Adjunctive cannabidiol offer long term efficacy for adult patients with Dravet’s and Lennox-Gastaut Syndromes’

<h3></h3> To determine if Concomitant use of Cannabidiol and Clobazam can improve seizure control in patients with epileptic encephalopathies. <h3>Methods</h3> Epileptic encephalopathies are a disabling and life-limiting cause of childhood-onset epilepsy; Dravet’s syndrome (DS) and Lennox Gastaut syndrome (LGS) are characteristic examples. In spite of the development of multiple medical and surgical therapies, many patients with these conditions remain treatment-resistant. Cannabidiol was licenced by NICE in December 2019 for the adjunctive treatment of seizures associated with (DS ) 614 ] and LGS. As the largest complex epilepsy centre in the Midlands, we present our experience of Cannabidiol in 53 adult patients with DS/LGS- associated epilepsy. This single centre prospective study examined the efficacy of Cannabidiol on seizures of differing types over a 6-24 month period. Patients were treated with adjunctive Cannabidiol (with Clobazam, as per NICE recommendations). Usual anti-seizure medications (ASMs) were continued. Patients with a Vagal Nerve Stimulator (VNS) in situ continued therapy, including adjustment to VNS settings where necessary. <h3>Results</h3> Gradual titration of Cannabidiol from 1mg/kg/day up to modest doses of up to 10mg/kg/day reduced the frequency of both focal and generalised seizures (GTCS) with ≥50% seizure reduction in over two thirds of the cohort. No patients became seizure free. Cannabidiol was well tolerated; over 95% of the cohort remained on the drug at last follow up.