Shimrit Uliel-Sibony, MD: Can Patients Develop a CBD Tolerance?

With the approval of cannabidiol (CBD; Epidiolex, GW Pharmaceuticals) in the US in 2018, the popularity of CBD as a treatment among patients has continued to grow, with the parents of patients with epilepsy asking for it straight away on clinic visits, according to some physicians.

At the American Epilepsy Society’s annual meeting in New Orleans, Louisiana, in December 2018, Shimrit Uliel-Sibony, MD, from the Dana-Dwek Children's Hospital at Tel-Aviv Sourasky Medical Center, and colleagues presented data from a trial of 92 patients with treatment-resistant epilepsy, both adults and children, who were treated with CBD. They sought to discover if a tolerance could be developed, what the rate of tolerance development was, and if there were differences between the adult and pediatric patients’ tolerances.

Ultimately, they found that tolerance to CBD does exist, which called into question its long-term effectiveness as an antiseizure treatment in patients with epilepsy.1 Tolerance was observed in 32.6% of the patients, with the average dose reported being 12.6 mg/kg/day. The mean time until appearance of tolerance was 7.3 months (range, 1 to 24). To discuss the study and its findings further, Uliel-Sibony sat with NeurologyLive at the conference.