Abstract
Treatment-resistant epilepsy (TRE) is associated with severe morbidity and mortality and affects over 30% of epilepsy patients. Despite advances in epilepsy management over the last 30 years, this rate has largely remained unchanged. Through a largely patient driven movement and despite federal regulations, cannabidiol (CBD) emerged as a candidate drug for improving the management of treatment-resistant epilepsies. This review highlights the available research on CBD and its therapeutic role in the treatment of TREs. Randomized controlled trials have established CBD as an add-on treatment option for the management of seizures in Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS), and there is a growing body of additional literature supporting CBD’s use as an add-on therapy in other TREs. Several studies have shown CBD to be a safe anti-seizure medication with dose-dependent mild-moderate adverse events which resolve with treatment de-escalation. CBD does affect toxicity with other anti-seizure medications including clobazam and valproate. CBD is a safe and efficacious adjunctive therapy in the management of treatment-resistant epilepsies.
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