Dispensary Cannabidiol (CBD): Nothing to Worry About!
Abstract number :
3.296
Submission category :
7. Anti-seizure Medications / 7C. Cohort Studies
Year :
2022
Submission ID :
2204209
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Taylor Elliott, Student – Le Bonheur Children's Hospital; Andrew Gienapp, BS – Program Coordinator, Medical Editor, Neuroscience Institute, Le Bonheur Children's Institute; Tracee Ridley-Pryor, DNP, APRN – Director, Research Strategies and Collaboration, Neuroscience Institute, Le Bonheur Children's Hospital; James Wheless, BScPharm, MD – Professor/Chief/Le Bonheur Chair of Pediatric Neurology; Director, Neuroscience Institute, Le Bonheur Comprehensive Epilepsy Program and Neuroscience Institute, Le Bonheur Children's Hospital
Rationale: Even before the U.S. Food and Drug Administration (FDA) approved a prescription formulation of cannabidiol (CBD) in 2019, a number of epilepsy patients obtained internet-based dispensary CBD and added this to their prescribed treatment regimen. This has persisted even with a prescription CBD product. This retrospective chart review aims to document the pharmacology of internet dispensary CBD in a clinical setting. We reviewed serum levels of CBD in patients taking dispensary products purchased from various internet services to evaluate their pharmacokinetic profile. The purpose of this study is to demonstrate the pharmacokinetics of dispensary CBD and help bring awareness to their lack of efficacy, lack of cannabidiol contained in the product, and the utility of assaying CBD serum levels in patients on these products.
Methods: We performed a retrospective chart review of all patients presenting with a diagnosis of epilepsy who were reported taking a non-prescription, internet obtained, cannabidiol at Le Bonheur Children’s Hospital. Data collected include demographic data, epilepsy type, etiology, dispensary cannabidiol brand name, daily dosage, serum level, and any reported clinical effects. Serum levels were obtained through reports from NMS Labs and Quest Diagnostics (who currently use a reporting limit of 1 ng/mL).
Results: Of the 17 patients included in the study, 3 were over the age of 18 years. Six patients had a level of CBD below the reporting level (see Table 1 for a list of product used, dose given, and serum level obtained). Two patients modified their dosages of dispensary CBD but maintained levels well below therapeutic range (Suggested to be > 100-150 ng/ml). Of the 11 brands represented in the study, Charlotte’s Web hemp oil was the most readily obtained and showed higher CBD levels, however even these were well below the therapeutic range. No patient had a level that even approached the therapeutic range.
Conclusions: This study provided evidence to demonstrate the utility in obtaining serum levels of cannabidiol in patients treated with internet-based dispensary products. All these patients had no therapeutic level and would potentially benefit from switching to prescription cannabidiol. Even those with a recorded serum level above the reporting limit never achieved therapeutic levels (i.e., typically >150 ng/mL). The serum levels of patients with dispensary cannabidiol may help in determining the starting dose for prescription cannabidiol when physicians discuss switching to the prescription formulation. Given that serum levels obtained with internet-based dispensary cannabidiol are typically nontherapeutic, it is very unlikely that dispensary cannabidiol contributes any to seizure control.
Funding: Not applicable
Anti-seizure Medications