The one-third of people who do not gain seizure control through current treatment options need a revolution in epilepsy therapeutics. The general population appears to be showing a fundamental and rapid shift in its opinion regarding cannabis and cannabis-related drugs. It is quite possible that cannabidiol, licensed in the USA for treating rare genetic epilepsies, may open the door for the widespread legalisation of recreational cannabis. It is important that neurologists understand the difference between artisanal cannabidiol products available legally on the high street and the cannabidiol medications that have strong trial evidence. In the UK in 2018 there are multiple high-profile reports of the response of children taking cannabis-derived medication, meaning that neurologists are commonly asked questions about these treatments in clinic. We address what an adult neurologist needs to know now, ahead of the likely licensing of Epidiolex in the UK in 2019.
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Contributors RHT and MOC contributed equally to the design, drafting and development of this review.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests RHT receives speaker fees from Eisai Ltd and UCB Pharma, he has consulted for Sanofi and Zogenix. RHT is an associate Editor of Practical Neurology. MOC has consulted for Neurexpert and Eisai Ltd. MOC has active scientific collaborations with Takeda, Eisai and Autifony Therapeutics. MOC has scientific collaborations with GW Pharma and GSK.
Patient consent Not required.
Provenance and peer review Commissioned. Externally peer reviewed by Helen Cross, London, UK.