects of CBD. This finding is noteworthy and deserves further study.

Read the original research

Efficacy of artisanal preparations of cannabidiol for the treatment of epilepsy: Practical experiences in a tertiary medical center.

Epilepsy & behavior : E&B, 80, 240-246

View on PubMed ↗Publisher’s paper ↗

Citation

Porcari, Giulia S; Fu, Cary; Doll, Emily D; Carter, Emma G; Carson, Robert P. (2018). Efficacy of artisanal preparations of cannabidiol for the treatment of epilepsy: Practical experiences in a tertiary medical center.. Epilepsy & behavior : E&B, 80, 240-246. https://doi.org/10.1016/j.yebeh.2018.01.026