Shimrit Uliel-Sibony, MD: Can Patients Develop a CBD Tolerance?


Uliel-Sibony discussed her and her colleagues' study of CBD, and its findings on when tolerance develops for which patient population.

"Trying to explain this [is difficult] because, in the literature, most of the reports of tolerance to marijuana are due to THC, not the CBD...It's a long-term follow up compared to other studies, and it's possible that it wasn't [noticed] before because of shorter studies."

With the approval of cannabidiol (CBD; Epidiolex, GW Pharmaceuticals) in the US in 2018, the popularity of CBD as a treatment among patients has continued to grow, with the parents of patients with epilepsy asking for it straight away on clinic visits, according to some physicians.

At the American Epilepsy Society’s annual meeting in New Orleans, Louisiana, in December 2018, Shimrit Uliel-Sibony, MD, from the Dana-Dwek Children's Hospital at Tel-Aviv Sourasky Medical Center, and colleagues presented data from a trial of 92 patients with treatment-resistant epilepsy, both adults and children, who were treated with CBD. They sought to discover if a tolerance could be developed, what the rate of tolerance development was, and if there were differences between the adult and pediatric patients’ tolerances.

Ultimately, they found that tolerance to CBD does exist, which called into question its long-term effectiveness as an antiseizure treatment in patients with epilepsy.1 Tolerance was observed in 32.6% of the patients, with the average dose reported being 12.6 mg/kg/day. The mean time until the appearance of tolerance was 7.3 months (range, 1 to 24). To discuss the study and its findings further, Uliel-Sibony sat with NeurologyLive at the conference.


Uliel-Sibony S, Hausman-Kedem M, Kramer U. Cannabidiol tolerance in adults and children with treatment-resistant epilepsy. Poster presented


AES annual meeting; November 30 to December 4, 2018; New Orleans, Louisiana. Accessed


17, 2019.

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