Effect of Cannabidiol on Drop Seizures in the Lennox–Gastaut Syndrome

Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi SM, GWPCARE3 Study Group. N Engl J Med, May 17, 2018; 378:1888-1897.

The following study published in the New England Journal of Medicine presented results from a study of cannabidiol in people with Lennox-Gastaut syndrome (LGS).

Purpose

• Lennox-Gastaut syndrome (LGS) is a type of epilepsy that starts in childhood. Many different types of seizures may be seen in LGS.
• Almost all children with LGS show learning delays and intellectual disabilities.
• One of the therapies being tested for LGS and other epilepsy syndromes is cannabidiol (CBD) oil.
• In one of the articles in this basic science series, we talked about an enhancement of inhibitory GABAergic transmission as a potential mechanism by which CBD might reduce seizures.
• In this article by Devinsky and colleagues, the authors observed the effects of CBD in addition to the typical seizure medicines used in LGS.

Description of Study

• People with LGS between the ages of 2 and 55 years old were randomized to different groups. Two doses of CBD were tested. One group was given CBD 20 mg/kg, one group was given CBD 10 mg/kg daily, and one group was given a placebo.
• This study was done at 30 epilepsy centers.
• The scientists looked at the change in number of atonic or drop seizures in people taking the CBD as compared to those taking the placebo.

Summary of Study Findings

• Both doses of CBD were associated with a decrease in the number of drop seizures as compared to placebo.
• The most common side events were sleepiness, diarrhea, and decreased appetite. These were more common in people taking 20 mg CBD as compared to the 10 mg CBD or placebo.

What does this mean?

• Thanks to this, and other studies, the U.S. Food and Drug Administration (FDA) recently approved cannabidiol (CBD) oral solution for the treatment of LGS and Dravet syndrome.
• Recently on epilepsy.com we also published an article that recounted the journey of a patient with LGS and the family’s experience with the CBD trial.
• The approval of CBD for LGS is a one example of how basic and clinical science research together can lead to tangible, improved outcomes and options for people with epilepsy.