Δ9-THC Intoxication by Cannabidiol-Enriched Cannabis Extract in Two Children with Refractory Epilepsy: Full Remission after Switching to Purified Cannabidiol

• Published in: Frontiers in pharmacology Vol. 7; p. 359
• Main Authors: Crippa, José A S, Crippa, Ana C S, Hallak, Jaime E C, Martín-Santos, Rocio, Zuardi, Antonio W
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 30-09-2016
• Subjects: Pharmacology; cannabidiol; epilepsy; refractory reriod; Cbd; intoxication; electrophysiological
• ISSN: 1663-9812; 1663-9812
• DOI: 10.3389/fphar.2016.00359

Animal studies and preliminary clinical trials have shown that cannabidiol (CBD)-enriched extracts may have beneficial effects for children with treatment-resistant epilepsy. However, these compounds are not yet registered as medicines by regulatory agencies. We describe the cases of two children with treatment-resistant epilepsy (Case A with left frontal dysplasia and Case B with Dravet Syndrome) with initial symptom improvement after the introduction of CBD extracts followed by seizure worsening after a short time. The children presented typical signs of intoxication by Δ9-THC (inappropriate laughter, ataxia, reduced attention, and eye redness) after using a CBD-enriched extract. The extract was replaced by the same dose of purified CBD with no Δ9-THC in both cases, which led to improvement in intoxication signs and seizure remission. These cases support pre-clinical and preliminary clinical evidence suggesting that CBD may be effective for some patients with epilepsy. Moreover, the cases highlight the need for randomized clinical trials using high-quality and reliable substances to ascertain the safety and efficacy of cannabinoids as medicines.