O uso do canabidiol como anticonvulsivante no tratamento sintomático da Síndrome de Lennox-Gastaut
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Feb 2, 2025
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Resumo
Objetivo: Avaliar o uso do canabidiol no tratamento sintomático da Síndrome de Lennox- Gastaut (SLG) e os seus efeitos adversos. Revisão bibliográfica: O uso do canabidiol é eficiente no tratamento da SLG, seja na dose de 10mg/kg/d seja na de 20mg/kg/d, na redução da frequência de crises convulsivas e na melhora da qualidade de vida dos pacientes e familiares. Observa-se uma redução na frequência de crises convulsivas em pacientes com a SLG após o uso do canabidiol, sobretudo quando há a associação com outros anticonvulsivantes, especialmente na posologia de 20 mg/kg/dia. Porém, é preciso compreender também que o aumento da dose motiva alguns efeitos adversos, como diarreia, náusea, sonolência e aumento de transaminases hepáticas. Considerações finais: São escassas as evidências que relacionam o uso do canabidiol com outros anticonvulsivantes na SLG. Nessa óptica, o objetivo do estudo foi avaliar o uso do canabidiol no tratamento sintomático da Síndrome de Lennox-Gastaut, a fim de que essa terapia seja discutida no âmbito sociocultural e científico de forma imperativa. SLG – Síndrome de Lennox - Gastaut
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Como Citar
MedeirosB. A. G., CostaM. T. L. da, PereiraL. M. de O., & CecílioS. G. (2025). O uso do canabidiol como anticonvulsivante no tratamento sintomático da Síndrome de Lennox-Gastaut. Revista Eletrônica Acervo Saúde, 25, e17789. https://doi.org/10.25248/reas.e17789.2025
Seção
Revisão Bibliográfica
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Referências
1. ALALAWI A, et al. Cannabidiol improves vocal learning-dependent recovery from, and reduces magnitude of deficits following, damage to a cortical-like brain region in a songbird pre-clinical animal model. Neuropharmacology, 2019; 158: 107716.
2. AL-BANJI, M e ZAHR D, et al. Lennox-Gastaut syndrome. Management update. Neurosciences, 2015; 20(3) : 207–212.
3. ALI S e SCHEFFER IE, et al. Efficacy of cannabinoids in paediatric epilepsy. Developmental Medicine & Child Neurology, 2018; 61(1): 13–18.
4. ARZIMANOGLOU A, et al. Epilepsy and cannabidiol: a guide to treatment. Epileptic Disorders: International Epilepsy Journal with Videotape [Internet], 2020; 22(1): 1–14.
5. ASADI-POOYA AA. Lennox-Gastaut syndrome: a comprehensive review. Neurological Sciences, 2017; 39(3): 403–414.
6. AUVIN S. Lennox-Gastaut syndrome: New treatments and treatments under investigation. Revue Neurologique, 2020; 176(6): 444–447.
7. CHEN J e BORGELT LM, et al. Cannabidiol: A New Hope for Patients With Dravet or Lennox-Gastaut Syndromes. Annals of Pharmacotherapy [Internet], 2019; 53(6): 603–611.
8. CRUMRINE PK. Lennox-Gastaut Syndrome. Journal of Child Neurology, 2002; 17(1): 70–75.
9. DALE T, et al. Cannabis for refractory epilepsy in children: A review focusing on CDKL5 Deficiency Disorder. Epilepsy Research, 2019; 151: 31–39.
10. DEVINSKY O, et al. Effect of Cannabidiol on Drop Seizures in the Lennox–Gastaut Syndrome. New England Journal of Medicine, 2018; 378(20): 1888–1897.
11. FRANCO V e BIALER M, et al. Cannabidiol in the treatment of epilepsy: Current evidence and perspectives for further research. Neuropharmacology, 2021; 185: 108442.
12. GASTON TE e SZAFLARSKI JP. Cannabis for the Treatment of Epilepsy: an Update. Current Neurology and Neuroscience Reports, 2018; 18(11).
