CBD & Epilepsy in Kids: The State of the Science

Almost one-third of patients with epilepsy have a treatment-resistant form, which is associated with severe debilitation and increased mortality. Cannabis-based treatments for epilepsy have generated much interest; many families have turned to cannabis to treat their children in hopes of alleviating epileptic seizure activity and intensity. 

Using a mouse model of Dravet syndrome, which is a severe childhood epilepsy disorder caused by genetic mutations that alter brain function, researchers found that CBD reduced the duration, severity and frequency of seizures in mice. Treatment with lower doses of CBD also improved autistic-like social interaction deficits in these mice.

Consistent with these findings are results from one of the largest studies of treatment-resistant epilepsy in children and young adults (The Lancet Neurology).  162 patients were treated as an add-on to their existing medications with a 99% cannabidiol (CBD) extract, and monitored for 12 weeks. The researchers found that the intervention reduced seizures by 36.5%, and 2% of patients became completely seizure-free. Although serious adverse events were reported in 48 (30%) of patients, the researchers concluded that CBD might have an adequate safety profile in children and young adults that have highly treatment-resistant epilepsy.  

More evidence supports the potential anti-seizure efficacy of CBD following the completion of three high-quality placebo-controlled trials in patients with the epilepsy syndromes, Dravet syndrome and Lennox-Gastaut syndrome (J Epilepsy Res. 2017; 7(2): 61–76). In these studies, CBD was superior to placebo in reducing the frequency of convulsive seizures in patients with Dravet syndrome, and the frequency of drop seizures in patients with Lennox-Gastaut syndrome. It should be noted that in all of these studies, it’s unclear whether the improved seizure control described was directly related to the action of CBD, or was mediated through drug interactions with other medications given concurrently to these patients. Further clinical trials will be needed to discern the important role of CBD in the absence of other drugs in the treatment of specific epilepsy syndromes and treatment-resistant epilepsy.