Research Article| Volume 45, P49-52, April 2015

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Parental reporting of response to oral cannabis extracts for treatment of refractory epilepsy


      • Parents in our study reported a 33% response to OCE.
      • Relocating to Colorado had a significant effect on response rates.
      • The response rate is similar to previously reported placebo response rates.
      • Reported response was not correlated with improved background EEG data.
      • Parents reported a variety of additional benefits of OCE and adverse reactions.



      Oral cannabis extracts (OCEs) have been used in the treatment of epilepsy; however, no studies demonstrate clear efficacy. We report on a cohort of pediatric patients with epilepsy who were given OCE and followed in a single tertiary epilepsy center.


      A retrospective chart review of children and adolescents who were given OCE for treatment of their epilepsy was performed.


      Seventy-five patients were identified of which 57% reported any improvement in seizure control and 33% reported a >50% reduction in seizures (responders). If the family had moved to CO for OCE treatment, the responder rate was 47% vs. 22% for children who already were in CO. The responder rate varied based on epilepsy syndrome: Dravet 23%, Doose 0%, and Lennox–Gastaut syndrome (LGS) 88.9%. The background EEG of the 8 responders where EEG data were available was not improved. Additional benefits reported included: improved behavior/alertness (33%), improved language (10%), and improved motor skills (10%). Adverse events (AEs) occurred in 44% of patients including increased seizures (13%) and somnolence/fatigue (12%). Rare adverse events included developmental regression, abnormal movements, status epilepticus requiring intubation, and death.


      Our retrospective study of OCE use in pediatric patients with epilepsy demonstrates that some families reported patient improvement with treatment; however, we also found a variety of challenges and possible confounding factors in studying OCE retrospectively in an open-labeled fashion. We strongly support the need for controlled, blinded studies to evaluate the efficacy and safety of OCE for treatment of pediatric epilepsies using accurate seizure counts, formal neurocognitive assessments, as well as EEG as a biomarker. This study provides Class III evidence that OCE is well tolerated by children and adolescents with epilepsy.


      OCEs (Oral cannabis extracts), LGS (Lennox–Gastaut syndrome), AEs (Adverse Events), CO (Colorado), Δ9-THC (Δ9-Tetrahydrocannabinol)


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        • (CDC) Centers for Disease Control and Prevention
        Epilepsy in adults and access to care—United States, 2010.
        in: Morbidity and mortality weekly report. 61. MMWR, 2012: 909-913
        • Gloss D.
        • Vickrey B.
        Cannabinoids for epilepsy.
        Cochrane Database Syst Rev. 2012; 6: CD009270
        • Porter B.E.
        • Jacobson C.
        Report of a parent survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant epilepsy.
        Epilepsy Behav. 2013; 29: 574-577
        • Honarmand K.
        • Tierney M.C.
        • O'Connor P.
        • Feinstein A.
        Effects of cannabis on cognitive function in patients with multiple sclerosis.
        Neurology. 2011; 76: 1153-1160
        • Pavisian B.
        • MacIntosh B.J.
        • Szilagyi G.
        • Staines R.W.
        • O'Connor P.
        • Feinstein A.
        Effects of cannabis on cognition in patients with MS: a psychometric and MRI study.
        Neurology. 2014; 82: 1879-1887
        • Beyenburg S.
        • Stavem K.
        • Schmidt D.
        Placebo-corrected efficacy of modern antiepileptic drugs for refractory epilepsy: systematic review and meta-analysis.
        Epilepsia. 2010; 51: 7-26
        • Elger C.
        • Halász P.
        • Maia J.
        • Almeida L.
        • Soares-da-Silva P.
        • Group B–IS
        Efficacy and safety of eslicarbazepine acetate as adjunctive treatment in adults with refractory partial-onset seizures: a randomized, double-blind, placebo-controlled, parallel-group phase III study.
        Epilepsia. 2009; 50: 454-463
        • French J.A.
        • Krauss G.L.
        • Biton V.
        • Squillacote D.
        • Yang H.
        • Laurenza A.
        • et al.
        Adjunctive perampanel for refractory partial-onset seizures: randomized phase III study 304.
        Neurology. 2012; 79: 589-596
        • Ng Y.T.
        • Conry J.A.
        • Drummond R.
        • Stolle J.
        • Weinberg M.A.
        • Investigators O.-S.
        Randomized, phase III study results of clobazam in Lennox–Gastaut syndrome.
        Neurology. 2011; 77: 1473-1481
        • Porter R.J.
        • Burdette D.E.
        • Gil-Nagel A.
        • Hall S.T.
        • White R.
        • Shaikh S.
        • et al.
        Retigabine as adjunctive therapy in adults with partial-onset seizures: integrated analysis of three pivotal controlled trials.
        Epilepsy Res. 2012; 101: 103-112
        • Chervin R.D.
        • Ruzicka D.L.
        • Giordani B.J.
        • Weatherly R.A.
        • Dillon J.E.
        • Hodges E.K.
        • et al.
        Sleep-disordered breathing, behavior, and cognition in children before and after adenotonsillectomy.
        Pediatrics. 2006; 117: e769-e778
        • Carlini E.A.
        • Cunha J.M.
        Hypnotic and antiepileptic effects of cannabidiol.
        J Clin Pharmacol. 1981; 21: 417S-427S
        • Murillo-Rodríguez E.
        • Millán-Aldaco D.
        • Palomero-Rivero M.
        • Mechoulam R.
        • Drucker-Colín R.
        Cannabidiol, a constituent of Cannabis sativa, modulates sleep in rats.
        FEBS Lett. 2006; 580: 4337-4345
        • Nicholson A.N.
        • Turner C.
        • Stone B.M.
        • Robson P.J.
        Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults.
        J Clin Psychopharmacol. 2004; 24: 305-313
        • Russo E.B.
        • Guy G.W.
        • Robson P.J.
        Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine.
        Chem Biodivers. 2007; 4: 1729-1743