Authors: Pelliccia A, Grassi G, Romano A, Crocchialo P
ntroduction: As shown by Turkanis et al. (Epilepsy, 1979), cannabidiol (CBD), similarly to d9-tetrahydrocannabinol (d9-THC) and Phenytoin (PHT) increases the “afterdischarge” and seizures threshold, mainly at the limbic level, without exhibiting the side effects induced by drugs such as PHT. Studies on rats were conducted that confirmed the anticonvulsant effects of both CBD (Chiu et al., 1979) and of d 9-THC (Cosroe and Mechoulam, 1987). However, in spite of other studies having confirmed the anticonvulsant effect of cannabinoids, up to date no trials were conducted on man and, the less so, on the child.
Methods: We collected data on a population of children who presented with traditional antiepileptic drugs-resistant seizures, treated with a 2.5% corn oily solution of CBD as part of an open study, by modulating administration and titration schedules on a case by case basis, according to clinical response.
Results: On June 2002 we started to treat an eleven year-old girl affected with a highly drug-resistant Lennox-Gastaut syndrome, with CBD, a substance not included in the list of illicit drugs, in a 2.5% corn oily solution, administered at gradually increasing doses up to the present 20 drops daily. Results have been encouraging: the girl, since she assumes CBD, did not need any longer to be admitted to hospital for her epileptic seizures, while her attacks decreased both in frequency and intensity, in addition her awareness, postural tone and speaking ability improved, as to allow us to gradually decrease her barbiturate intake. Along the same line, CBD was proposed to another patient, a 17 year-old boy with an equally drug-resistant Lennox-Gastaut syndrome: although he reached the dose of only 30 drops daily, he also exhibited a slight improvement of the
crises and, first and foremost, a clear-cut attention-behavioural improvement, and even in his case a suspension of the barbiturate treatment was initiated. During the last year, 16 more children were started on CBD, all of them affected with symptomatic drug-resistant epilepsy; however, only 9 out of these are currently on treatment, since the parents of the remaining children, although appreciating the improvement of their offspring, not only concerning the fits but also the awareness and the muscular tone, preferred to discontinue due to the economic overcharge induced by the treatment (approximately 300 EURos per month).
Conclusions: So far obtained results in our open study appear encouraging for various reasons:
1) no side effects of such a severity were observed as to require CBD discontinuation;
2) in most of the treated children an improvement of the crises was obtained equal to, or higher than, 25% in spite of the low CBD doses administered;
3) in all CBD- treated children a clear improvement of consciousness and spasticity (whenever present) was observed.