13. GONZALEZ-GIRALDO E e SULLIVAN JE. Advances in the Treatment of Drug-Resistant Pediatric Epilepsy. Seminars in Neurology [Internet], 2020; 40(2): 257–262.
14. GUNNING, B, et al. Cannabidiol in conjunction with clobazam: analysis of four randomized controlled trials. Acta Neurologica Scandinavica [Internet], 2021; 143(2): 154–163.
15. HUESTIS MA, et al. Cannabidiol adverse effects and toxicity. Current neuropharmacology, 2019; 17(10): 974–989.
16. KOO CM, et al. Cannabidiol for treating Lennox-Gastaut syndrome and Dravet syndrome in Korea. Journal of Korean medical science, 2020; 35(50): 427.
17. LATTANZI S, et al. Cannabidiol efficacy and clobazam status: A systematic review and meta‐analysis. Epilepsia, 2020; 61(6): 1090–1098.
18. LATTANZI S, et al. Efficacy and Safety of Adjunctive Cannabidiol in Patients with Lennox–Gastaut Syndrome: A Systematic Review and Meta-Analysis. CNS Drugs, 2018; 32(10): 905–916.
19. LATTANZI S, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs, 2018; 78(17): 1791–1804.
20. LATTANZI S, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs, 78(17): 1791.
21. LATTANZI S, et al. Highly Purified Cannabidiol for Epilepsy Treatment: A Systematic Review of Epileptic Conditions Beyond Dravet Syndrome and Lennox–Gastaut Syndrome. CNS Drugs, 2021; 35(3): 265–281.
22. MASTRANGELO M. Lennox–Gastaut Syndrome: A State of the Art Review. Neuropediatrics, 2017; 48(3): 143–151.
23. NEUBERGER EE e CARLSON JJ, et al. Cost-Effectiveness of Cannabidiol Adjunct Therapy versus Usual Care for the Treatment of Seizures in Lennox-Gastaut Syndrome. PharmacoEconomics, 2020; 38(11): 1237–1245.
24. NUNES ML e GEIB LTC, et al. Incidence of epilepsy and seizure disorders in childhood and association with social determinants: a birth cohort study. Jornal de Pediatria, 2011.
25. PATSALOS PN, et al. Clinical implications of trials investigating drug-drug interactions between cannabidiol and enzyme inducers or inhibitors or common antiseizure drugs. Epilepsia, 2020.
26. PIETRAFUSA N, et al. Purified Cannabidiol for Treatment of Refractory Epilepsies in Pediatric Patients with Developmental and Epileptic Encephalopathy. Paediatric drugs [Internet], 2019. Disponível em: https ://www.ncbi.nlm.nih.gov/pubmed/31179531. Acesso em: 31 maio 2024.
27. PRIVITERA M, et al. Epilepsia, 2021; 62(5): 1130–1140.
28. PRIVITERA M, et al. Time to onset of cannabidiol (CBD) treatment effect in Lennox–Gastaut syndrome: Analysis from two randomized controlled trials. Epilepsia, 2021; 62(5): 1130–1140.
29. SILVA GD, et al. Cannabidiol in the Treatment of Epilepsy: A Focused Review of Evidence and Gaps. Frontiers in Neurology, 2020; 11.
30. SILVINATO A e FLORIANO I, et al. Use of cannabidiol in the treatment of epilepsy: Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. Revista da Associação Médica Brasileira, 2022; 68(10): 1345–1357.
31. STRICKLAND JC, et al. Cross-sectional and longitudinal evaluation of cannabidiol (CBD) product use and health among people with epilepsy. Epilepsy & Behavior, 2021; 122: 108205.
32. STRZELCZYK A e SCHUBERT-BAST S. Expanding the Treatment Landscape for Lennox-Gastaut Syndrome: Current and Future Strategies. CNS Drugs [Internet], 2021; 35(1): 61–83.
