Trevor Resnick, MD, an epileptologist with special qualifications in pediatric neurology at the Nicklaus Children's Hospital, discusses cannabidiol tolerance in two studies including patients with either Lennox-Gastaut syndrome or Dravet syndrome.
Trevor Resnick, MD: There was a study looking at the tolerance of cannabidiol in those 2 syndromes [Lennox-Gastaut syndrome and Dravet syndrome]. And they define tolerance as a 30% of the patients needing a change in their dose. And, based upon that definition and a mean dose of 12mg/kg, they found that tolerance did exist in a signficant number of patients in that study.
Interestingly, in that other study that we were discussing earlier, relating to the approval of cannabidiol in Dravet syndrome and Lennox-Gastaut syndrome, there was an open-label extension looking at how those patients in the study did if they were maintained on cannabidiol subsequent to the study. And, in that study, there was no demonstrated tolerance. And I think the reason for that, and there may be other reasons as well, but I think the reason for that is that the mean dose in that open-label extension for cannabidiol was 20-something 23mg/kg, whereas the mean dose in the study that demonstrated tolerance was 12mg/kg. So, because there was a lower dose, there was a greater likelihood that there would be a need to increase the dose. And in fact, in that tolerance study, when they did increase the dose, about 50% of the patients did well. So, I think it was more an issue of dosing, rather than true tolerance.