The effectiveness of cannabidiol in the treatment of epilepsy

Authors

DOI:

https://doi.org/10.33448/rsd-v11i16.38057

Keywords:

Epilepsy; Convulsion; Cannabidiol; Cannabis sativa.

Abstract

Introduction: Epilepsy is a brain dysfunction characterized by the periodic and unpredictable occurrence of seizures, which are temporary changes in behavior caused by abnormal, disordered, synchronous and rhythmic neuronal activity. Cannabidiol acts as an anticonvulsant through three mechanisms: neuroprotection, stress modulation, or even the neuronal excitation/inhibition balance. Objective: To describe aspects related to the treatment of epilepsy with Cannabidiol and derivatives. Methodology: Systematic review following the guidelines described in the PRISMA method. A search was carried out in the following databases: PUBMED, BVS and SciELO using the terms: “cannabidiol”, “CNB”, “epilepsy”, “epilepsy” and “cannabidiol” as descriptors, which were combined with the connector “ and”. Primary studies were included, in full, published during the period from 2012 to 2022, in Portuguese or English, which addressed the theme related to the isolated use of Cannabidiol in the treatment of Epilepsy. Results: 12 articles were included to compose this systematic review, which demonstrated a clinically significant reduction in seizures after treatment with cannabidiol. Most studies addressed Lennox-Gastaut or Dravet syndrome, while other trials addressed treatment-resistant epilepsies of different diagnoses. The most used dose was 20 mg/kg/day and 10 mg/kg/day. Conclusion: Cannabidiol is effective in reducing and controlling seizures in different pathologies. It is safe and effective for adult and pediatric use. It produces an effect both at higher doses (20mg/kg/day) and at low doses (10mg/kg/day).

References

Belgo, B. L. S., et al. (2021). Canabidiol e epilepsia - o uso do canabidiol para tratamento de crises epiléticas. Brazilian Journal of Development, 7(3).

Cilio, M. R., et al. (2014). The case for assessing cannabidiol in epilepsy. Epilepsia, 55(6), 787-90.

Costa, L. L. O., et al. (2020). Atualização em epilepsia. Rev Med, São Paulo, 99(2), 170-81.

Devinsky, O., et al. (2020). Cannabidiol in Dravet Syndrome Study Group. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. N Engl J Med, 376(21).

Devinsky, O., et al. (2016). Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. Lancet Neurol, 15 (3): 270-8.

Devinsky, O., et al. (2018). GWPCARE3 Study Group. Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome. N Engl J Med, 378(20): 1888-1897.

Engelhardt, E. Z. (2014). John Hughlings Jackson: um neurologista inglês / John Hughlings Jackson: a British neurologist. Rev. Bras. Neurol, 50(4), 91- 94.

Fernandes, M. J. S. (2013). Epilepsia do lobo temporal: mecanismos e perspectivas. Estudos Avançados, 27(77), 85-96.

Fonseca, J. J. S. (2002). Metodologia da pesquisa científica. Fortaleza: UEC, Apostila.

Gaston, T. E. et al. (2021). UAB CBD Program. Long-term safety and efficacy of highly purified cannabidiol for treatment refractory epilepsy. Epilepsy Behav, 117, 107862.

Klotz, K. A. (2021). Effect of Cannabidiol on Interictal Epileptiform Activity and Sleep Architecture in Children with Intractable Epilepsy: A Prospective Open-Label Study. CNS Drugs, 35 (11):1207-1215.

Kwan, P., et al. (2011). Drug-resistant epilepsy. N Engl J Med. 8(10), 919-26.

Laux, L. C., et al. (2019). Long-term safety and efficacy of cannabidiol in children and adults with treatment resistant Lennox-Gastaut syndrome or Dravet syndrome: Expanded access program results. Epilepsy Research, 154, 13-20.

Matos, R. L. A., et al. (2017). O Uso do Canabidiol no Tratamento da Epilepsia. Rev. Virtual Quim, 9(2), 786-814.

Miller, I., et al. (2020). Study Group. Dose-Ranging Effect of Adjunctive Oral Cannabidiol vs Placebo on Convulsive Seizure Frequency in Dravet Syndrome: A Randomized Clinical Trial. JAMA Neurol, 77 (5), 613-621.

Mitelpunkt, A., et al. (2019). The safety, tolerability, and effectiveness of PTL-101, an oral cannabidiol formulation, in pediatric intractable epilepsy: A phase II, open-label, single-center study. Epilepsy Behav, 98 (Pt A):233-237.

Riggs, A. J., & Riggs, J. E. (2005). Epilepsy's role in the historical differentiation of religion, magic, and science. Epilepsia, 46(3), 452-3.

Szaflarski, J. P., et al. (2018). UAB CBD Program. Cannabidiol improves frequency and severity of seizures and reduces adverse events in an open-label add-on prospective study. Epilepsy Behav, 87, 131-136.

Szaflarski, J. P., & Bebin, E. M. (2014). Cannabis, cannabidiol, and epilepsy--from receptors to clinical response. Epilepsy Behav, 41, 277-82.

Thiele, E. A., et al. (2018). GWPCARE4 Study Group. Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 391(10125), 1085-1096.

Uliel-Sibony, S., et al. (2021). Cannabidiol-enriched oil in children and adults with treatment-resistant epilepsy-does tolerance exist? Brain Dev., 43(1):89-96.

Zilmer, M., & Olofsson, K. (2021). Cannabidiol treatment of severe refractory epilepsy in children and young adults. Dan Med J, 68(5): A07200527.

Zuberi, S. M., et al. (2015). Atualização sobre o diagnóstico e tratamento de epilepsias da infância. Review articles J. Pediatr, Rio J, 91(6).

Published

30/11/2022

How to Cite

OMENA, B. L. .; CAVALCANTE, D. S. .; GUSMÃO, E. de S. .; SILVA, L. J. C. da .; ALMEIDA, A. C. G. de . The effectiveness of cannabidiol in the treatment of epilepsy. Research, Society and Development, [S. l.], v. 11, n. 16, p. e71111638057, 2022. DOI: 10.33448/rsd-v11i16.38057. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/38057. Acesso em: 26 dec. 2024.

Issue

Section

Review Article