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ORIGINAL RESEARCH article
Front. Neurosci.
Sec. Neuropharmacology
Volume 19 - 2025 | doi: 10.3389/fnins.2025.1570531
9 Patients Report Seizure Freedom with Medical Cannabis Treatment for Drug-Resistant Epilepsy: A Case Series
Provisionally accepted
Frank Yizhao Chen1*
Joshua Myles Duckman1
Brenden Samuel Rabinovitch1,2,3*
Katrin Julia Hannesson1
Evan Cole Lewis1,4*- 1North Toronto Neurology, Toronto, Canada
- 2Krembil Brain Institute, University Health Network (UHN), Toronto, Ontario, Canada
- 3Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- 4Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Purpose: Seizure freedom (SF) is the primary goal of epilepsy treatment. More treatments that produce SF in drug-resistant epilepsy (DRE) are needed. Cannabis-based products for medicinal use (CBPMs) containing cannabidiol (CBD) and ∆9-tetrahydrocannabinol (THC) have been shown to induce SF in DRE. However, there remains a paucity of published real-world evidence in both pediatrics and adults on SF resulting from CBPM therapy.Methods: This is a retrospective case series at an outpatient neurology clinic in Toronto, Canada, on patients with DRE who experienced significant SF during CBPM treatment. All patients were treated via the clinic's stepwise treatment protocol. The study describes clinical features of patients and their CBPMrelated SF.We report 19 DRE cases that experienced SF; 15 pediatric, 4 adults. The median cumulative SF duration was 245 days, split between continuous SF periods lasting at least 90 days. Five patients had continuous SF periods lasting ≥1 year. Most patients used CBD+THC regimens. Three patients weaned all concomitant ASMs. Adverse events (AEs) were reported by half of the patients.The results of the study support prioritizing CBPMs in cases of DRE. It also supports research into identifying clinical and biological biomarkers for DRE cases that may achieve SF under CBPM treatment. Lastly, the study supports improving the accessibility of CBPMs, using SF as a primary outcome in future CBPM epilepsy trials, and assessing the role of THC in reducing seizures.
Keywords: Epilepsy, Cannabis, CBD - cannabidiol, THC - tetrahydrocannabinol, Seizure freedom, pediatric epilepsy, Seizures, Cannabis medicine
Received: 05 Feb 2025; Accepted: 17 Apr 2025.
Copyright: © 2025 Chen, Duckman, Rabinovitch, Hannesson and Lewis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Frank Yizhao Chen, North Toronto Neurology, Toronto, Canada
Brenden Samuel Rabinovitch, Krembil Brain Institute, University Health Network (UHN), Toronto, M5G 2C4, Ontario, Canada
Evan Cole Lewis, North Toronto Neurology, Toronto, Canada
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.