Efficacy of cannabidiol in convulsive and nonconvulsive seizure types associated with treatment‐resistant epilepsies in the Expanded Access Program

Abstract

The cannabidiol (CBD) Expanded Access Program (EAP), initiated in 2014, provided CBD (Epidiolex) to patients with treatment‐resistant epilepsy (TRE). In the final pooled analysis of 892 patients treated through January 2019 (median exposure = 694 days), CBD treatment was associated with a 46%–66% reduction in median monthly total (convulsive plus nonconvulsive) seizure frequency. CBD was well tolerated, and adverse events were consistent with previous findings. We used pooled EAP data to investigate the effectiveness of add‐on CBD therapy for individual convulsive seizure types (clonic, tonic, tonic–clonic, atonic, focal to bilateral tonic–clonic), nonconvulsive seizure types (focal with and without impaired consciousness, absence [typical and atypical], myoclonic, myoclonic absence), and epileptic spasms. CBD treatment was associated with a reduction in the frequency of convulsive seizure types (median percentage reduction = 47%–100%), and nonconvulsive seizure types and epileptic spasms (median percentage reduction = 50%–100%) across visit intervals through 144 weeks of treatment. Approximately 50% of patients had ≥50% reduction in convulsive and nonconvulsive seizure types and epileptic spasms at nearly all intervals. These results show a favorable effect of long‐term CBD use in patients with TRE, who may experience various convulsive and nonconvulsive seizure types. Future controlled trials are needed to confirm these findings.

Antimicrobial, Probiotic, and Immunomodulatory Potential of Cannabis sativa Extract and Delivery Systems

“…Cannabinoids might be used in neuropathic pain, spasticity in multiple sclerosis, nausea, vomiting, cancer pain, and certain behavioral symptoms in dementia [11][12][13][14][15][16][17]. Additionally, cannabis use might be beneficial in patients with inflammatory bowel diseases, anxiety disorders, and sleep disorders [18][19][20][21]. The essential oil of cannabis comprises mono-and sesquiterpenes, encompassing various chemical groups, including alcohols, aldehydes, and ketones, as well as acyclic, monocyclic, and bicyclic structures [2,22].…”