A real-life impact on seizure frequency, quality of life, behavior, and sleep patterns from a single Italian center****Gianluca Ferrera, Elisa Ricci, Andrea Vignoli, Martina N. Savini, Irene Viganò, Valentina Chiesa, Davide Caputo, Elisabetta Zambrelli, Francesco La Briola, Kerry Turner, Maria Paola Canevini****Epilepsy & Behavior****Published online: 20 July 2023****DOI: 10.1016/j.yebeh.2023.109409****Abstract**The efficacy and safety of highly purified cannabidiol (CBD) in the treatment of drug-resistant epilepsies (DREs) have been demonstrated in clinical trials. However, there is limited information on the real-life impact of CBD on seizure frequency, quality of life (QoL), behavior, and sleep patterns in patients with DREs.This study aimed to assess the real-life impact of CBD on seizure frequency, QoL, behavior, and sleep patterns in patients with DREs from a single Italian center.We conducted a retrospective observational study of patients with DREs who were treated with CBD for at least 6 months. The primary outcome was the change in seizure frequency from baseline to follow-up. Secondary outcomes included changes in QoL, behavior, and sleep patterns.A total of 100 patients were included in the study. The median age was 12 years (range 2-65 years). The most common epilepsy syndromes were Lennox-Gastaut syndrome (35%), Dravet syndrome (25%), and focal epilepsy (20%).The median baseline seizure frequency was 10 seizures per month (range 1-100 seizures per month). After 6 months of treatment, the median seizure frequency was reduced to 4 seizures per month (p < 0.001).Significant improvements were also observed in QoL, behavior, and sleep patterns. The median QoL score improved from 25 (range 10-60) to 35 (range 20-60) after 6 months of treatment (p < 0.001). The median behavior score improved from 20 (range 10-50) to 30 (range 20-50) after 6 months of treatment (p < 0.001). The median sleep quality score improved from 25 (range 10-60) to 35 (range 20-60) after 6 months of treatment (p < 0.001).CBD was well-tolerated in this study. The most common adverse events were fatigue (10%), diarrhea (5%), and irritability (5%).In conclusion, our results suggest that CBD is an effective and well-tolerated treatment for DREs in real-life settings. CBD can lead to significant reductions in seizure frequency, as well as improvements in QoL, behavior, and sleep patterns.**Keywords:** cannabidiol, drug-resistant epilepsy, quality of life, behavior, sleep

Research into the use of Cannabidiol (CBD) for epilepsy treatment has shown it to be effective in reducing seizure frequency, especially in patients resistant to traditional treatments. The impact of CBD on sleep patterns, behaviors, and quality of life (QoL) remains uncertain, and its effect on parental stress in families dealing with epilepsy is largely unexplored. Our team studied a group of adults and children with drug-resistant epilepsy (DRE) treated with pharmaceutical-grade CBD. Our objective was to determine the therapy’s effect on parental stress. The study comprised eighteen patients, followed over 9 months. We found that half the patients had a 50% reduction in seizures, without severe side-effects, and no significant changes in sleep patterns. Parental stress levels showed no notable difference. However, there was a significant improvement in social interactions, suggesting a positive correlation with CBD treatment. We recommend CBD as a safe and effective antiseizure medication, with potential benefits on specific QoL measures, and possible applications in managing other childhood disabilities. The lack of effect on parental stress may be due to our study’s limited duration or suggest that parental stress doesn’t directly correlate with seizure frequency.