A Comprehensive Review of CBD (Epidiolex) for Treatment-Resistant Epilepsy in Children and Adults

Randomized clinical trials support CBD for seizures in three rare epileptic encephalopathies: Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex. CBD shows broad-spectrum efficacy across seizure types and possesses anti-inflammatory and neuroprotective properties. Key challenges include limited understanding of pharmacodynamics, complex drug interactions, and lack of expert dosing guidelines.

Comprehensive narrative review of preclinical and clinical evidence for CBD in refractory epilepsy, covering mechanisms, clinical trials, pharmacokinetics, and outstanding challenges.

For families dealing with severe childhood epilepsies that resist standard medications, CBD represents the first plant-derived cannabinoid to receive FDA approval. This review maps both its promise and its unresolved clinical challenges.

The approval of Epidiolex was a landmark moment for cannabinoid medicine, establishing that at least one cannabis-derived compound can meet the rigorous standards of pharmaceutical regulation. The remaining challenges around drug interactions and dosing guidelines highlight how much work remains.

Narrative review without systematic methodology. Some included trial data are industry-sponsored. Long-term seizure freedom data are limited. CBD pharmacokinetics are complex with significant drug interactions.