The Proven Therapeutic Effects of CBD

CBD's breakthrough into popularity was related to its success in treating pediatric seizures. Now rigorous clinical trials confirm these benefits. 

Despite the emerging evidence supporting CBD's use in seizure disorders beginning in the 1970s, clinical research only sped up after the public became aware of CBD around 2013. Since that time, a huge body of evidence has concluded that CBD is an effective treatment for a variety of seizure disorders, including some notoriously difficult to treat conditions like Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS). 

Epidiolex was the first cannabis-based cannabinoid pharmaceutical drug approved in the United States that has been tested in several high-quality randomized controlled trials on epilepsy. Epidiolex is a solution containing CBD at 100mg/ml, and is currently indicated for only DS and LGS, but can be prescribed off-label for other seizure disorders and conditions. 

Overall, in patients older than 2 years, Epidiolex was shown to reduce convulsive seizures in DS by 17% and to reduce drop seizures in LGS by 23% (compared to placebo, when added to current anti-epileptic medications). While patients receiving CBD do experience some drug interactions and adverse effects (to be discussed in a future post), in general, CBD is safer and better tolerated than most or all other anti-epileptic drugs. 

The anti-epileptic effects of CBD are clearly not limited to DS and LGS. Uncontrolled studies have also shown the effectiveness of Epidiolex in more common seizure disorders. In a series of 26 children, aged 4-11, with mixed types of epilepsy that had failed to respond to conventional treatment, researchers followed their response for up to 4 years (average 21 months). 26.9% of the patients had a sustained a greater than 50% reduction in seizure frequency during the course of the treatment, and 11.5% remained seizure-free.

This information applies more directly to common clinical situations, because many patients are using CBD to treat many different types of epilepsy, and because it shows the response over a longer course of treatment. It's common for new anti-epileptic agents (including cannabinoids) to work at first and then stop working after 1-2 months. It's important to set realistic expectations for parents desperate to try new treatments, and it's informative for them to hear that approximately 25% of the toughest cases of pediatric epilepsy experience greater than 50% reduction of seizures sustained over months and years. 

Keep in mind that the above information is related to treatment with pharmaceutical-grade, purified CBD. Increased content of other cannabinoids and phytoconstituents often improves the outcomes and lowers the required dose. Retrospective studies using artisanal cannabis preparations that contained mostly CBD, but often some THC and THCA as well, demonstrate even better results. 

A paper published by Dr. Dustin Sulak along with Bonni Goldstein MD and Russell Saneto MD found that in 272 patients with refractory epilepsy, 86% of patients treated with artisanal cannabis had some improvement, and 55% of patients had >50% seizure reduction. Four percent experienced increased seizures with the treatment.

Treatment-resistant epilepsy is strongly associated with poor quality of life. In a recent study on 53 adults using Epidiolex to treat a variety of seizure disorders, the patient's quality of life improved significantly, independently of the beneficial effects on seizure frequency, seizure intensity, or adverse effects of medications. The improvement in quality of life was associated with improved mood 

A similar outcome in a pediatric study showed improved quality of life somewhat independent of seizure control. Parents certainly report non-seizure improvements such as mood, behavior, communication, and much more when their children take CBD. 

Remember:

The strongest evidence for CBD's effectivness is in epilepsy, with more gold standard trial data emerging all the time.

• In children with mixed types of refractory epilepsy, Epidiolex reduced seizures by 50% or more (a good outcome) in 27% of patients.

• Artisanal cannabis products containing other phytoconstituents helped 86% of patients with refractory epilepsy, and reduced seizures by 50% or more in 55% of patients.

• Apart from CBD's ability to decrease seizures, it can improve the quality of life in patients with seizures.

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