CBD Reduced Seizures by 50% or More in Children With Severe Epilepsies

Pharmaceutical CBD (up to 50 mg/kg/day) achieved 50% or greater seizure reduction in at least 20% of participants in 11 of 14 included studies. Common adverse events were somnolence, appetite loss, diarrhea, fatigue, and elevated liver enzymes, mostly mild to moderate.

Systematic review searching MEDLINE, Cochrane Central Register, and trial registries through March 2024. All study types were eligible with no language or date restrictions. Risk of bias assessed using RoB2 and ROBINS-I V2. 14 of 722 identified records met inclusion criteria.

Developmental and epileptic encephalopathies are among the most treatment-resistant forms of epilepsy in children, often failing multiple medications. This systematic review confirms that CBD provides meaningful seizure reduction for a substantial minority of these children.

CBD (as Epidiolex) is already approved for certain severe epilepsies, but this review broadens the evidence to the wider category of developmental and epileptic encephalopathies. The consistent findings across different study designs and populations strengthen the case for CBD as a treatment option in refractory pediatric epilepsy.

Included studies varied widely in design (RCTs, open-label, retrospective). No meta-analysis was performed due to heterogeneity. Most studies were relatively small. Long-term efficacy and developmental outcomes were not well captured. Publication bias may favor positive results.