33. THIELE EA, et al. Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet (London, England) [Internet], 2018; 391(10125): 1085–1096. Disponível em: https ://www.ncbi.nlm.nih.gov/pubmed/29395273. Acesso em: 31 maio 2024.
34. THIELE E, et al. Cannabidiol in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension study. Epilepsia [Internet], 2019; 60(3): 419–428.
35. THIELE E, et al. Cannabidiol in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension study. Epilepsia [Internet], 2019; 60(3): 419–428.
36. VARADKAR S. Cannabidiol for drop seizures in Lennox-Gastaut syndrome. The Lancet, 2018; 391(10125): 1006–1007.
37. VERROTTI A, et al. The pharmacological management of Lennox-Gastaut syndrome and critical literature review. Seizure [Internet], 2018; 63: 17–25.
38. WIJNEN, B, et al. Cannabidiol for Adjuvant Treatment of Seizures Associated with Lennox–Gastaut Syndrome and Dravet Syndrome: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. PharmacoEconomics, 2020; 38(10): 1043–1053.
2. AL-BANJI, M e ZAHR D, et al. Lennox-Gastaut syndrome. Management update. Neurosciences, 2015; 20(3) : 207–212.
3. ALI S e SCHEFFER IE, et al. Efficacy of cannabinoids in paediatric epilepsy. Developmental Medicine & Child Neurology, 2018; 61(1): 13–18.
4. ARZIMANOGLOU A, et al. Epilepsy and cannabidiol: a guide to treatment. Epileptic Disorders: International Epilepsy Journal with Videotape [Internet], 2020; 22(1): 1–14.
5. ASADI-POOYA AA. Lennox-Gastaut syndrome: a comprehensive review. Neurological Sciences, 2017; 39(3): 403–414.
6. AUVIN S. Lennox-Gastaut syndrome: New treatments and treatments under investigation. Revue Neurologique, 2020; 176(6): 444–447.
7. CHEN J e BORGELT LM, et al. Cannabidiol: A New Hope for Patients With Dravet or Lennox-Gastaut Syndromes. Annals of Pharmacotherapy [Internet], 2019; 53(6): 603–611.
8. CRUMRINE PK. Lennox-Gastaut Syndrome. Journal of Child Neurology, 2002; 17(1): 70–75.
9. DALE T, et al. Cannabis for refractory epilepsy in children: A review focusing on CDKL5 Deficiency Disorder. Epilepsy Research, 2019; 151: 31–39.
10. DEVINSKY O, et al. Effect of Cannabidiol on Drop Seizures in the Lennox–Gastaut Syndrome. New England Journal of Medicine, 2018; 378(20): 1888–1897.
11. FRANCO V e BIALER M, et al. Cannabidiol in the treatment of epilepsy: Current evidence and perspectives for further research. Neuropharmacology, 2021; 185: 108442.
12. GASTON TE e SZAFLARSKI JP. Cannabis for the Treatment of Epilepsy: an Update. Current Neurology and Neuroscience Reports, 2018; 18(11).
13. GONZALEZ-GIRALDO E e SULLIVAN JE. Advances in the Treatment of Drug-Resistant Pediatric Epilepsy. Seminars in Neurology [Internet], 2020; 40(2): 257–262.
14. GUNNING, B, et al. Cannabidiol in conjunction with clobazam: analysis of four randomized controlled trials. Acta Neurologica Scandinavica [Internet], 2021; 143(2): 154–163.
15. HUESTIS MA, et al. Cannabidiol adverse effects and toxicity. Current neuropharmacology, 2019; 17(10): 974–989.
16. KOO CM, et al. Cannabidiol for treating Lennox-Gastaut syndrome and Dravet syndrome in Korea. Journal of Korean medical science, 2020; 35(50): 427.
17. LATTANZI S, et al. Cannabidiol efficacy and clobazam status: A systematic review and meta‐analysis. Epilepsia, 2020; 61(6): 1090–1098.
