Cannabis-based products for pediatric epilepsy: A systematic review
Jesse Elliott1,2, Deirdre DeJean3, Tammy Clifford1,4
1School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Epilepsia
|December 6, 2018
Summary
Cannabidiol likely reduces seizures in children with drug-resistant epilepsy. However, findings are limited to cannabidiol and do not apply to all cannabis products.
Area of Science:
- Neurology
- Pharmacology
- Pediatrics
Background:
- Pediatric epilepsy is a significant concern, with drug-resistant cases posing therapeutic challenges.
- Cannabis-based products, particularly cannabidiol, have emerged as potential treatments.
- Assessing the efficacy and safety of these products in children is crucial.
Purpose of the Study:
- To systematically review the benefits and harms of cannabis-based products for pediatric epilepsy.
- To evaluate the impact on seizure control, quality of life, and adverse events.
Main Methods:
- A living systematic review of randomized controlled trials (RCTs) and nonrandomized studies (NRSs) was conducted.
- Searches included major databases and gray literature up to April 25, 2018.
- Primary outcomes were seizure freedom and frequency; secondary outcomes included quality of life, sleep, and adverse events. Data were analyzed using random-effects meta-analysis with GRADE assessment for evidence quality.
Main Results:
- Four RCTs and 19 NRSs were included, primarily investigating cannabidiol.
- RCTs showed no significant difference in seizure freedom, quality of life, sleep, or vomiting compared to placebo.
- However, cannabidiol significantly reduced monthly seizure frequency and increased seizure reduction rates (≥50%), with increased diarrhea as a notable adverse event.
Conclusions:
- High-quality RCT evidence suggests cannabidiol likely reduces seizures in children with drug-resistant epilepsy.
- Current evidence is predominantly based on cannabidiol and should not be generalized to all cannabis-based products.
- Further research is needed to explore the broader applications and long-term effects of cannabis-based therapies in pediatric epilepsy.
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