John Libbey Eurotext

Epilepsy and cannabidiol: a guide to treatment Volume 22, issue 1, February 2020

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Authors
Oliver Gubbay and other members of The Cannabinoids International Experts Panela 1
1 Paediatric Epilepsy Dpt., University Hospitals of Lyon (HCL), Member of the ERN EpiCARE, and Inserm U1028 / CNRS UMR5292, Lyon, France
2 Epilepsy Unit, Child Neurology Dpt., Hospital San Juan de Dios, Member of the ERN EpiCARE, Universitat de Barcelona, Barcelona, Spain
3 Department of Neuropediatrics, University Hospital Jena, Jena, Germany
4 UCL NIHR BRC Great Ormond Street Institute of Child Health, Member of the ERN EpiCARE, London, UK
5 Hospital Ruber Internacional, Epilepsy program, Madrid, Spain
6 University Hospitals KULeuven, Department Development and Regeneration, Section Pediatric Neurology, Member of the ERN EpiCARE, Leuven Belgium
7 Program for Pharmacy, Oslo Metropolitan University and The National Center for Epilepsy and Dept of Pharmacology, Oslo University Hospital, Norway
8 Rare and Complex Epilepsy Unit, Department on Neuroscience, Bambino Gesu’ Children's Hospital, IRCCS, Member of the ERN EpiCARE, Rome, Italy
9 Pediatric neurology department, Reference centre for rare epilepsies, Member of the ERN EpiCARE, Necker Enfants Malades University Hospital, APHP, Inserm UMR1163, Institut Imagine, Paris Descartes University, Paris, France
10 Department of Neurology, Massachusetts General Hospital, Boston, USA
* Correspondence: Alexis Arzimanoglou Head Paediatric Epilepsy Dpt, University Hospitals of Lyon, 59, boulevard Pinel, 69677 Lyon, France

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The growing interest in cannabidiol (CBD), specifically a pure form of CBD, as a treatment for epilepsy, among other conditions, is reflected in recent changes in legislation in some countries. Although there has been much speculation about the therapeutic value of cannabis-based products as an anti-seizure treatment for some time, it is only within the last two years that Class I evidence has been available for a pure form of CBD, based on placebo-controlled RCTs for patients with Lennox-Gastaut syndrome and Dravet syndrome. However, just as we are beginning to understand the significance of CBD as a treatment for epilepsy, in recent years, a broad spectrum of products advertised to contain CBD has emerged on the market. The effects of these products are fundamentally dependent on the purity, preparation, and concentration of CBD and other components, and consensus and standardisation are severely lacking regarding their preparation, composition, usage and effectiveness. This review aims to provide information to neurologists and epileptologists on the therapeutic value of CBD products, principally a purified form, in routine practice for patients with intractable epilepsy.