cbd oil dosage for child seizures

U of S study shows medicinal cannabis oil could be effective for treating children with severe epilepsy

Preliminary results from a new study out of the University of Saskatchewan showed medicinal cannabis oil containing both cannabidiol (CBD) and a small amount of THC can drastically reduce seizures in a small subgroup of children with severe, drug-resistant epilepsy.

According to research published in Frontiers in Neurology, children in the study who had severe epilepsy experienced an improvement in quality of life after taking low doses of the medicinal cannabis oil.

The study was designed to test the effects of oil with 95 per cent CBD, a chemical that does not create a high, and five per cent THC, an intoxicating substance in large doses.

The dosage escalation study saw researchers measure levels of CBC and THC in the blood of patients, something never done before in similar studies.

Patients had their dosage of oil increased in scheduled amounts every month and researchers monitored side effects to gain a better understanding of appropriate dosages.

Three of seven children in the study — which has 19 in total — stopped having seizures altogether. The average patient saw a 75 per cent reduction in seizures, while two saw under a 50 per cent reduction. The results are early and very preliminary.

The study found that most children had a reduction in seizures with a twice daily dose of CBD totalling five to six milligrams of cannabis extract per kilogram of weight per day. By the time the dosage reached 10 to 12 mg/kg per day, all children experienced a reduction in their seizures, most by more than 50 per cent.

Alongside this, the team was able to scientifically dispel some of the concerns about how to dose CBD oil and the possibility of them causing a high in children.

Dr. Richard Huntsman, a pediatric neurologist at the Royal University Hospital, said the results are encouraging as they could open up possible treatment options for children who have failed to respond to traditional medications and face severe seizures.

“What we have been able to do with this study is provide a dosage guideline for physicians,” he said. “We have been able to show by using THC, levels in the blood and observing the children closely. We saw no signs of THC intoxication, even on the highest doses we used.”

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He said accessing pharmaceutical grade CBD oils can be difficult for many families as they are quite expensive and many physicians are reluctant to prescribe cannabis herbal extracts as there is no data about dosage amounts and concerns about getting high from the THC.

Dr. Huntsman, however, said he would not recommend this treatment as a first line medication for all children with epilepsy, only those who have failed to be remedied on multiple medications and have severe pediatric epilepsy.

Prince Albert’s Allyssa Sanderson’s eight-year-old son Ben was one of the participants in the study.

When Ben was two, he was diagnosed with Lennox-Gastaut syndrome, a severe form of epilepsy. Despite trying different types of treatments, Ben’s seizures remained unpredictable. The family considered this trial as a last resort for Ben.

Once Ben started taking CBD, he began showing improvements in his seizure frequency and then became seizure-free during the study.

“I was seeing the change in Ben every single day. I was thankful as I watched his little personality come out. He was back to his silly self that I hadn’t seen in years. He was stronger. I believe this research is one of the greatest things to happen for kids with epilepsy,” Sanderson said in a media release from the university.

Next up, the doctor said, are plans to work collaboratively with the national Canadian Childhood Cannabinoid Clinical Trial Network on a large scale international trial.

Dr. Huntsman is proud of the fact the study was a Saskatchewan initiative, developed by teams at the U of S, funded heavily by the Jim Pattison Children’s Hospital Foundation.

“These guys have been so supportive and without their support we would not have been able to do this,” he said.

Five years ago when he approached the group for financial assistance, he said many organizations would have called him crazy for wanting to conduct cannabis research on children.

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“But they had the courage to and foresight to listen to what we were saying,” he said. “These are desperate families and we have to do something to help them and they had the courage to do that.”

The research team included neurologists, psychologists and pharmacologists from the university’s Cannabinoid Research Initiative of Saskatchewan. Funding also came from the Saskatchewan Health Research Foundation, the Durwood Seafoot Estate and the Savoy Foundation.

First Canadian paediatric study of mixed THC/CBD cannabis oil shows promise for children with drug-resistant epilepsy

Researchers at The Hospital for Sick Children (SickKids) have established safe dosing and tolerability of a pharmaceutical formulation of tetrahydrocannabidiol (THC) and cannabidiol (CBD) given to reduce seizures and improve quality of life for children with drug-resistant epilepsy (DRE) due to Dravet Syndrome.

TORONTO ON – Researchers at The Hospital for Sick Children (SickKids) have established safe dosing and tolerability of a pharmaceutical formulation of tetrahydrocannabidiol (THC) and cannabidiol (CBD) given to reduce seizures and improve quality of life for children with drug-resistant epilepsy (DRE) due to Dravet syndrome. Suffering from prolonged and frequent seizures, Dravet syndrome is a rare, catastrophic, form of epilepsy that begins in the first year of life. Seizures are typically difficult to treat, and children have many other comorbidities such as developmental delay and significant learning disabilities. There is no cure and the disease is lifelong.

Despite the expansion of available anti-epileptic drugs, dietary and surgical therapies in the last 20 years, up to 30 per cent of children with epilepsy suffer from DRE and the effects are devastating. “Our study adds to a growing body of evidence that cannabinoids can exert anti-seizure effects and are safe and tolerable in treating paediatric DRE,” says Dr. Blathnaid McCoy, Staff Neurologist at SickKids. The paper was published August 1 in Annals Clinical Translational Neurology.

Until recently, the clinical use of cannabis plant extracts in epilepsy has been limited by concern of the psychotropic effect of THC. Much of the evidence to date has focused on research with a single CBD-only product. Research suggests that THC-containing cannabinoid preparations may be superior to CBD-only preparations in their anticonvulsant effect and that the combination CBD/THC products may increase tolerance of THC by reducing its psychoactive properties.

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“Our study used a specific preparation containing both THC and CBD with a conservative dose of THC,” says McCoy. “In the participants who reached the target treatment dose we saw a statistically significant reduction in motor seizures, and an increase in seizure-free days compared to those who did not reach the target dose. We observed promising clinically beneficial effect’s including a reduction in seizure frequency and improvements in certain aspects of adaptive functioning and quality of life measures.”

The realities and risks of severe DRE and the fears that families live with on a daily basis are what drive researchers to find new improved therapies. For Laura Weightman, mother of SickKids patient Abigail, 16, this new therapy provides much-needed hope. “This therapy has turned our lives around,” says Weightman. “Abigail’s seizures started at eight months old at a frequency of up to 100 per month. At the time of the trial they had been reduced to 10 – 20 per month with medical and surgical interventions and since participating in this trial, Abigail has only had three seizures in the past year.”

As the first study of its kind to examine with rigor the dosing and tolerability of a mixed cannabinoid product containing both CBD and THC in children with DRE due to Dravet Syndrome, these results set the foundation for further work to advance successful treatment and outcomes for this population of children who until now, had little hope for better health outcomes.

A limitation in this study concerns the small number of participants, the majority of whom were already taking a prescribed antiepileptic drug.

Next steps include a large open label study in children with drug resistant epilepsy to assess efficacy.