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Artisanal cannabidiol as adjunct treatment for refractory epilepsy: A Brazilian experience

Luiz Fernando Fonseca, Karina Soares Loutfi, Clara Gontijo Camelo, José Humberto Santos Soares, Paula Carvalho Ribeiro, Raquel Machado Tófani, Bárbara Campos Mattos.


Abstract

Introduction: The treatment of refractory epilepsy in childhood is a challenge in medical practice. The authors describe the experience with cannabidiol (CBD) use in patients with refractory epilepsy. Objectives: To evaluate the response to CBD treatment in the control of epileptic seizures, as well as their tolerability and side effects. Methods: A retrospective descriptive, series of cases study was performed, with data collected from 24 patients aged 1 to 45 years, diagnosed with refractory epilepsy, and who used CBD as adjunctive therapy. The CBD dose used ranged from 2.5mg/kg/day to 14mg/kg/day, with an average of 6.3mg/kg/day. Results: Of the twenty four patients analyzed, there was a reduction in seizure frequency in 19 patients (79.2%), and of these, five patients (20.8%) presented seizure reduction between 50-79% (moderate response), ten patients (41.6%) presented seizure reduction between 80-99% (marked response) and four patients (16.6%) presented complete seizure resolution. On the other hand, five patients (20.8%) did not respond to CBD treatment. Of these, one patient had no change in seizure pattern and four patients (16.6%) had increased seizure frequency. Among the positive aspects of the use of CBD were reduction in the number of hospitalizations, reduction in polytherapy (70% of cases) and improvement in some cognitive and behavioral aspects. The adverse effects mentioned were considered mild. Conclusion: CBD represents a promising alternative in refractory patients to conventional anticonvulsants

Key words: Anticonvulsants, Cannabidiol, Cannabis sativa, Epilepsy, Pharmacological Treatment






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