CBD May Ease Seizures And Anxiety In Children

What was studied

This was a small early study of prescription cannabidiol (CBD, brand name Epidiolex) in 12 children and teens with refractory epilepsy. The average age was about 12 years, and 6 of the 12 were female. The participants represented different seizure etiologies, not only the rare pediatric epilepsies for which Epidiolex is already approved.

They started Epidiolex and were followed for 4 to 6 weeks. Caregivers completed seizure diaries and validated questionnaires about anxiety and quality of life. The researchers also measured blood levels of CBD metabolites and endocannabinoids and related lipids.

What they found

After treatment, 73% of caregivers reported improvements in anxiety and seizure frequency. Caregivers also reported improved sleep, and side effects were described as minimal. In blood tests, one endocannabinoid called 2-arachidonoylglycerol increased from baseline to study end, with greater increases in children who started with lower levels. A CBD metabolite called 7-OH-CBD also increased, confirming systemic CBD exposure. The authors suggest Epidiolex may provide anxiolytic benefits across pediatric epilepsy, but this was a preliminary finding.

Limits of the evidence

This study was very small, with only 12 participants, and it lasted just 4 to 6 weeks. There was no comparison group or placebo group, so it cannot show that Epidiolex caused the reported improvements. The main results about anxiety and seizures were based on caregiver reports, which can be influenced by expectations. Because the children had different seizure etiologies and the sample was small, it is hard to know which patients might benefit most. The biomarker findings are interesting, but they do not show exactly how Epidiolex works or whether those blood changes directly relate to symptom improvement.

For families and caregivers

This study suggests that prescription CBD might help some children with difficult-to-treat epilepsy not only with seizures, but possibly with anxiety and sleep as well. That could matter because anxiety commonly co-occurs with childhood epilepsy and can affect daily life.

Still, the evidence here is early and limited. Families should not take this study as proof that CBD will help every child or that non-prescription CBD products are the same as Epidiolex.

What to watch next

Stronger evidence would come from larger, longer studies with a placebo or comparison group, and families can ask a clinician whether prescription CBD is appropriate for their child’s seizure type and other symptoms.

Terms in this summary

refractory epilepsy

Epilepsy that is hard to control even after trying standard seizure medicines.

cannabidiol (CBD)

A compound from cannabis that can be made as a prescription medicine and does not cause a marijuana "high".

Epidiolex

A prescription, pharmaceutical-grade form of cannabidiol approved for certain seizure disorders.

anxiolytic

Something that may reduce anxiety.

endocannabinoids

Natural chemicals made by the body that help regulate brain and body functions.

2-arachidonoylglycerol

One type of endocannabinoid measured in the blood in this study.

7-OH-CBD

A breakdown product of CBD in the body that can show the medicine was absorbed.