Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy.

@article{McGrath2019RandomizedBC,
  title={Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy.},
  author={Stephanie McGrath and Lisa R. Bartner and Sangeeta Rao and Rebecca A Packer and Daniel L. Gustafson},
  journal={Journal of the American Veterinary Medical Association},
  year={2019},
  volume={254 11},
  pages={
          1301-1308
        }
}
OBJECTIVE To assess the effect of oral cannabidiol (CBD) administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with idiopathic epilepsy. DESIGN Randomized blinded controlled clinical trial. ANIMALS 26 client-owned dogs with intractable idiopathic epilepsy. PROCEDURES Dogs were randomly assigned to a CBD (n = 12) or placebo (14) group. The CBD group received CBD-infused oil (2.5 mg/kg [1.1 mg/lb], PO) twice daily for 12 weeks in addition to… 

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References

SHOWING 1-10 OF 46 REFERENCES
Chronic administration of cannabidiol to healthy volunteers and epileptic patients.
TLDR
Four of the 8 CBD subjects remained almost free of convulsive crises throughout the experiment and 3 other patients demonstrated partial improvement in their clinical condition, while CBD was ineffective in 1 patient.
Randomized, dose-ranging safety trial of cannabidiol in Dravet syndrome
TLDR
This study provides Class I evidence that for children with Dravet syndrome, CBD resulted in more AEs than placebo but was generally well-tolerated.
The efficacy and tolerability of levetiracetam in pharmacoresistant epileptic dogs.
Effect of Cannabidiol on Drop Seizures in the Lennox–Gastaut Syndrome
TLDR
Among children and adults with the Lennox–Gastaut syndrome, the addition of cannabidiol at a dose of 10 mg or 20 mg per kilogram per day to a conventional antiepileptic regimen resulted in greater reductions in the frequency of drop seizures than placebo.
Investigating the potential of the anti-epileptic drug imepitoin as a treatment for co-morbid anxiety in dogs with idiopathic epilepsy
TLDR
Imepitoin does not appear to improve anxiety-related behaviour in dogs with IE treated with this medication for its anti-epileptic effects; however, imepitoin did not appear effective in reducing seizure frequency in a minority of cases.
Therapeutic serum drug concentrations in epileptic dogs treated with potassium bromide alone or in combination with other anticonvulsants: 122 cases (1992-1996).
TLDR
Serum bromide and phenobarbital concentrations and therapeutic outcome were determined for all dogs and a therapeutic response (improved seizure control) was defined as a > or = 50% reduction in seizure frequency following initiation of bromides treatment.
Therapeutic efficacy of phenobarbital and primidone in canine epilepsy: a comparison.
TLDR
Phenobarbital is regarded as the drug of first choice for the treatment of canine epilepsy, and primidone gave rise to signs of liver toxicity in fourteen out of twenty dogs, as indicated by considerable elevations of liver enzyme values.
Therapeutic serum concentrations of primidone and its metabolites, phenobarbital and phenylethylmalonamide in epileptic dogs.
TLDR
Serum phenobarbital was the best metabolite of primidone to use to assess therapeutic serum concentrations and was found to be between 25 and 40 micrograms/ml of serum.
...
...