Chronic diseases like epilepsy can have a big impact on a person’s well-being. A new study published in the journal Epilepsy & Behavior finds that CBD, aside from its antiseizure effects, can also help improve the mood and quality of life for adults with treatment-resistant epilepsy.
When Suffering from Epilepsy, Quality of Life Suffers Too
Clinical researchers are starting to focus more heavily on quality of life (QOL) as a clinical outcome. In healthcare, QOL refers to how emotional, social, and physical well-being is affected by a disease or disorder. Patients with chronic diseases like epilepsy often suffer the most when it comes to QOL. Likewise, the research shows that health-related decreases in QOL can affect disease progression and have a large-scale social burden due to disability.
Epilepsy is the fourth most common neurological disorder in the world. It’s characterized by unpredictable seizures and can affect people of all ages. When poorly controlled, epilepsy lowers a patient’s health-related QOL. This has damaging effects on mental health, social activity, physical ability, as well as a patient’s perception of their own health and even mortality.
Mood—including feelings of depression and anxiety—length of seizures, and adverse medication effects are the strongest predictors of QOL for epileptics. For patients with treatment-resistant epilepsy, the correlation between QOL and depression is even stronger than QOL and seizure frequency. The same is true for unwanted side effects caused by medications.
Therefore, a novel antiseizure treatment with few side effects that can alleviate depression would be ideal for epilepsy. Such a drug could help improve the QOL for epilepsy patients thereby reducing the societal burden.
CBD: A Novel Epilepsy Treatment
Over the years, anecdotal evidence has been mounting for cannabidiol (CBD)—one of the primary, but non-intoxicating, cannabinoid components in the cannabis plant. CBD’s therapeutic effects in the case of epilepsy were finally validated in clinical trials. As a result, the FDA approved Epidiolex—a purified oral formulation of CBD—as an antiseizure drug for treating Lennox-Gastaut and Dravet syndromes.
Moreover, open-label clinical studies demonstrate that CBD is effective for treatment-resistant epilepsy. For example, children reported improved QOL after CBD treatment. And parents reported increased alertness, better mood, and improved sleep. Although promising, there are no similar studies in adults with treatment-resistant epilepsy.
Can CBD Improve QOL for Adults with Epilepsy?
Researchers from the University of Alabama at Birmingham set out to assess the effects of CBD on QOL in adults with treatment-resistant epilepsy.
The researchers designed an open-label study. Open-label studies are not as rigorous as double-blind controlled studies where neither the researcher or the participants know who is getting the real drug treatment vs. placebo. However, open-label studies can be useful as an exploratory method to discover new findings and inform future, more rigorous studies.
The researchers recruited participants through a state-funded University of Alabama CBD program. The program helped them find adults diagnosed with treatment-resistant epilepsy. In total, 53 adults enrolled and completed the study. The researchers administered CBD via Epidiolex, the FDA-approved 100 mg/ml oral CBD oil formulation.
Participants started with a 5 mg/kg of body weight dose of CBD per day. Depending on how they responded, they could increase the dose every 2 weeks by increments of 5 mg/kg/day with a maximum dose of 50 mg/kg/day. The participants received the treatment for one year unless they left the study early.
The researchers assessed the participants at enrollment and at a one-year follow-up visit. They used experimentally validated questionnaire methods to evaluate:
- Adverse medical events
- Seizure frequency
- Seizure severity
The researchers saw significant improvements in all of the measured metrics between the time of enrollment and after one year of CBD treatment. On average, the participants experienced:
- Fewer and less severe seizures
- Fewer adverse medical events related to seizure medications
- Improved mood
- Improved QOL
The key takeaway from this study? CBD appears to improve patient outcomes for a group of who had trouble finding relief from other medications.
After closer analysis, the researchers confirmed that these effects are all independent of one another. The only exception being that patient QOL was dependent on patient mood.
In other words, if a patient continued to suffer from mood problems like depression or anxiety, their QOL wasn’t likely to improve. This is consistent with other research that shows mood is a strong predictor of QOL in people with treatment-resistant epilepsy. Given the significant improvement to QOL in this study, it’s possible that CBD can improve mood and QOL independent of its effects on seizure frequency and severity.
This possibility has some pretty big implications in its own right. People suffering from epilepsy AND symptoms of depression perceive their seizures to be more severe. They also have more doctor and emergency room visits. Therefore, improvements to mood, like those seen in this study with CBD treatment, might help lower the healthcare resource impacts from epilepsy.
Epilepsy takes a toll on those that must live with the disease. The daily struggle to control seizures often results in a lower quality of life and mood disorders like depression and anxiety. This new study demonstrated that CBD could potentially help improve the mood and quality of life for even the toughest cases of epilepsy. Future research should focus on testing this outcome under more controlled conditions.