Elliott Taylor, Gienapp Andrew J, Wheless James W
Department of Biochemistry and Molecular Biology, Rhodes College, Memphis, TN, USA.
Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA.
Child Neurol Open. 2023 Apr 19;10:2329048X231169395. doi: 10.1177/2329048X231169395. eCollection 2023 Jan-Dec.
Despite US FDA approval of cannabidiol (CBD) liquid (Epidiolex®), patients with epilepsy still supplement prescription treatments with dispensary CBD. This study aimed to evaluate therapeutic effectiveness of dispensary CBD. We retrospectively collected dosage information, CBD serum levels, efficacy, and adverse effects from patient charts (children, adolescents, adults) (n = 18). All 18 patients showed no clinical benefit from dispensary CBD as detectable serum levels never reached a therapeutic range of 150 ng/mL (6 patients had barely detectable levels that were below laboratory reporting thresholds). Minute levels of tetrahydrocannabinol (THC) were found in 3 patients, and moderate levels were found in 1 patient. Dispensary CBD failed to reach effective therapeutic levels in all of these patients. The presence of THC demonstrates the current lack of regulation of dispensary CBD. Anecdotal reports of clinical effectiveness should be considered an effect of concomitant prescription antiseizure medications and not dispensary CBD.
尽管美国食品药品监督管理局（FDA）已批准大麻二酚（CBD）口服液（艾必妥®），但癫痫患者仍会在处方治疗的基础上补充药房售卖的CBD。本研究旨在评估药房售卖的CBD的治疗效果。我们回顾性地从患者病历（儿童、青少年、成人）中收集了剂量信息、CBD血清水平、疗效和不良反应（n = 18）。所有18例患者均未从药房售卖的CBD中获得临床益处，因为可检测到的血清水平从未达到150 ng/mL的治疗范围（6例患者的水平几乎检测不到，低于实验室报告阈值）。3例患者检测到微量四氢大麻酚（THC），1例患者检测到中等水平的THC。在所有这些患者中，药房售卖的CBD均未达到有效的治疗水平。THC的存在表明目前药房售卖的CBD缺乏监管。临床有效性的轶事报道应被视为同时使用的处方抗癫痫药物的效果，而非药房售卖的CBD的效果。
