Uso do canabidiol em pacientes com epilepsia refratária

Abstract

Introduction: Epilepsy is a chronic neurological disease that affects millions of people worldwide. About 30% of patients do not respond to conventional anticonvulsants, characterizing its refractory form. Cannabidiol (CBD), a compound from Cannabis sativa, stands out as a promising alternative, acting on multiple receptors and ion channels associated with epileptic seizures.

Objectives: Demonstrate the use of CBD in the treatment of refractory epilepsy, in addition to reporting its pharmacological actions and highlighting the combinatorial treatment with other anticonvulsants.

Methodology: Systematic review conducted according to the PRISMA model, including articles published between 2020 and 2025, searched in the Scielo and PubMed databases. Randomized clinical trials, meta-analyses and observational and laboratory studies in Portuguese and English, involving patients of all ages with refractory epilepsy, were included. Studies published before 2020, in other languages, or that did not address the use of cannabidiol in refractory epilepsy were excluded.

Results and discussion: 522 studies were identified, of which 11 were selected for systematic review. CBD exhibits multiple mechanisms of action that reduce neuronal hyperexcitability and has been shown to be effective in controlling refractory epilepsy. It is well tolerated, with mild adverse effects, and may act synergistically with other anticonvulsants, although some combinations require caution.

Conclusion: The study demonstrated the therapeutic potential of CBD in the treatment of refractory epilepsy, highlighting its effectiveness in reducing seizures and its safe use as an alternative or adjuvant to traditional anticonvulsants, despite the limitation of few direct comparative studies.