Background: Several antiepileptic drugs (AEDs), about 25, are currently clinically
available for the treatment of patients with epilepsy. Despite this armamentarium and
the many recently introduced AEDs, no major advances have been achieved considering the
number of drug resistant patients, while many benefits have been indeed obtained for other
clinical outcomes (e.g. better tolerability, less interactions). Cannabinoids have long been
studied for their potential therapeutical use and more recently phytocannabinoids have been
considered a valuable tool for the treatment of several neurological disorders including epilepsy.
Among this wide class, the most studied is cannabidiol (CBD) considering its lack of
psychotropic effects and its anticonvulsant properties.
Objective: Analyse the currently available literature on CBD also in light of other data on
phytocannabinoids, reviewing data spanning from the mechanism of action, pharmacokinetic
to clinical evidences.
Results: Several preclinical studies have tried to understand the mechanism of action of CBD, which still remains
largely not understood. CBD has shown significant anticonvulsant effects mainly in acute animal models of seizures;
beneficial effects were reported also in animal models of epileptogenesis and chronic models of epilepsy,
although not substantial. In contrast, data coming from some studies raise questions on the effects of other cannabinoids
and above all marijuana.
Conclusion: There is indeed sufficient supporting data for clinical development and important antiepileptic effects
and the currently ongoing clinical studies will permit the real usefulness of CBD and possibly other cannabinoids.
Undoubtedly, several issues also need to be addressed in the next future (e.g. better pharmacokinetic
profiling). Finally, shading light on the mechanism of action and the study of other cannabinoids might represent
an advantage for future developments.