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Adjunctive Cannabidiol for Drug-Resistant Epilepsy: A Systematic Review and Meta-Analysis of Randomized Trials Across
Reza Pratama1,2, Muhaimin Muhaimin3, Miski Aghnia Khairinisa4
1Doctoral Program, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, 45363, Indonesia.
Therapeutics and Clinical Risk Management
|May 25, 2026
Summary
Cannabidiol (CBD) effectively reduces seizures in drug-resistant epilepsy. Oral CBD at 20 mg/kg daily is most effective, with a good safety profile, though alternative formulations need more study.
Area of Science:
- Neurology
- Pharmacology
- Clinical Trials
Background:
- Cannabidiol (CBD) shows promise for drug-resistant epilepsy.
- Clinical trial results for CBD in epilepsy are inconsistent.
- This meta-analysis evaluates CBD's efficacy, safety, and formulation effects.
Purpose of the Study:
- To assess the efficacy of adjunctive cannabidiol (CBD) in treatment-resistant epilepsy.
- To evaluate the safety profile of CBD in epilepsy patients.
- To compare the performance of different CBD formulations.
Main Methods:
- Systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials.
- Searched PubMed, Scopus, and CENTRAL for relevant studies.
- Synthesized data using random-effects models to determine pooled risk ratios for seizure reduction and adverse events.
Main Results:
- Seven trials with 1154 participants were included.
- Adjunctive CBD significantly reduced seizure frequency versus placebo (RR = 0.72).
- Optimal efficacy was seen with oral CBD at 20 mg/kg/day; liposomal showed modest benefit, transdermal none.
Conclusions:
- Oral CBD offers a reliable and significant seizure reduction in drug-resistant epilepsy.
- The 20 mg/kg/day oral dose is the current efficacy benchmark.
- Further research is needed for alternative formulations and long-term outcomes.
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