Brief Communication| Volume 47, P138-141, June 2015

Download started.


Perceived efficacy of cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy: A potential role for infantile spasms and Lennox–Gastaut syndrome


      There is a great need for safe and effective therapies for treatment of infantile spasms (IS) and Lennox–Gastaut syndrome (LGS). Based on anecdotal reports and limited experience in an open-label trial, cannabidiol (CBD) has received tremendous attention as a potential treatment for pediatric epilepsy, especially Dravet syndrome. However, there is scant evidence of specific utility for treatment of IS and LGS. We sought to document the experiences of children with IS and/or LGS who have been treated with CBD-enriched cannabis preparations. We conducted a brief online survey of parents who administered CBD-enriched cannabis preparations for the treatment of their children's epilepsy. We specifically recruited parents of children with IS and LGS and focused on perceived efficacy, dosage, and tolerability. Survey respondents included 117 parents of children with epilepsy (including 53 with IS or LGS) who had administered CBD products to their children. Perceived efficacy and tolerability were similar across etiologic subgroups. Eighty-five percent of all parents reported a reduction in seizure frequency, and 14% reported complete seizure freedom. Epilepsy was characterized as highly refractory with median latency from epilepsy onset to CBD initiation of five years, during which the patient's seizures failed to improve after a median of eight antiseizure medication trials. The median duration and the median dosage of CBD exposure were 6.8 months and 4.3 mg/kg/day, respectively. Reported side effects were far less common during CBD exposure, with the exception of increased appetite (30%). A high proportion of respondents reported improvement in sleep (53%), alertness (71%), and mood (63%) during CBD therapy. Although this study suggests a potential role for CBD in the treatment of refractory childhood epilepsy including IS and LGS, it does not represent compelling evidence of efficacy or safety. From a methodological standpoint, this study is extraordinarily vulnerable to participation bias and limited by lack of blinded outcome ascertainment. Appropriately controlled clinical trials are essential to establish efficacy and safety.


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


        • Hussain S.A.
        • Sankar R.
        Pharmacologic treatment of intractable epilepsy in children: a syndrome-based approach.
        Semin Pediatr Neurol. 2011; 18: 171-178
        • Szaflarski J.P.
        • Bebin E.M.
        Cannabis, cannabidiol, and epilepsy — from receptors to clinical response.
        Epilepsy Behav. 2014; 41C: 277-282
        • Devinsky O.
        • Cilio M.R.
        • Cross H.
        • Fernandez-Ruiz J.
        • French J.
        • Hill C.
        • et al.
        Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders.
        Epilepsia. 2014; 55: 791-802
        • Sirven J.I.
        Cannabis, cannabidiol, and epilepsies: the truth is somewhere in the middle.
        Epilepsy Behav. 2014; 41: 270-271
        • Maa E.
        • Figi P.
        The case for medical marijuana in epilepsy.
        Epilepsia. 2014; 55: 783-786
        • Cilio M.R.
        • Thiele E.A.
        • Devinsky O.
        The case for assessing cannabidiol in epilepsy.
        Epilepsia. 2014; 55: 787-790
        • 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
        • Mathern G.W.
        • Beninsig L.
        • Nehlig A.
        Fewer specialists support using medical marijuana and CBD in treating epilepsy patients compared with other medical professionals and patients: result of Epilepsia's survey.
        Epilepsia. 2015; 56: 1-6
        • Dulac O.
        Epileptic encephalopathy.
        Epilepsia. 2001; 42: 23-26
        • Guerrini R.
        Dravet syndrome: the main issues.
        Eur J Paediatr Neurol. 2012; 16: S1-S4
        • Stott C.
        • White L.
        • Wright S.
        • Wilbraham D.
        • Guy G.
        A phase I, open-label, randomized, crossover study in three parallel groups to evaluate the effect of rifampicin, ketoconazole, and omeprazole on the pharmacokinetics of THC/CBD oromucosal spray in healthy volunteers.
        SpringerPlus. 2013; 2: 236