18. LATTANZI S, et al. Efficacy and Safety of Adjunctive Cannabidiol in Patients with Lennox–Gastaut Syndrome: A Systematic Review and Meta-Analysis. CNS Drugs, 2018; 32(10): 905–916.
19. LATTANZI S, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs, 2018; 78(17): 1791–1804.
20. LATTANZI S, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs, 78(17): 1791.
21. LATTANZI S, et al. Highly Purified Cannabidiol for Epilepsy Treatment: A Systematic Review of Epileptic Conditions Beyond Dravet Syndrome and Lennox–Gastaut Syndrome. CNS Drugs, 2021; 35(3): 265–281.
22. MASTRANGELO M. Lennox–Gastaut Syndrome: A State of the Art Review. Neuropediatrics, 2017; 48(3): 143–151.
23. NEUBERGER EE e CARLSON JJ, et al. Cost-Effectiveness of Cannabidiol Adjunct Therapy versus Usual Care for the Treatment of Seizures in Lennox-Gastaut Syndrome. PharmacoEconomics, 2020; 38(11): 1237–1245.
24. NUNES ML e GEIB LTC, et al. Incidence of epilepsy and seizure disorders in childhood and association with social determinants: a birth cohort study. Jornal de Pediatria, 2011.
25. PATSALOS PN, et al. Clinical implications of trials investigating drug-drug interactions between cannabidiol and enzyme inducers or inhibitors or common antiseizure drugs. Epilepsia, 2020.
26. PIETRAFUSA N, et al. Purified Cannabidiol for Treatment of Refractory Epilepsies in Pediatric Patients with Developmental and Epileptic Encephalopathy. Paediatric drugs [Internet], 2019. Disponível em: https ://www.ncbi.nlm.nih.gov/pubmed/31179531. Acesso em: 31 maio 2024.
27. PRIVITERA M, et al. Epilepsia, 2021; 62(5): 1130–1140.
28. PRIVITERA M, et al. Time to onset of cannabidiol (CBD) treatment effect in Lennox–Gastaut syndrome: Analysis from two randomized controlled trials. Epilepsia, 2021; 62(5): 1130–1140.
29. SILVA GD, et al. Cannabidiol in the Treatment of Epilepsy: A Focused Review of Evidence and Gaps. Frontiers in Neurology, 2020; 11.
30. SILVINATO A e FLORIANO I, et al. Use of cannabidiol in the treatment of epilepsy: Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex. Revista da Associação Médica Brasileira, 2022; 68(10): 1345–1357.
31. STRICKLAND JC, et al. Cross-sectional and longitudinal evaluation of cannabidiol (CBD) product use and health among people with epilepsy. Epilepsy & Behavior, 2021; 122: 108205.
32. STRZELCZYK A e SCHUBERT-BAST S. Expanding the Treatment Landscape for Lennox-Gastaut Syndrome: Current and Future Strategies. CNS Drugs [Internet], 2021; 35(1): 61–83.
33. THIELE EA, et al. Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet (London, England) [Internet], 2018; 391(10125): 1085–1096. Disponível em: https ://www.ncbi.nlm.nih.gov/pubmed/29395273. Acesso em: 31 maio 2024.
34. THIELE E, et al. Cannabidiol in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension study. Epilepsia [Internet], 2019; 60(3): 419–428.
35. THIELE E, et al. Cannabidiol in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension study. Epilepsia [Internet], 2019; 60(3): 419–428.
36. VARADKAR S. Cannabidiol for drop seizures in Lennox-Gastaut syndrome. The Lancet, 2018; 391(10125): 1006–1007.
37. VERROTTI A, et al. The pharmacological management of Lennox-Gastaut syndrome and critical literature review. Seizure [Internet], 2018; 63: 17–25.
38. WIJNEN, B, et al. Cannabidiol for Adjuvant Treatment of Seizures Associated with Lennox–Gastaut Syndrome and Dravet Syndrome: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. PharmacoEconomics, 2020; 38(10): 1043–1053.