Abstract
Recent approval of Epidiolex® (pharmaceutical cannabidiol/CBD) for the treatment of Lennox Gastaut syndrome (LGS) and Dravet syndrome highlights a therapeutic efficacy of CBD in the treatment of epilepsy. However, a large number of patients with epilepsy elect to use alternative artisanal CBD products due to cost or access constraints. Despite widespread availability and variety of these artisanal CBD products, studies evaluating their safety or efficacy are rare, making conclusions about clinical utility uncertain. The purpose of the present study was to evaluate cross-sectional and longitudinal associations of artisanal CBD product use with quality of life, mental health, healthcare utilization, and epilepsy-specific outcomes within a large, observational cohort of people with epilepsy. Participants who reported using artisanal CBD products at baseline (Artisanal CBD Users; n = 280) and participants who used no cannabis-based products (Controls; n = 138) completed web-based assessments evaluating psychiatric symptoms, healthcare utilization, and epilepsy-specific factors. Follow-up surveys were collected in a subset of participants (n = 190) following baseline assessment for longitudinal comparison. Cross-sectionally, higher quality of life, lower psychiatric symptom severity, and improved sleep were observed among Artisanal CBD Users at baseline compared with Controls. Initiation of artisanal CBD product use was also related to improved health outcomes longitudinally. No group differences were observed for seizure control, but both groups included a high number of individuals with no past month seizures. Artisanal CBD Users reported significantly better epilepsy medication tolerability, use of fewer prescription medications overall, and reduced healthcare utilization compared with Controls. These findings are consistent with research indicating that practitioners recommending CBD in clinical care for epilepsy report integrating the use of CBD both as a means to improve patient quality of life as well as for seizure control.
Highlights
Cannabis and select chemicals found in the cannabis plant have received significant clinical attention as evidence accumulates suggesting potential utility for varied health conditions [1,2]
This study extends previously published studies by evaluating health outcomes in a large cohort of people with epilepsy using artisanal cannabinoid products compared with a control group, as well as a within-subject longitudinal evaluation of a subset of participants who initiated artisanal CBD product use during study participation
Data were collected as a part of an observational cohort study conducted by Realm of Caring Foundation (Colorado Springs, CO, USA), a nonprofit organization dedicated to therapeutic cannabinoid research and education, in collaboration with researchers at the Johns Hopkins University School of Medicine (Baltimore, MD, USA)
Summary
Cannabis and select chemicals found in the cannabis plant have received significant clinical attention as evidence accumulates suggesting potential utility for varied health conditions [1,2]. A number of recent studies demonstrated the safety and efficacy of cannabidiol (CBD) in the reduction of seizures for several specific epilepsy syndromes [3,4,5]. This led to the widespread regulatory approval of EpidiolexÒ, a pharmaceutical grade CBD product, for. A large number of patients with epilepsy elect to use alternative CBD products sold widely as dietary supplements by commercial vendors [6].
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