Advertisement

Report of a parent survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant epilepsy

      Abstract

      Severe childhood epilepsies are characterized by frequent seizures, neurodevelopmental delays, and impaired quality of life. In these treatment-resistant epilepsies, families often seek alternative treatments. This survey explored the use of cannabidiol-enriched cannabis in children with treatment-resistant epilepsy. The survey was presented to parents belonging to a Facebook group dedicated to sharing information about the use of cannabidiol-enriched cannabis to treat their child's seizures. Nineteen responses met the following inclusion criteria for the study: a diagnosis of epilepsy and current use of cannabidiol-enriched cannabis. Thirteen children had Dravet syndrome, four had Doose syndrome, and one each had Lennox–Gastaut syndrome and idiopathic epilepsy. The average number of antiepileptic drugs (AEDs) tried before using cannabidiol-enriched cannabis was 12. Sixteen (84%) of the 19 parents reported a reduction in their child's seizure frequency while taking cannabidiol-enriched cannabis. Of these, two (11%) reported complete seizure freedom, eight (42%) reported a greater than 80% reduction in seizure frequency, and six (32%) reported a 25–60% seizure reduction. Other beneficial effects included increased alertness, better mood, and improved sleep. Side effects included drowsiness and fatigue. Our survey shows that parents are using cannabidiol-enriched cannabis as a treatment for their children with treatment-resistant epilepsy. Because of the increasing number of states that allow access to medical cannabis, its use will likely be a growing concern for the epilepsy community. Safety and tolerability data for cannabidiol-enriched cannabis use among children are not available. Objective measurements of a standardized preparation of pure cannabidiol are needed to determine whether it is safe, well tolerated, and efficacious at controlling seizures in this pediatric population with difficult-to-treat seizures.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Epilepsy & Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wheless J.W.
        Managing severe epilepsy syndromes of early childhood.
        J Child Neurol. 2009; 24 ([quiz 33S-26S]): 24S-32S
        • McTague A.
        • Cross J.H.
        Treatment of epileptic encephalopathies.
        CNS Drugs. 2013; 27: 175-184
        • Mechoulam R.
        • Shani A.
        • Edery H.
        • Grunfeld Y.
        Chemical basis of hashish activity.
        Science. 1970; 169: 611-612
        • Izzo A.A.
        • Borrelli F.
        • Capasso R.
        • Di Marzo V.
        • Mechoulam R.
        Non-psychotropic plant cannabinoids: new therapeutic opportunities from an ancient herb.
        Trends Pharmacol Sci. 2009; 30: 515-527
        • Zuardi A.W.
        Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action.
        Rev Bras Psiquiatr. 2008; 30: 271-280
        • Meier M.H.
        • Caspi A.
        • Ambler A.
        • Harrington H.
        • Houts R.
        • Keefe R.S.
        • et al.
        Persistent cannabis users show neuropsychological decline from childhood to midlife.
        Proc Natl Acad Sci U S A. 2012; 109: E2657-E2664
        • D'Souza D.C.
        • Sewell R.A.
        • Ranganathan M.
        Cannabis and psychosis/schizophrenia: human studies.
        Eur Arch Psychiatry Clin Neurosci. 2009; 259: 413-431
        • Karler R.
        • Turkanis S.A.
        Subacute cannabinoid treatment: anticonvulsant activity and withdrawal excitability in mice.
        Br J Pharmacol. 1980; 68: 479-484
        • Izquierdo I.
        • Orsingher O.A.
        • Berardi A.C.
        Effect of cannabidiol and of other cannabis sativa compounds on hippocampal seizure discharges.
        Psychopharmacologia. 1973; 28: 95-102
        • Izquierdo I.
        • Tannhauser M.
        Letter: the effect of cannabidiol on maximal electroshock seizures in rats.
        J Pharm Pharmacol. 1973; 25: 916-917
        • Cox B.
        • ten Ham M.
        • Loskota W.J.
        • Lomax P.
        The anticonvulsant activity of cannabinoids in seizure sensitive gerbils.
        Proc West Pharmacol Soc. 1975; 18: 154-157
        • Consroe P.
        • Benedito M.A.
        • Leite J.R.
        • Carlini E.A.
        • Mechoulam R.
        Effects of cannabidiol on behavioral seizures caused by convulsant drugs or current in mice.
        Eur J Pharmacol. 1982; 83: 293-298
        • Jones N.A.
        • Hill A.J.
        • Smith I.
        • Bevan S.A.
        • Williams C.M.
        • Whalley B.J.
        • et al.
        Cannabidiol displays antiepileptiform and antiseizure properties in vitro and in vivo.
        J Pharmacol Exp Ther. 2010; 332: 569-577
        • Jones N.A.
        • Glyn S.E.
        • Akiyama S.
        • Hill T.D.
        • Hill A.J.
        • Weston S.E.
        • et al.
        Cannabidiol exerts anti-convulsant effects in animal models of temporal lobe and partial seizures.
        Seizure. 2012; 21: 344-352
        • Mechoulam R.
        • Carlini E.A.
        Toward drugs derived from cannabis.
        Die Naturwissenschaften. 1978; 65: 174-179
        • Cunha J.M.
        • Carlini E.A.
        • Pereira A.E.
        • Ramos O.L.
        • Pimentel C.
        • Gagliardi R.
        • et al.
        Chronic administration of cannabidiol to healthy volunteers and epileptic patients.
        Pharmacology. 1980; 21: 175-185
        • Ames F.R.
        • Cridland S.
        Anticonvulsant effect of cannabidiol.
        S Afr Med J. 1986; 69: 14
        • Harris P.A.
        • Taylor R.
        • Thielke R.
        • Payne J.
        • Gonzalez N.
        • Conde J.G.
        • et al.
        Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inform. 2009; 42: 377-381
        • Chiron C.
        • Marchand M.C.
        • Tran A.
        • Rey E.
        • d'Athis P.
        • Vincent J.
        • et al.
        Stiripentol in severe myoclonic epilepsy in infancy: a randomised placebo-controlled syndrome-dedicated trial. STICLO study group.
        Lancet. 2000; 356: 1638-1642
        • Wheless J.W.
        Intractable epilepsy: a survey of patients and caregivers.
        Epilepsy Behav. 2006; 8: 756-764
        • Bourgeois B.F.
        Initiating antiepileptic drug treatment and characteristics of drugs.
        Handb Clin Neurol. 2013; 111: 719-725
        • Consroe P.
        • Martin P.
        • Eisenstein D.
        Anticonvulsant drug antagonism of delta9tetrahydrocannabinol-induced seizures in rabbits.
        Res Commun Chem Pathol Pharmacol. 1977; 16: 1-13
        • Turkanis S.A.
        • Karler R.
        Excitatory and depressant effects of delta 9-tetrahydrocannabinol and cannabidiol on cortical evoked responses in the conscious rat.
        Psychopharmacology. 1981; 75: 294-298