“Background: Several studies have reported the effectiveness and tolerability of cannabidiol (CBD)-enriched oil adjunctive treatment in children with drug-resistant epilepsy. This is the first multicenter cohort study of medical-grade CBD-enriched drugs in pediatric drug-resistant epilepsy in Thailand.

Methods: A prospective observational study was conducted across 19 Thai government hospitals between 2021 and 2023. The study aimed to assess CBD-enriched adjunctive treatment in pediatric drug-resistant epileptic patients with various etiologies ensuring a follow-up period of at least three months including cases wherein the medication was discontinued before three months.

Results: Of 101 patients, 42% were male with a median age of 10 years, experiencing a seizure frequency of 75 per month, and having failed treatment with an average of seven types of antiseizure medications. The median follow-up duration was 15 months with a median modal CBD dose of 6 mg/kg/day. The ≥50% seizure reduction rate and the median monthly total seizure reduction showed consistent improvement with reductions at three-, six-, nine-, and 12-month and the latest follow-up visits. Most seizure types responded positively to treatment, except for complex motor seizures. The effective CBD dose varied within a range of 1-15 mg/kg/day. Adverse events were reported in 92% of patients, predominantly mild (95%) and including somnolence, increased liver enzymes, anorexia, and irritability. Thirty-three patients discontinued CBD, with 57% due to intolerable adverse events, 30% ineffectiveness, and 12% noncompliance.

Conclusions: The Thai medical-grade CBD-enriched oil is effective and tolerable for at least 12 months of adjunctive treatment in pediatric drug-resistant epilepsy in Thailand.”

https://pubmed.ncbi.nlm.nih.gov/40460512/

“Cannabidiol (CBD) has emerged as a promising therapeutic option, demonstrating efficacy in reducing seizures in children with drug-resistant epilepsy.”

“In conclusion, the Thai medical grade CBD-enriched oil is effective and well tolerated for at least 12 months of continuous adjunctive treatment in pediatric drug-resistant epilepsy in Thailand even at lower CBD doses than those used in other CBD-purified studies.”

https://www.pedneur.com/article/S0887-8994(25)00111-0/fulltext

“Epilepsy is a widespread neurological disorder that remains a critical global public health challenge. While numerous antiepileptic drugs (AEDs) are available, many patients either fail to achieve adequate seizure control or experience significant side effects.

One promising alternative is pure cannabidiol (CBD), but using a whole cannabis extract may be equally effective and preferred for some patients.

In the current study, we employed the pentylenetetrazole (PTZ)-induced hyperactivity model in zebrafish to compare the effects of CBD with various cannabis extracts. We evaluated three cannabis strains, each subjected to three different extraction methods, and benchmarked the results against the commercially available AED valproic acid (VPA).

Our findings revealed that 5.7 µg/mL of CBD and 10 µg/mL of different extracts significantly reduced movement compared to PTZ and VPA. In addition, effective extracts produced effects similar to pure CBD despite containing much lower molecule levels.

These results reinforced and expanded previous evidence supporting the clinical potential of both CBD and whole cannabis extracts for seizure control while suggesting a possible entourage effect. Further research is necessary to determine which patients may benefit more from pure CBD versus those who might prefer whole cannabis extracts.”

https://pubmed.ncbi.nlm.nih.gov/40427547/

“In conclusion, our results validate and extend previous ones concerning the potential clinical effects of both CBD and whole cannabis extracts used for seizure control.”

https://www.mdpi.com/2218-273X/15/5/654

“Background: Epilepsy is a neurological chronic disorder that affects about 70 million people worldwide. Status epilepticus (SE) are neural disturbances that cause intense glutamatergic excitatory discharges that modulate changes in normal brain physiological activity. Cannabidiol (CBD) is the main nonpsychomimetic compound present in Cannabis sativa and exhibits a wide spectrum of neuroprotective properties. The use of zebrafish (Danio rerio) is regarded as an important alternative animal model for studies on seizures, as it has neuronal mechanisms similar to humans. 

Objective: This study aims to evaluate the effects of CBD on SE induced by kainic acid (KA) in zebrafish. 

Methods: Animals received CBD (5, 10, or 40 mg·L^-1 tank water) for 24 h followed by KA administration (5 mg/kg intraperitoneally). The convulsive pattern of alterations was then assessed. After 12 h, cerebral glutamate transport and oxidative stress were also verified. 

Results: CBD at 5 and 40 mg·L^-1 induced a significant decrease in the seizure intensity (26.1% and 29.9%) and an increase in the latency to reach SE (from 10.71 min to 17.5 and 25 min), respectively. In addition, CBD administration (40 mg·L^-1) attenuated the decrease in cerebral glutamate transport following 12 h KA-induced seizure. The KA-induced seizure was also able to alter the oxidative stress parameters 2′,7′-dichlorofluorescin, and catalase activity. However, CBD (40 mg·L^-1) did not influence these markers.

The present study indicates that CBD promotes a neuroprotective response against the epileptic profile in zebrafish. These findings contribute to the understanding of the influence of CBD on the modulation of excitatory/inhibitory disruption on zebrafish seizure.”

https://pubmed.ncbi.nlm.nih.gov/40354278/

https://www.liebertpub.com/doi/10.1089/can.2024.0189

“Background: A third of epilepsy patients fail to enter seizure remission despite optimal therapeutic management. Cannabis-based medicinal products (CBMPs) have shown promise as a potential therapy. However, a paucity of high-quality literature regarding CBMPs’ efficacy and safety profile means further investigation is needed. The study aimed to examine changes in epilepsy-specific and general health-related quality of life (HRQoL) patient-reported outcome measures (PROMs) in individuals with treatment-resistant epilepsy.

Methods: A case series of patients with epilepsy from the UK Medical Cannabis Registry analyzed changes in Quality of Life in Epilpesy-31 (QOILE-31), Single-Item Sleep Quality Score (SQS), EQ-5D-5L, Generalized Anxiety Disorder-7 (GAD-7) and Patient Global Impression of Change (PGIC) between baseline, one, three, and six months. Adverse events (AEs) were collected and classified by severity. p < 0.050 was considered statistically significant.

Results: There were 134 patients included. Improvements were recorded from baseline to one, three, and six months in QOILE-31 and all HRQoL PROMs (p < 0.050). Forty patients (29.85%) reported a minimal clinically important difference in Quality of Life in Epilepsy-31 (QOLIE-31) at six months. There were 18 (13.43%) AEs reported by 5 (3.73%) patients, mainly mild and moderate.

Discussion: The proportion of patients achieving a clinically significant change is similar to existing CBMPs in epilepsy literature. AE incidence was lower than similar studies although this may be due to the large proportion (67.16%) of individuals who were not cannabis naïve.

Conclusion: Initiation of CBMPs was associated with an improvement across all PROMs. CBMPs were well tolerated across the cohort. However, randomized controlled trials are needed to help determine causality.”

https://pubmed.ncbi.nlm.nih.gov/40249168/

“Treatment with CBMPs was associated with an improvement in both epilepsy-specific and general HRQoL outcomes at one, three, and six months. This study shows the promising potential of CBMPs as an adjunctive treatment option in the management of TRE.”

https://onlinelibrary.wiley.com/doi/10.1002/brb3.70490