Purpose of study: Despite very strict cannabis regulations in Japan, some cannabidiol (CBD) products have been legally distributed since 2013 and taken by some epilepsy patients. However, its efficacy and safety have not been evaluated. Basic procedures: A self-administered questionnaire was sent to 38 patients with intractable epilepsy who were taking CBD. The questionnaire sought information on patient background (sex, age) and medical history (diagnosis, type of seizures), characteristics of CBD use (frequency, route of administration), and the safety of CBD use (adverse events, side effects). Patients were also asked about changes in seizure frequency, intensity, and duration; effect on sleep; effect on daytime activity/vitality; increase/decrease in antiepileptic drugs dosage; quality of life (QOL); and caregiver-assessed QOL. Findings: Responses were received from 28 of 38 patients. The median CBD intake was 12.0 mg/kg/day. Nine patients (32.1%) were suspected of having an adverse event, but all were mild and no patients discontinued CBD due to adverse events. Fifteen patients (53.6%) reported a decrease in seizure frequency, and 2 patients (7.1%) showed complete resolution of seizures. No significant correlation was found between the patient’s diagnosis and the seizure type or efficacy. Conclusions: This is the first cross-sectional study of CBD users in Japan, suggesting that CBD may be an effective option for Asian patients with refractory epilepsy, regardless of diagnosis or seizure type.
Aim: To determine the risk factors for cannabis use disorders and cannabis psychosis in Japan based on a 2021 online survey among Japanese users of social network services. Methods:The 3142 respondents who had used cannabis within the preceding year were categorized into two groups based on the development of cannabis use disorder and/or cannabis psychosis. Analyses were performed to determine these conditions' risk factors.Results: Multivariate analysis revealed that factors significantly associated with cannabis use disorders were "cannabis-use initiation at a young age" (p = 0.004, OR: 0.951, 95% CI [0.920-0.984]), "family history of mental health problems" (p < 0.001, OR: 1.988, 95% CI [1.545-2.556]), "psychiatric disorders preceding cannabis use" (p = 0.039, OR: 1.672, 95% CI [1.026-2.722]), and "use of cannabis products other than dry flower" (p < 0.001, OR: 2.725, 95% ). Factors significantly associated with cannabis psychosis were "cannabis-use initiation at a young age" (p = 0.011, OR: 0.888, 95% CI [0.811-0.973]) and "family history of mental health problems" (p = 0.002, OR: 2.531, 95% ). Conclusion:Risk factors for problematic cannabis use were cannabis initiation at a young age, pre-cannabis psychiatric disorders, family history of mental health problems, and the use of cannabis products other than dry flower. However, the causal relationship among these factors remains ambivalent.
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