Effect of Cannabidiol on Drop Seizures in the Lennox–Gastaut Syndrome
Open accessAbstract
BACKGROUND: Cannabidiol has been used for treatment-resistant seizures in patients with severe early-onset epilepsy. We investigated the efficacy and safety of cannabidiol added to a regimen of conventional antiepileptic medication to treat drop seizures in patients with the Lennox-Gastaut syndrome, a severe developmental epileptic encephalopathy. METHODS: In this double-blind, placebo-controlled trial conducted at 30 clinical centers, we randomly assigned patients with the Lennox-Gastaut syndrome (age range, 2 to 55 years) who had had two or more drop seizures per week during a 28-day baseline period to receive cannabidiol oral solution at a dose of either 20 mg per kilogram of body weight (20-mg cannabidiol group) or 10 mg per kilogram (10-mg cannabidiol group) or matching placebo, administered in two equally divided doses daily for 14 weeks. The primary outcome was the percentage change from baseline in the frequency of drop seizures (average per 28 days) during the treatment period. RESULTS: A total of 225 patients were enrolled; 76 patients were assigned to the 20-mg cannabidiol group, 73 to the 10-mg cannabidiol group, and 76 to the placebo group. During the 28-day baseline period, the median number of drop seizures was 85 in all trial groups combined. The median percent reduction from baseline in drop-seizure frequency during the treatment period was 41.9% in the 20-mg cannabidiol group, 37.2% in the 10-mg cannabidiol group, and 17.2% in the placebo group (P=0.005 for the 20-mg cannabidiol group vs. placebo group, and P=0.002 for the 10-mg cannabidiol group vs. placebo group). The most common adverse events among the patients in the cannabidiol groups were somnolence, decreased appetite, and diarrhea; these events occurred more frequently in the higher-dose group. Six patients in the 20-mg cannabidiol group and 1 patient in the 10-mg cannabidiol group discontinued the trial medication because of adverse events and were withdrawn from the trial. Fourteen patients who received cannabidiol (9%) had elevated liver aminotransferase concentrations. CONCLUSIONS: Among children and adults with the Lennox-Gastaut syndrome, the addition of cannabidiol at a dose of 10 mg or 20 mg per kilogram per day to a conventional antiepileptic regimen resulted in greater reductions in the frequency of drop seizures than placebo. Adverse events with cannabidiol included elevated liver aminotransferase concentrations. (Funded by GW Pharmaceuticals; GWPCARE3 ClinicalTrials.gov number, NCT02224560 .).
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Randomised placebo-controlled trials (RCTs) of cannabidiol demonstrated efficacy in Dravet syndrome, LGS and TSC, with significant median percent reductions in target seizures compared with placebo of 38.9%, 41.9% and 48.6%.
“Randomised placebo-controlled trials (RCTs) of cannabidiol demonstrated efficacy in Dravet syndrome, LGS and TSC, with significant median percent reductions in target seizures compared with placebo of 38.9% 188 , 41.9% 189 and 48.6% 190 .”
From Developmental and epileptic encephalopathies (2024) · cites this paper as [189]
Open-blind and double-blind controlled clinical trials confirmed and expanded preliminary findings on the efficacy, security and tolerability of CBD in children and adolescents with treatment-resistant epilepsy, particularly Dravet and Lennox-Gastaut syndromes.
“More recently, open-blind and double-blind, controlled clinical trials investigated the efficacy, security and tolerability of CBD in children and adolescents with treatment-resistant epilepsy (particularly Dravet and Lennox-Gastaut syndromes) confirmed and expanded these preliminary findings (137–140).”
From Translational investigation of the therapeutic potential of Cannabidiol (CBD): Toward a new age (2018) · cites this paper as [139]
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- Authors
- Devinsky, O., Patel, A. D., Cross, J. H., Villanueva, V., Wirrell, E. C., Privitera, M., Greenwood, S. M., Roberts, C., Checketts, D., VanLandingham, K. E., & Zuberi, S. M.
- Affiliations
- Nationwide Children's Hospital (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2018-05-17
- Volume
- 378
- Issue
- 20
- Pages
- 1888-1897
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2804921146
- Cited by
- 1,015
- References
- 18
- Citations by year
- 2026: 79 · 2025: 120 · 2024: 83 · 2023: 119 · 2022: 145 · 2021: 144 · 2020: 173 · 2019: 117 · 2018: 35
- FWCI
- 91.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Funders
- GW Research Ltd
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- cannabidiol, Lennox-Gastaut syndrome, drop seizures, seizure frequency, drug-resistant epilepsy, developmental and epileptic encephalopathy, combination antiepileptic therapy, sleepiness, pediatric epilepsy, drug safety and efficacy
- MeSH terms
- Adolescent, Adult, Transaminases, Anticonvulsants, Cannabidiol, Child, Child, Preschool, Dose-Response Relationship, Drug, Double-Blind Method, Drug Therapy, Combination, Humans, Male, Middle Aged, Seizures, Odds Ratio, Young Adult, Lennox Gastaut Syndrome
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