Results of a recent systematic review and meta-analysis of cannabidiol’s (CBD’s) efficacy in reducing seizure frequency in patients with pharmacoresistant epilepsy were encouraging, but further research is needed.
Epilepsy affects an estimated 50 million people around the world. Beyond seizures, it can cause serious impairments for some individuals with the syndrome. While around 80% of epilepsy cases can be treated effectively with monotherapy (the use of a single drug), 20% of patients are pharmacoresistant. This means adequate seizure control cannot be achieved with two or more relevant antiepileptic drugs. In extreme cases, some patients may continue to experience thousands of seizures each month. Other terms used for this situation are refractory, drug-resistant or intractable epilepsy.
A non-intoxicating cannabinoid, cannabidiol has shown promise as an alternative treatment for patients with intractable epilepsy, and in some jurisdictions governments have recognised its potential value. For example, a specific cannabidiol formulation was approved for the treatment of seizures associated with Lennox-Gastaut syndrome (LGS) and Dravet syndrome in Australia more than 4 years ago.
Researchers from Tiradentes University in Brazil and Universidade de São Paulo set out to determine how effective CBD has been through a review of previous studies.
After applying exclusion criteria, six studies met the criteria for further investigation. Three of these focused on patients diagnosed with Dravet syndrome, while the other 3 related to patients diagnosed with Lennox-Gastaut syndrome.
Subsequent analysis indicated the patients who received CBD experienced an approximate 41.1% reduction in the total number of seizures, compared to an average reduction of 18.1% in placebo groups. This represented a 127% higher response rate for patients who received the intervention.
As for adverse effects, the three main issues related to CBD treatment were: somnolence (sleepiness/drowsiness) at 24.5−28.2% compared to 8.4–9.8% in placebo groups. This was followed by decreased appetite: 20.1−25.7% (compared to 4.8–6.1% in placebo groups) and diarrhea: 18.2−21.9% (8.6–9.9% for placebo).
While concluding cannabidiol is worthy of consideration in new protocols and of being added to public healthcare systems for treating drug-resistant epilepsy, the research said the high efficacy rate in the placebo group suggests that other methods of data collection analysis may be used in further research to assess efficacy.
The researchers’ findings have been published in the journal Acta Epileptologica.
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