Last year, a study published in the New England Journal of Medicine made headlines by announcing the first double-blind, placebo-controlled study of cannabidiol(CBD) for the treatment of a form of childhood epilepsy. This study not only demonstrated that CBD is a safe and effective treatment for this type of therapy, but also vindicated parents who had turned to medical cannabis as a last resort treatment for their children. Now, the results of a similar study have been released in The Lancet, demonstrating CBD’s effectiveness for Lennox-Gestaut Syndrome.
Lennox-Gestaut Syndrome(LGS) is a rare form of childhood epilepsy. It accounts for 1-4% of pediatric epilepsies, but it is particularly severe in nature. Onset happens typically between the ages of 3 and 5, and is associated with lifelong cognitive impairment that may get worse with age. Patients with LGS suffer from what are known as drop seizures. These are the sort of severe and dramatic seizures often portrayed on television, in which the person having the seizure is highly likely to fall to the ground, potentially resulting in physical injury. LGS is difficult to treat, as most known anticonvulsant drugs are ineffective. This makes the search for new treatments incredibly important for these patients.
A group of patients from the United States and Europe with treatment-resistant LGS took part in this study. All patients were taking at least one anti-epilepsy medication, and had at least two drop seizures per week. They also excluded patients with a positive cannabis drug test; this was important to the design, as they needed to ensure that one group had no exposure to CBD for comparison purposes.
The age range for the patients was between 2-55 years of age. There are drastic differences in physiology between children and adults, so the patients were separated into smaller groups based on age for the purpose of data analysis. Within each subgroup, half were given a CBD oral solution, and the other half were given a placebo. Neither the researchers nor the patients knew which treatment they were taking. The patients or their caregivers then reported each time they had a seizure over the course of fourteen weeks.
The results were quite dramatic. There was a range of responses across the patient groups, with 64% of patients experiencing a 25% reduction in drop seizures. More encouraging is that 44% of patients experienced half as many seizures, and 20% of patients had a 75% reduction or better. The placebo groups also experienced drops in seizure frequency, but to a much lesser degree. CBD decreased the rate of all seizure types as well, by nearly fifty percent for the typical patient. Finally, patients and caregivers completed a survey addressing improvements in general well-being. Over half of the CBD treated patients reported some level of improvement in quality of life. In contrast, over half of the placebo group experienced no change.
Lennox-Gestaut Syndrome is a devastating childhood epilepsy that is often treatment resistant. This trial, the first of its kind, demonstrates the usefulness of CBD in treating this disease. The patients in this trial were specifically chosen because their previous medications had limited effect. Therefore, if these patients were able to achieve significant symptom relief, it’s possible that other patients may see greater effects. It’s also important to note that CBD was taken in addition to any current medications. This means that CBD may be enhancing the action of other medications, rather than easing symptoms on its own. Regardless, this research demonstrates the power of CBD to calm seizures in this rare form of childhood epilepsy.
As with all scientific literature, there are some limitations to this study. For example, the long-term effects of CBD use are unknown, even in healthy populations. It’s possible that CBD may cause unforeseen side effects in these patients after years or decades of use. Another issue is that of optimum dose. The researchers used 20mg/kg as their standard dose. Follow-up work could explore the effect of higher or lower doses. Lower doses could lead to fewer side effects while still being effective. Conversely, higher doses might lead to even more improvement in seizure rates and quality of life. These issues are relatively minor, and easily addressed with more research.
This work presents an exciting opportunity for the parents of children with LGS. While none of the patients in this study were completely free of drop seizures, they were significantly reduced. Overall quality of life was improved, with minimal side effects. For parents desperate for effective treatments, CBD may prove to be the final piece of the puzzle, and help them provide a better life for their children.