2018
DOI: 10.1007/s40265-018-0992-5
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Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis

Abstract: Background Approximately one-third of patients with epilepsy presents seizures despite adequate treatment. Hence, there is the need to search for new therapeutic options. Cannabidiol (CBD) is a major chemical component of the resin of Cannabis sativa plant, most commonly known as marijuana. The anti-seizure properties of CBD do not relate to the direct action on cannabinoid receptors, but are mediated by a multitude of mechanisms that include the agonist and antagonist effects on ionic channels, neurotransmitt… Show more

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Cited by 175 publications
(183 citation statements)
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“…Two randomized double‐blind trials, published in the New England of Medicine , have shown that the addition of CBD (10–20 mg·kg −1 ) to the conventional antiepileptic regimen resulted in a greater reduction in convulsive‐seizure frequency than placebo among patients with the Dravet syndrome (Devinski et al, ) or with Lennox–Gastaut syndrome (Devinski et al, ), that are two rare and severe form of epilepsy. This and other robust clinical evidence (Lattanzi et al, ) has led to the Food and Drug Administration (FDA) approval of CBD (Epidiolex®, i.e. a 99% pure oral CBD extract) for the treatment of these rare form of epilepsy in patients of 2 years and older.…”
Section: Cannabidiolmentioning
confidence: 99%
See 1 more Smart Citation
“…Two randomized double‐blind trials, published in the New England of Medicine , have shown that the addition of CBD (10–20 mg·kg −1 ) to the conventional antiepileptic regimen resulted in a greater reduction in convulsive‐seizure frequency than placebo among patients with the Dravet syndrome (Devinski et al, ) or with Lennox–Gastaut syndrome (Devinski et al, ), that are two rare and severe form of epilepsy. This and other robust clinical evidence (Lattanzi et al, ) has led to the Food and Drug Administration (FDA) approval of CBD (Epidiolex®, i.e. a 99% pure oral CBD extract) for the treatment of these rare form of epilepsy in patients of 2 years and older.…”
Section: Cannabidiolmentioning
confidence: 99%
“…Historically, CBD has been believed to be extremely safe, with doses up to 600 mg not resulting in psychotic symptoms and chronic use and high doses up to 1,500 mgÁday −1 reportedly well tolerated in humans (Bergamaschi, Queiroz, Zuardi, & Crippa, 2011;Welty, Luebke, & Gidal, 2014). In more recent years, in randomized trials in epileptic patients, adverse events have been shown to occur in 87.9% and 72.2% of patients treated with CBD and placebo respectively (Lattanzi et al, 2018). CBD adverse events were somnolence, decreased appetite, diarrhoea and increased serum aminotransferases.…”
Section: Safety Of Cbdmentioning
confidence: 99%
“…Most other adverse effects were not significant relative to the placebo groups. The odds ratio for discontinuation due to adverse effects was 1.45 (95% CI: 0.28-7.41; p = 0.657) and 4.20 (95% CI: 1.82-9.68; p = 0.001) for CBD at the doses of 10 and 20 mg/kg/day, respectively, in comparison to placebo based on a meta-analysis from the available controlled studies (Lattanzi et al, 2018). Efficacy data, however, show that a significant proportion of children already respond to doses of 10 mg/kg/day ( figure 4) in studies on Lennox-Gastaut syndrome.…”
Section: Recommendations For Handling Of Cbdmentioning
confidence: 99%
“…CBD is an effective adjuvant and is FDA approved for managing uncontrolled seizures associated with Lennox‐Gastaut syndrome and Dravet syndrome . All the RCTs conducted to date examined CBD only, and so the efficacy of CBD for epilepsy management should not be considered analogous/comparable to other cannabis products .…”
Section: Background and Objectivesmentioning
confidence: 99%