doi: 10.1016/j.pediatrneurol.2025.04.015. Online ahead of print.
National Multicenter Cohort Study: Adjunctive Cannabidiol-Enriched Cannabis Oil for Pediatric Drug-Resistant Epilepsy Treatment in Thailand
- PMID: 40460512
- DOI: 10.1016/j.pediatrneurol.2025.04.015
Abstract
Background: Several studies have reported the effectiveness and tolerability of cannabidiol (CBD)-enriched oil adjunctive treatment in children with drug-resistant epilepsy. This is the first multicenter cohort study of medical-grade CBD-enriched drugs in pediatric drug-resistant epilepsy in Thailand.
Methods: A prospective observational study was conducted across 19 Thai government hospitals between 2021 and 2023. The study aimed to assess CBD-enriched adjunctive treatment in pediatric drug-resistant epileptic patients with various etiologies ensuring a follow-up period of at least three months including cases wherein the medication was discontinued before three months.
Results: Of 101 patients, 42% were male with a median age of 10 years, experiencing a seizure frequency of 75 per month, and having failed treatment with an average of seven types of antiseizure medications. The median follow-up duration was 15 months with a median modal CBD dose of 6 mg/kg/day. The ≥50% seizure reduction rate and the median monthly total seizure reduction showed consistent improvement with reductions at three-, six-, nine-, and 12-month and the latest follow-up visits. Most seizure types responded positively to treatment, except for complex motor seizures. The effective CBD dose varied within a range of 1-15 mg/kg/day. Adverse events were reported in 92% of patients, predominantly mild (95%) and including somnolence, increased liver enzymes, anorexia, and irritability. Thirty-three patients discontinued CBD, with 57% due to intolerable adverse events, 30% ineffectiveness, and 12% noncompliance.
Conclusions: The Thai medical-grade CBD-enriched oil is effective and tolerable for at least 12 months of adjunctive treatment in pediatric drug-resistant epilepsy in Thailand.
Wares of Wisdom
Thailand’s landmark multicenter study delivers a powerful message: CBD-enriched cannabis oil is not only effective but also clinically tolerable for many children facing drug-resistant epilepsy. With sustained seizure reduction across 12 months and a wide dosing window, this real-world evidence reinforces what patient families have long known; cannabis can be life-changing where pharmaceuticals have failed.
While adverse effects were common, they were mostly mild and manageable, echoing global safety profiles. The high rate of improvement, even in patients who had tried an average of seven other drugs, highlights CBD’s critical role as an adjunct therapy. This study adds weight to global calls for access, education, and continued research into cannabinoid medicine, not just in Thailand, but everywhere children continue to suffer without options.
Nature is proving, once again, that it has something powerful to offer.
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