Seizure control greater with prescription vs. artisanal CBD in pediatric epilepsy

Pediatric patients with epilepsy treated with pharmaceutical CBD had better seizure control than those treated with artisanal CBD, according to findings from a retrospective chart review that will be presented at the American Academy of Neurology annual meeting this spring.

In 2018, the FDA approved Epidiolex (cannabidiol, GW Research) — the first approval of a purified drug substance derived from marijuana in the United States — for the treatment of seizures in patients aged at least 2 years with Dravet Syndrome and Lennox-Gastaut Syndrome. Epidolex does not include THC. Conversely, the manufacturing process of artisanal CBD varies and contains variable amounts of CBD and THC, according to researchers.

“While not always legal, artisanal CBD has been available longer, so some people have been using it to treat epilepsy for years,” Nathan T. Cohen, MD, a fellow at Children’s National Hospital in Washington D.C., said in a press release.

Cohen and colleagues examined the medical charts of 31 patients aged 3 to 20 years who had some form of epilepsy (32% Lennox-Gastaut syndrome, 6% Dravet syndrome and 62% other form). Forty-eight percent were female, 22 were taking pharmaceutical CBD and nine were taking artisanal CBD.

Reference: Cohen N, et al. Keep off the grass: Artisanal versus pharmaceutical cannabidiol in pediatric refractory epilepsy patients.

Results showed that after a median 11.8 months, the artisanal CBD cohort had a 70% increase in overall seizures while the prescription CBD cohort had a 39% reduction in overall seizures. However, all adverse events — diarrhea, diminished appetite, emesis and somnolence — occurred in the pharmaceutical CBD cohort.

“The difference in seizure control is dramatic and is definitely of concern since many people continue to use artisanal CBD,” he said in the release. “[Patients with epilepsy] may want to reconsider because our research indicates that pharmaceutical CBD may indeed be more effective than artisanal CBD.” – by Janel Miller

Reference: Cohen N, et al. Keep off the grass: Artisanal versus pharmaceutical cannabidiol in pediatric refractory epilepsy patients. To be presented at: American Academy of Neurology annual meeting; April 25-May 1, 2020; Toronto.

Disclosure: Healio Primary Care could not confirm researchers’ relevant financial disclosures at the time of publication.