Long-term safety and efficacy of highly purified cannabidiol for treatment refractory epilepsy

Gaston, Tyler E.; Ampah, Steve; Bebin, E. Martina; Grayson, Leslie P.; Cutter, Gary; Hernando, Kathleen; Szaflarski, Jerzy P.; Program, Uab Cbd

doi:10.1016/j.yebeh.2021.107862

Cited by 29 publications

(35 citation statements)

References 30 publications

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“…However, VPA is known to be associated with two types of hepatotoxicity: dose dependent and reversible elevation of serum liver enzymes (type I), and rare but often fatal, idiosyncratic hepatotoxicity (type II) [85]. The risk of VPA-related hepatotoxicity is increased in children below 2 years of age and in patients receiving other anticonvulsants [86][87][88][89]. Also, VPA has been reported to cause some coagulopathies (von Willebrand's disease, factor XIII deficiency, thrombocytopenia); however, their clinical relevance remains uncertain [85].…”

Section: General Management Implicationsmentioning

confidence: 99%

“…In the EU, CBD (Epidyolex®, GW Pharmaceuticals, Cambridge, UK) has been approved for the adjunctive treatment (in combination with CLB) of seizures associated with LGS or DS in patients aged ≥ 2 years [100] and for seizures associated with tuberous sclerosis complex in patients aged ≥ 1 year [101]. There is some evidence that, in addition to reducing the frequency and severity of seizures, CBD improves mood and quality of life in patients with treatment-resistant epilepsy [87,102]. In this population, long-term use of CBD does not appear to be associated with negative effects on cognitive functioning [103].…”

Section: General Management Implicationsmentioning

confidence: 99%

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Comorbidities in Dravet Syndrome and Lennox–Gastaut Syndrome

Marchese

Cappelletti

Filippini³

et al. 2021

SN Compr. Clin. Med.

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This study aims to describe the main cognitive and behavioral comorbidities of Dravet syndrome (DS) and Lennox–Gastaut syndrome (LGS), their impact on the health-related quality of life (QOL) of patients and their caregivers, and provide a summary of the neuropsychological tools available for the evaluation of these comorbidities. The cognitive and behavioral comorbidities in patients with DS and LGS have a profound effect on the QOL of affected individuals and their caregivers and, as patients grow, tend to surpass the impact of the seizures. DS is a genetic condition associated with loss-of-function mutations in the SCNA1 sodium channel gene; LGS is an etiologically heterogeneous condition that is often secondary to structural brain abnormalities. The first seizures associated with DS typically present in the first year of life, and developmental delay becomes progressively evident thereafter. LGS usually starts between the ages of 3 and 8 years, with cognitive impairment becoming clinically evident in most patients within 5 years from the onset. In both DS and LGS, cognitive impairment is generally moderate to severe and is often accompanied by behavioral problems such as hyperactivity and inattention. In addition to optimal seizure control, regular assessment and active management of cognitive and behavioral comorbidities are required to meet the complex needs of patients with DS or LGS.

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Section: General Management Implicationsmentioning

confidence: 99%

Section: General Management Implicationsmentioning

confidence: 99%

Comorbidities in Dravet Syndrome and Lennox–Gastaut Syndrome

Marchese

Cappelletti

Filippini³

et al. 2021

SN Compr. Clin. Med.

View full text Add to dashboard Cite

show abstract

“…Interesting conclusions came from the study by Gaston et al comparing a group of adults and children treated with CBD. The authors noted a significant difference in seizure severity reduction, with adults reporting a greater reduction in seizure severity [34].…”

Section: Other Clinical Studiesmentioning

confidence: 96%

Use of cannabidiol in the treatment of epilepsy

Zawadzka

Mazurkiewicz-Bełdzińska

2022

Neurol Neurochir Pol.

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Introduction.Cannabis sativa has been cultivated for human use for about 5,000 years, and has likewise been used in the treatment of epilepsy for thousands of years.State of the art. Cannabidiol (CBD), which was isolated from cannabis sativa in 1940, has an anti-seizure effect and no psychoactive activity. Its effectiveness in reducing various types of seizures has been proven in animal seizure and epilepsy models. Recent randomised, placebo-controlled trials have confirmed its effectiveness in patients with drug-resistant epilepsy.Clinical implications. The aim of this position paper was to present the specific mechanism of CBD's anti-seizure action and current indications for CBD's use in epilepsy. The only cannabis-derived drug that has successfully passed clinical trials and has obtained United States Food and Drug Administration and European Medicines Agency approval for epilepsy is Epidiolex®. This paper presents the outcomes of the completed clinical trials with the use of this drug.Future directions. CBD may be an effective drug in drug-resistant epilepsy, particularly in Dravet Syndrome, Lennox-Gastaut Syndrome and seizures associated with tuberous sclerosis complex. Additional randomised, placebo-controlled studies with CBD are needed.

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“…Six of the studies evaluated add-on treatment of CBD for treatment-resistant epilepsy (TRE) in general, one for LGS, one for epilepsy associated with TS, and one for epileptic spasms. [29][30][31][32][33][34][35][36][37] EMJ CBD: cannabidiol; CI: confidence interval; DS: Dravet syndrome; IQR: interquartile range; LGS: Lennox-Gastaut syndrome; TS: tuberous sclerosis.…”

Section: Clinical Efficacy In Current Usementioning

confidence: 99%

Cannabinoids in the Treatment of Epilepsy: A Review

Zhou

Dennis

Snehal

et al. 2021

EMJ

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Cannabinoids have been studied for their role in the treatment of epilepsy for many years. The U.S. Food and Drug Administration (FDA) approved them for the treatment of some refractory syndromes in 2018. Cannabidiol and tetrahydrocannabinol are the most commonly studied cannabinoids and have been studied in great depth vis-à-vis their pharmacokinetics and pharmacodynamics. Studies have shown the efficacy of cannabinoids in the treatment of refractory epilepsy. A substantial amount of research has been performed exploring the interactions between cannabinoids and other conventional antiseizure medications. The exact mechanisms by which cannabinoids exert their effects on seizure control remain unclear and research into these mechanisms continues in great earnest. Cognitive changes from cannabinoids are constantly being studied and add to potential benefits from the use of these compounds. Cultural and social misconceptions and roadblocks about the use of cannabinoids persist and represent an ongoing obstacle to increasing research and therapeutic use of these compounds. This review focuses on all these aspects and of the use of these cannabinoids in the treatment of epilepsy and seeks to offer a fairly comprehensive description of the facets of cannabinoid therapy for refractory epilepsy.

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Long-term safety and efficacy of highly purified cannabidiol for treatment refractory epilepsy

Cited by 29 publications

References 30 publications

Comorbidities in Dravet Syndrome and Lennox–Gastaut Syndrome

Comorbidities in Dravet Syndrome and Lennox–Gastaut Syndrome

Use of cannabidiol in the treatment of epilepsy

Cannabinoids in the Treatment of Epilepsy: A Review

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