Still little used in France, CBD-based oils have proved their worth in treating certain forms of intractable epilepsy, in both children and adults. Pending further studies that could broaden its indications, this molecule derived from hemp is already changing the daily lives of many suffering patients.
Three studies have already demonstrated the efficacy of CBD in the treatment of epilepsy. The molecule, which was legalized for sale in 2019, could halve the frequency of seizures in 40-50% of epileptic patients refractory to other treatments.
Emblematic is the anti-epileptic drug Epidyolex marketed by Jazz Pharmaceuticals. This controlled-manufacture oil with a CBD content of 10% received its marketing authorization (AMM) on September 19, 2019, and has only been reimbursed by the French health insurance scheme since December 20, 2022.
1066€: the price of Epidyolex, the only prescription CBD drug available in pharmacies.
Available in a 100 ml bottle of an oil with a high CBD content, Epidiolex is currently the only hemp-based drug reimbursed in France. Subject to an initial hospital prescription and then a prescription, it costs €1,066, and is reimbursed at 65% by the Assurance Maladie.
Epidyolex is currently prescribed only for three rare epileptic indications when other anti-epileptic molecules fail. ” These are the treatment of epileptic seizures associated with Bourneville’s tuberous sclerosis, or with the syndrome of Lennox-Gastaut or Dravet syndrome. This only concerns a small number of epileptic patients who have many seizures and respond poorly to other treatments. This is the reason why Epidyolex is so popular”, sums up Dr. Bastien Herlin, neurologist at the Pitié-Salpêtrière hospital in Paris. The explanation is simple: the laboratory that developed Epidyolex only carried out studies on these diseases, following a number of reports from patients’ families in the United States.
THC boosts CBD therapeutic effects
” Parents whose children suffer from these syndromes have reported a marked improvement in their child’s condition thanks to therapeutic cannabis. This is why the laboratory has conducted studies on these populations. “One hope, however: further studies are currently underway on other indications. ” If the new studies prove the efficacy of therapeutic cannabis in more common epileptic syndromes, we would then enter a phase of more economic discussions with social security, as many other patients could then potentially benefit .”
” These treatments act on the cerebral nervous system, so we have no way of predicting how each individual will react to these different molecules, in terms of both efficacy and tolerance. It’s sometimes really difficult to find a suitable treatment, especially for patients with severe forms of epilepsy. So the more options we have, the better! ”
Efficacy and side effects
The efficacy of Epidyolex is comparable to that of other first-line antiepileptic treatments. Three clinical trials conducted on Lennox Gastaut and Dravet syndromes demonstrated a 43.9% reduction in the frequency and intensity of monthly epileptic seizures.
” It’s an additional option for patients who don’t tolerate other antiepileptic molecules well, or for whom other treatments have not proved effective. Overall, in the adult patients I’ve prescribed it to, the results are variable: for around a third, there’s a fairly significant reduction in their seizures; for a third, the efficacy is not high enough. Finally, the last third discontinue treatment because of its side effects ( digestive disorders, fatigue and drowsiness) “, adds Dr. Herlin.
While Epidyolex and CBD and THC treatments remain promising, decades of prohibition have considerably delayed studies on the efficacy of these molecules present in cannabis. We can only hope that governments will stop shaking when it comes to making CBD and therapeutic cannabis more accessible to the world’s 50 million epileptics.
C.I.
