Δ9-THC Intoxication by Cannabidiol-Enriched Cannabis Extract in Two Children with Refractory Epilepsy: Full Remission after Switching to Purified Cannabidiol
Δ9-THC Intoxication by Cannabidiol-Enriched Cannabis Extract in Two Children with Refractory Epilepsy: Full Remission after Switching to Purified Cannabidiol
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DOI：
10.3389/fphar.2016.00359
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发表时间：
2016-09-30
影响因子：
5.6
通讯作者：
Zuardi, Antonio W.
中科院分区：
文献类型：
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作者：
Crippa, Jose A. S.;Crippa, Ana C. S.;Zuardi, Antonio W.
动物研究和初步临床试验表明，富含大麻二酚（CBD）的提取物可能对患有难治性癫痫的儿童有有益的影响。然而，这些化合物尚未被监管机构注册为药物。我们描述了两例难治性癫痫患儿（左侧额叶发育不良的病例A和Dravet综合征的病例B），在引入CBD提取物后，最初症状改善，随后在短时间内癫痫发作恶化。这些儿童在使用富含CBD的提取物后表现出典型的Delta 9-THC中毒症状（不适当的笑声，共济失调，注意力下降和眼睛发红）。在这两种情况下，提取物被相同剂量的纯化CBD替代，没有Delta 9-THC，这导致中毒症状和癫痫缓解的改善。这些病例支持临床前和初步临床证据，表明CBD可能对某些癫痫患者有效。此外，这些案件强调需要使用高质量和可靠的物质进行随机临床试验，以确定大麻素作为药物的安全性和有效性。
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 Delta 9-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 Delta 9-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.