{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:16:37Z","timestamp":1788592597905,"version":"build-2803163510"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Highly purified cannabidiol (CBD), recently approved for various neurological disorders, is explored as a potential therapeutic avenue for drug-resistant epilepsy (DRE) among adult people with epilepsy (PWE) in this systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To conduct an extensive literature review and meta-analysis of CBD use for DRE in adult PWE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources and methods:<\/jats:title>\n                    <jats:p>We conducted a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and two electronic resources; we searched Ovid MEDLINE and Scopus using appropriate keywords until August 2023. Data were presented as standardized mean difference (SMD) and odds ratio with confidence interval (CI) via random effect. We appraised the risk of bias of the included studies using the Joanna Briggs Institute critical appraisal tool while their strength of evidence with the Oxford Centre for Evidence-Based Medicine (OCEBM) and Grading of Recommendations Assessment Development and Education (GRADE) Levels of Evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 16 studies, 3 of which were randomized controlled trials and 3 prospective cohort studies, while the rest were expanded access programs, deriving a total of 668 participants receiving CBD for seizure control. CBD was used concomitantly with antiseizure medications in all studies. There was a reduction in seizures in the group receiving CBD therapy compared to the placebo group [SMD: \u22121.50, 95% CI (\u22123.47, 0.47)], though this did not reach statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The evidence on CBD use in adult patients with DRE demonstrates a moderate level of certainty according to GRADE level and OCEBM level 2. Further prospective studies involving multiple centers are encouraged to study both the efficacy and safety of CBD in adult patients with DRE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>International Prospective Register of Systematic Reviews (PROSPERO) 2023 CRD42023449955.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864251313914","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T13:47:43Z","timestamp":1738158463000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The use of cannabidiol as adjunctive therapy in adult patients with drug-resistant epilepsy: a systematic review and meta-analysis"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8087-7464","authenticated-orcid":false,"given":"Marjorie Jia Yi","family":"Ong","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia"},{"name":"Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2733-0005","authenticated-orcid":false,"given":"Muhammad Samir Haziq","family":"Abd Rahman","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Medicine, Hospital Canselor Tuanku Muhriz UKM, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa Lin Lin","family":"Lee","sequence":"additional","affiliation":[{"name":"Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1480-659X","authenticated-orcid":false,"given":"Kong Heng","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0930-0837","authenticated-orcid":false,"given":"Carmen Jia Yinn","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching Soong","family":"Khoo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia"},{"name":"Neurology Unit, Department of Medicine, Hospital Canselor Tuanku Muhriz UKM, Kuala Lumpur, Malaysia"},{"name":"Centre for Global Epilepsy, Wolfson College, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozita","family":"Hod","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Jan","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia"},{"name":"Neurology Unit, Department of Medicine, Hospital Canselor Tuanku Muhriz UKM, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5950-2692","authenticated-orcid":false,"given":"Eugen","family":"Trinka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurological Intensive Care and Neurorehabilitation, Christian Doppler University Hospital, Paracelsus Medical University and Center for Cognitive Neuroscience, Member of the European Reference Network EpiCARE, Salzburg, Austria"},{"name":"Neuroscience Institute, Christian Doppler University Hospital, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria"},{"name":"Karl Landsteiner Institute of Neurorehabilitation and Space Neurology, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0013-9580.2005.66104.x"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68477-8"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003509"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2008.01.003"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.674483"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2014.05.031"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fepid.2023.1081757"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02397.x"},{"key":"e_1_3_6_10_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7812\/TPP\/19.200","article-title":"Mechanisms of action and pharmacokinetics of cannabis","volume":"25","author":"Chayasirisobhon S.","year":"2020","unstructured":"Chayasirisobhon S. Mechanisms of action and pharmacokinetics of cannabis. Permanente J 2020; 25: 1\u20133.","journal-title":"Permanente J"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-018-0992-5"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.109.159145"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.18773\/austprescr.2020.052"},{"key":"e_1_3_6_14_2","unstructured":"U.S. Food & Drug Administration. FDA approves new indication for drug containing an active ingredient derived from cannabis to treat seizures in rare genetic disease www.fda.gov\/news-events\/press-announcements\/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare (2020 accessed 30 January 2024)."},{"key":"e_1_3_6_15_2","unstructured":"Court of Justice of the European Union. A Member State may not prohibit the marketing of cannabidiol (CBD) lawfully produced in another Member State when it is extracted from the Cannabis sativa plant in its entirety and not solely from its fibre and seeds. Press Release No. 141\/20 ed. Luxembourg 2020."},{"key":"e_1_3_6_16_2","unstructured":"European Medicines Agency. Epidyolex www.ema.europa.eu\/en\/medicines\/human\/EPAR\/epidyolex (2023 accessed 6 April 2024)."},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2019-300117"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13499"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2018.07.020"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.03.035"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.04.044"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.03.042"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaa140"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107297"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.107862"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.108190"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2021.106603"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16936"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2021.05.014"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-022-06393-1"},{"issue":"7","key":"e_1_3_6_31_2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.20189","article-title":"Adjunctive transdermal cannabidiol for adults with focal epilepsy: a randomized clinical trial","volume":"5","author":"O\u2019Brien TJ","year":"2022","unstructured":"O\u2019Brien TJ, Berkovic SF, French JA, et al. Adjunctive transdermal cannabidiol for adults with focal epilepsy: a randomized clinical trial. JAMA Netw Open 2022; 5(7): e2220189-e.","journal-title":"JAMA Netw Open"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1143783"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2023.109210"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.12809"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.5698\/1535-7597-14.5.250"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16546"},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aww019"},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2016.05.014"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.15096"},{"key":"e_1_3_6_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.621"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0b013e3181d64b1e"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2019.100341"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.04.008"},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2013.08.007"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.1089\/brain.2012.0103"},{"key":"e_1_3_6_46_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.0335"},{"key":"e_1_3_6_47_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-022-06303-5"},{"key":"e_1_3_6_48_2","doi-asserted-by":"publisher","DOI":"10.1002\/adbi.202300090"},{"issue":"3","key":"e_1_3_6_49_2","first-page":"1210","article-title":"\u201cHigh\u201d achievers? cannabis access and academic performance","volume":"84","author":"Marie O","year":"2017","unstructured":"Marie O, Z\u00f6litz U. \u201cHigh\u201d achievers? cannabis access and academic performance. Rev Econ Stud 2017; 84(3): 1210\u20131237.","journal-title":"Rev Econ Stud"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000108"}],"updated-by":[{"DOI":"10.1177\/17562864251400528","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000}}],"container-title":["Therapeutic Advances in Neurological Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562864251313914","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17562864251313914","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562864251313914","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T12:02:43Z","timestamp":1764072163000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17562864251313914"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":49,"alternative-id":["10.1177\/17562864251313914"],"URL":"https:\/\/doi.org\/10.1177\/17562864251313914","relation":{},"ISSN":["1756-2864","1756-2864"],"issn-type":[{"value":"1756-2864","type":"print"},{"value":"1756-2864","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"article-number":"17562864251313914"}}