A systematic review of highly purified cannabidiol in developmental and epileptic encephalopathies and complex treatment-resistant epilepsies: Nonseizure outcomes.
Debopam Samanta, Lisa Moore-Ramdin, Marco Navetta et al.
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In 30 seconds
This systematic literature review assessed nonseizure outcomes after highly purified cannabidiol (CBD) initiation in people with developmental and epileptic encephalopathies or complex treatment-resistant epilepsies, excluding Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. The review included 32 studies comprising 1343 patients, with results summarized narratively. Thirty-one studies reported improvement in at least one nonseizure outcome in at least one patient; reported domains included cognition, communication, behavior, and quality of life. The evidence was mainly observational and carried moderate to high risk of bias, so the findings suggest potential benefit rather than establishing efficacy.
Key findings
- Thirty-one of 32 included studies reported improvement in at least one nonseizure outcome in at least one patient.
- Cognitive and neuropsychiatric improvements were reported in 9/9 studies each; communication improvements in 7/7 studies.
- Commonly reported adverse events included diarrhea (17-34%), vomiting (5-50%), and decreased appetite (7-20%).
Why it matters
Seizure control is not the only outcome relevant to people with complex epilepsies; cognition, behavior, communication, sleep, and quality of life also matter. This review brings together reports suggesting that nonseizure outcomes may improve after CBD initiation, while the largely observational evidence and risk of bias mean these signals should be interpreted cautiously.
What to keep in mind
The review mainly identified observational studies with moderate to high risk of bias, and results were narratively summarized.