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Background. Lennox-Gastaut Syndrome (LGS) and Dravet Syndrome(DS) are two types of childhood epilepsy syndromes that are often resistant to traditional anti-epileptic drug (AED) regimens. With the development of a pharmaceutical grade purified cannabidiol (CBD), there has been increasing interest in its utility for treatment of epilepsy. We conducted a systematic review to explore the efficacy of CBD in reducing seizure frequency when added to traditional AED regimens in those who are considered to have treatment resistant epilepsy (TRE).
Method. A search of PubMed was performed in September 2020 using the terms “cannabidiol”, “Lennox-Gastaut Syndrome”, “Dravet Syndrome”, and “epilepsy” with a filter for clinical trials and randomized control trials (RCTs). Six studies were selected that evaluated the efficacy of pharmaceutical grade cannabidiol as adjuvant therapy in treating treatment resistant epilepsy. Treatment efficacy was measured by seizure frequency and was documented similarly among trials to allow for relative comparison between studies. Two of the six studies looked at long-term safety in addition to efficacy, which provided a more clinical application for the drug.
Results. Of the six studies analyzed, the mean percent reduction in all seizure frequency from baseline was 41.5% in the treatment groups and 17.4% in the placebo groups. Of the two studies looking at long-term safety data, an average of 92.1% of participants experienced an adverse event.
Conclusion. CBD as an adjuvant medication for treatment resistant epilepsy may have potential to reduce seizure frequency, but not without the risk of adverse effects. Additional research with larger sample sizes is warranted to better understand its utility and safety.
Anadale M, Gray H. Effects of Cannabidiol as Adjunct Therapy for Management of Treatment-Resistant Epilepsy. 2021