BOSTON—Cannabidiol (CBD) add-on therapy may reduce drop seizures by 50% in some adults and
children with Lennox-Gastaut syndrome (LGS), according to research presented at the 69th Annual Meeting of
the American Academy of Neurology. “Our study found
that CBD shows great promise, in that it may reduce
seizures that are otherwise difficult to control,” said
Anup Patel, MD, a pediatric neurologist at Nationwide
Children’s Hospital in Columbus, Ohio.
Evaluating CBD in LGS
LGS is a severe form of epilepsy that starts in childhood and causes multiple kinds of seizures, including
drop seizures and tonic-clonic seizures, which can lead
to serious injuries. To evaluate the efficacy of add-on
CBD for the treatment of drop seizures associated with
LGS, Dr. Patel and colleagues conducted a randomized,
double-blind, placebo-controlled trial.
Eligible participants were between ages 2 and 55
and had a clinical diagnosis of LGS, eight or more
drop seizures during a four-week baseline, and
documented failures on one or more antiepileptic
drugs. Participants received 20 mg/kg/day of CBD,
10 mg/kg/day of CBD, or placebo for 14 weeks, in
addition to their current medications. The primary
efficacy end point was the percentage change from
baseline in drop seizures per month over the course
of the study.
Researchers randomized 225 patients; 76 patients
received 20 mg/kg/day of CBD, 73 patients received
10 mg/kg/day of CBD, and 76 patients received placebo. At baseline, the participants had a median
monthly drop seizure frequency of 85, and they had
previously failed a median of six epilepsy drugs.
Participants were taking a median of three epilepsy
drugs, in addition to CBD or placebo, throughout
CBD Versus Placebo
Investigators observed a significantly greater reduction in drop seizure frequency in patients who received
20 mg/kg/day of CBD (42%) or 10 mg/kg/day of CBD
(37%) than in patients who received placebo (17%). In
addition, about 40% of patients who received CBD had
at least a 50% reduction in drop seizures, compared
with 15% of patients who received placebo.
Ninety-four percent of patients who received the higher
dose of CBD reported adverse events, compared with 84%
of participants who received the lower dose of CBD and
72% of participants who received placebo. The two most
commonly reported adverse events were somnolence and
decreased appetite. Most adverse events were mild or moderate. Treatment-related serious adverse events occurred in
five patients who received 20 mg/kg/day of CBD and in two
patients who received 10 mg/kg/day of CBD. No serious
adverse events were reported in the placebo group, and no
one died in any of the treatment groups.
In addition, patients who received CBD were more likely
to report that their overall condition had improved, compared with patients who received placebo. Sixty-six percent
of patients who received CBD reported improvement, compared with 44% of patients who received placebo.
“Our results suggest that CBD may be effective for
people with Lennox-Gastaut syndrome in treating drop
seizures,” said Dr. Patel. “While there were more side
effects for those taking CBD, they were mostly well tol-
erated. I believe that it may become an important new
treatment option for these patients.”
This study was supported by GW Pharmaceuticals,
the developer of the CBD formulation. NR
Hussain SA, Zhou R, Jacobson C, et al. Perceived efficacy of cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy: A potential
role for infantile spasms and Lennox-Gastaut syndrome. Epilepsy Behav.
Cannabidiol Reduces Drop Seizures in
Patients With Lennox-Gastaut Syndrome
More adverse events were reported among patients who received CBD as an add-
on therapy, compared with patients who received placebo, but the treatment was
generally well tolerated.