Medical cannabis for children: Evidence and recommendations

Paediatrics & Child Health, Journal Year: 2024, Volume and Issue: 29(2), P. 104 - 112

Published: April 5, 2024

Abstract Interest in using cannabis products for a medical purpose children under the age of 18 years is increasing. There are many available that can include cannabidiol (CBD) or delta-9-tetrahydrocannabinol (THC), both. Despite therapeutic claims, there few rigorous studies to inform dosing, safety, and efficacy paediatric clinical practice. This statement reviews current evidence provides recommendations children. Longer-term (2-year) reports support sustained tolerability therapy patients with Lennox-Gastaut Dravet syndromes. CBD-enriched extracts containing small amounts THC have been evaluated number patients, further research needed practice guidelines. Given widespread use Canada, paediatricians should be prepared engage open, ongoing discussions families about its potential benefits risks, develop individualized plans monitor efficacy, reduce harms, mitigate drug–drug interactions.

Language: Английский

---

Long-term efficacy and adverse effects of cannabidiol in adjuvant treatment of drug-resistant epilepsy: a systematic review and meta-analysis

Therapeutic Advances in Neurological Disorders, Journal Year: 2023, Volume and Issue: 16

Published: Jan. 1, 2023

Background: Epilepsy is one of the most common chronic brain diseases. Almost one-third patients have drug-resistant epilepsy (DRE). Cannabidiol being considered as a potential novel drug for treating DRE. Objectives: To investigate long-term efficacy and safety cannabidiol in treatment DRE differences among with different characteristics. Design: Systematic review meta-analysis. Data sources methods: Medline, Embase, CENTRAL were searched literature. RevMan5.4 was used The Intention-to-treat set random effect main analysis. Subgroup analyses performed according to age, dose, concomitant antiseizure medications (ASMs), syndromes, study designs. Results: Fifty studies included this systematic review. A total 4791 participants collected. responder rates (seizure frequency reduced at least 50%) 12-, 24-, 48-, 72-, 96-, 144-week 0.40 [0.36, 0.45], 0.39 [0.34, 0.44], 0.37 [0.30, 0.27 [0.17, 0.37], 0.22 [0.14, 0.30], 0.38 [0.23, 0.53]. Seizure-free 0.04 [0.03, 0.06], 0.05], 0.03 [0.02, 0.03], 0.02 [0.01, 0.06]. Proportion adverse events 0.72 [0.61, 0.83], 0.62 [0.42, 0.81], 0.60 [0.41, 0.79], 0.35 0.56], 0.83 [0.75, 0.90], 0.96 [0.94, 0.99]. pooled proportion serious 0.15 [0.09, 0.21], 0.23 0.31], 0.10 [0.06, 0.15], 0.31 [0.24, 0.38], [0.35, 0.45]. showed that there no significant difference on age subgroups syndromes subgroups. For periods, dose ASMs. However, higher doses more ASMs associated events. Conclusion: has stable fewer early period. Long-term use may decreased increased Dose escalation not increase efficacy, but Furthermore, reduce dosage other without reducing thereby effects. similar effects various syndromes. Trial registration: PROSPERO (CRD42022351250).

Language: Английский

---

Medicinal plants for epileptic seizures: Phytoconstituents, pharmacology and mechanisms revisited

Journal of Ethnopharmacology, Journal Year: 2023, Volume and Issue: 320, P. 117386 - 117386

Published: Nov. 11, 2023

Language: Английский

---

Population pharmacokinetics of cannabidiol and the impact of food and formulation on systemic exposure in children with drug‐resistant developmental and epileptic encephalopathies

Epilepsia, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 13, 2025

Abstract Objective Identifying factors influencing cannabidiol (CBD) exposure can optimize treatment efficacy and safety. We aimed to describe the population pharmacokinetics of CBD in children with drug‐resistant developmental epileptic encephalopathies (DEEs) assess influence environmental, pharmacological, clinical characteristics on systemic exposure. Methods Data from two pharmacokinetic studies patients aged 2–18 years DEEs were included ( N = 48 patients). Serial blood samples collected during maintenance treatment, before after morning dose, up 6 h a dose purified oil formulation, or without normocaloric breakfast. plasma concentrations also available following administration CBD‐enriched formulation. Samples quantified using validated liquid chromatography/tandem mass spectrometry assay. A model was developed nonlinear mixed‐effects modeling. The effects concomitant food intake, demographic, clinical, pharmacological evaluated. Simulated maximum concentration (C max ) area under concentration–time curve between 0 12 (AUC 0‐12 calculated. Results one‐compartment transit compartments first‐order elimination best described pharmacokinetics. Mean values for apparent clearance (CL/F) volume distribution (V/F) 143.5 L/h 1892.4 L, respectively. Weight allometrically scaled V/F CL/F, sex associated V/F, both formulation condition F (relative bioavailability). C increased by 41% AUC 45% when administered compared fasting. Dose‐normalized approximately 50% lower CBD. Significance In present study, we DEEs. Increased intake significant changes drug switching formulations should be considered patient management.

Language: Английский

---

Medicinal Cannabinoids in Children: A Scoping Review

Integrative Medicine Reports, Journal Year: 2025, Volume and Issue: 4(1), P. 9 - 43

Published: Jan. 1, 2025

Language: Английский

---

Cannabidiol as an adjuvant treatment in adults with drug-resistant focal epilepsy

Epilepsy & Behavior, Journal Year: 2023, Volume and Issue: 144, P. 109210 - 109210

Published: May 15, 2023

Language: Английский

---

Cannabis-based magistral formulation is highly effective as an adjuvant treatment in drug-resistant focal epilepsy in adult patients: an open-label prospective cohort study

Neurological Sciences, Journal Year: 2022, Volume and Issue: 44(1), P. 297 - 304

Published: Sept. 21, 2022

Language: Английский

---

CDKL5-associated developmental and epileptic encephalopathy: A long-term, longitudinal electroclinical study of 22 cases

Epilepsy Research, Journal Year: 2023, Volume and Issue: 190, P. 107098 - 107098

Published: Jan. 25, 2023

Language: Английский

---

Let food be thy medicine. The interaction between ketogenic diet therapy and anti‐seizure medications: A systematic review

Epileptic Disorders, Journal Year: 2023, Volume and Issue: 25(1), P. 18 - 27

Published: Feb. 1, 2023

Abstract Ketogenic diet therapy (KDT) is a nonpharmacological treatment that has been demonstrated to be effective in reducing seizures patients with drug‐resistant epilepsy. As the majority of on KDT are also receiving anti‐seizure medications (ASMs), questions about their combination often arise. typically implemented as an add‐on, and not substitute for ASMs. Drug monitoring specific laboratory studies may helpful cases cotherapy. Valproate, topiramate, zonisamide, lamotrigine potentially problematic KDT, but evidence this conclusive. ASM reduction usually attempted after 1 month if child showing seizure (but weaning ASMs does require freedom). Failure wean mean failed adding new beneficial those several months fine‐tuning. The purpose review was discuss possible negative (or positive) pharmacodynamic interactions between In addition, practical suggestions or provided.

Language: Английский

---

Cannabidiol in children with treatment-resistant epilepsy with myoclonic-atonic seizures

Epilepsy & Behavior, Journal Year: 2023, Volume and Issue: 143, P. 109245 - 109245

Published: May 12, 2023

Language: Английский

---