Preliminary Prospective Study of Pharmaceutical-Grade Cannabidiol for Seizure Frequency, Anxiety, and Comorbid Symptoms in Pediatric Epilepsy: Associations With Circulating Endocannabinoids and Lipid Biomarkers
Sophia Hopkins 1 , Amanda Weber 2 , Jamie MacDougall 3 , Julia Evanski 4 5 , Hilary A Marusak 6 7 8 , Aimee Luat 3 9
- 1College of Medicine, Central Michigan University, Mount Pleasant, MI, USA.
- 2Division of Neurology, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State, University College of Medicine, Columbus, OH, USA.
- 3Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA.
- 4Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI, USA.
- 5Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
- 6Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
- 7Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, USA.
- 8Merrill Palmer Skillman Institute for Child and Family Development, Detroit, MI, USA.
- 9Depatment of Pediatrics, Central Michigan University, Mount Pleasant, MI, USA.
Affiliationer
Abstract
Anxiety commonly co-occurs with childhood epilepsy, yet treatments targeting both are limited. Epidiolex (cannabidiol, CBD) is an FDA-approved treatment for seizures associated with rare pediatric epilepsies and may have anxiolytic effects. We evaluated its effects on seizures and anxiety in pediatric patients with refractory epilepsy, representing diverse seizure etiologies and circulating endocannabinoids and related biomarkers. Twelve participants (12.17 ± 5.17 years; 6 female) initiated Epidiolex for 4-6 weeks. Caregivers completed pre- and post-treatment seizure diaries; validated anxiety and quality-of-life assessments; and plasma endocannabinoids, related lipids, and CBD metabolites-including 7-hydroxycannabidiol (7-OH-CBD)-were measured. Post-treatment, 73% of caregivers reported improvements in anxiety and seizure frequency with minimal side effects and improved sleep. Plasma 2-arachidonoylglycerol increased from baseline to study end, with greater elevations in those with lower baseline concentrations. Plasma 7-OH-CBD increased from baseline to study end, confirming systemic CBD exposure. Epidiolex may provide anxiolytic benefits across pediatric epilepsy, potentially involving endocannabinoids.
Keywords: anxiety; children; epilepsy.
