Real-world CBD prescriptions reduced seizures in about half of epilepsy patients over 12 months | Research

The takeaway

In a real-world retrospective study of CBD-prescribed epilepsy patients, about half achieved meaningful seizure reduction at 12 months, with most adverse events being mild and manageable.

Epileptologists, patients with drug-resistant epilepsy, and healthcare systems evaluating CBD prescription programs.

Substantial proportion achieved >30% seizure reduction; some >80% (super-responders)

What the researchers found

In routine clinical practice, CBD produced clinically meaningful seizure reduction (>30%) in a substantial proportion of patients. Super-responders (>80% reduction) were also identified. Most adverse events were mild.

Why it matters

RCT data shows CBD works for specific epilepsy syndromes, but real-world effectiveness across broader epilepsy populations is less documented. This study fills that gap.

The numbers in context

Patients prescribed CBD from March 2019 to November 2022. Evaluated at 3, 6, and 12 months. Responders: >30% seizure reduction. Super-responders: >80% reduction. Most adverse events mild.

How the study worked

Retrospective observational study of epilepsy patients prescribed CBD between March 2019 and November 2022 with at least 3 months follow-up. Assessed at baseline, 3, 6, and 12 months. Responders defined as >30% seizure reduction; super-responders as >80%.

What this study cannot tell us

Retrospective design with no control group. Cannot attribute improvement to CBD versus natural seizure fluctuation or other treatment changes. Varied epilepsy etiologies and co-medications. Follow-up completeness may vary.

How to read the evidence

Retrospective real-world study. Complements RCT evidence but lacks control group and randomization.

When this study was published

Published 2023. Prescriptions from March 2019 to November 2022.

The bigger picture

Real-world data complements clinical trials by showing how treatments perform in diverse patient populations with varying comorbidities and co-medications. CBD appears to maintain effectiveness outside the controlled trial setting.

Questions still open

Which epilepsy types beyond Dravet, LGS, and TSC respond best to real-world CBD? Are there predictive markers for super-responders?

Common questions

Does CBD work for epilepsy in real patients?

This real-world study found a substantial proportion of epilepsy patients prescribed CBD achieved meaningful seizure reductions over 12 months. Some were super-responders with 80% or greater reduction. However, without a control group, some improvement could be due to natural seizure fluctuation.

What side effects did epilepsy patients have from CBD?

Most adverse events were mild and manageable. This is consistent with clinical trial data showing CBD is generally well-tolerated, though interactions with other seizure medications (particularly clobazam) require monitoring.

Read the original research

Real-world experience with cannabidiol as add-on treatment in drug-resistant epilepsy.

Seizure, 111, 39-41

View on PubMed ↗Publisher’s paper ↗

Citation

Vicino, Walter; Muccioli, Lorenzo; Pondrelli, Federica; Licchetta, Laura; Stipa, Carlotta; Mostacci, Barbara; Vito, Lidia Di; Ferri, Lorenzo; Cancellerini, Chiara; Sold, Martina; Tinuper, Paolo; Bisulli, Francesca. (2023). Real-world experience with cannabidiol as add-on treatment in drug-resistant epilepsy.. Seizure, 111, 39-41. https://doi.org/10.1016/j.seizure.2023.07.009