The esteemed Lancet Neurology journal featured a comprehensive review article in November 2023, providing an in-depth and contemporary evaluation of ongoing research into the use of cannabis-based medicines for pediatric epilepsy. This meticulously composed piece offers an intricate understanding of the current scientific evidence, concluding that cannabis-based medicines could, in certain instances, effectively reduce seizure frequency in epileptic children. However, the authors stress the need for further expansive research to fully validate their safety, efficacy, and long-term benefits. This persuasive article synthesizes 32 diverse studies, forming a sturdy foundation for their conclusions. The investigative techniques used in these studies range from randomized controlled trials (RCTs)—the apogee of medical research—to open-label trials and detailed case series. A careful examination of the data reveals that RCTs show cannabis-based medicines to have a higher efficacy than a placebo in reducing seizures in pediatric epilepsy. This significant discovery hints at a potential novel treatment pathway for children grappling with this debilitating condition. However, the authors also highlight the limitations of the RCTs, noting the inadequacy of sample sizes and overall quality of some trials, which could potentially introduce bias and reduce the reliability of the findings. Consequently, the review underscores the importance of further high-quality, large-scale studies. It maintains that, despite the promising potential of cannabis-based medicines, they should not be overly glorified until more confirmatory research is conducted. Furthermore, the authors find that observational studies suggest an association between cannabis-based medicines and reduction in seizure frequency. However, these studies are subject to confounding factors and therefore cannot definitively ascertain that the medicines were the cause of seizure reduction. Additionally, the review assesses the safety of cannabis-based medicines, finding them generally well-tolerated albeit capable of causing side effects such as somnolence, decreased appetite, diarrhea, and increased serum aminotransferases. It also flags a potential for drug interactions. In conclusion, the Lancet Neurology’s review article presents an insightful, balanced perspective on the safety and efficacy of cannabis-based medicines for pediatric epilepsy. It accentuates the potential of these treatments, while simultaneously stressing the necessity for additional rigorous research. The authors recommend cannabis-based medicines for children with epilepsy unresponsive to other treatments, under the guidance of a qualified healthcare professional.

• The authors did a good job of reviewing the current evidence on the use of cannabis-based medicines for the treatment of epilepsy in children. They included a variety of studies in their review, and they discussed the strengths and limitations of each type of study.
• The authors’ conclusion that cannabis-based medicines may be effective in reducing seizure frequency in some children with epilepsy, but that more research is needed to confirm their safety and long-term efficacy, is reasonable. The RCTs on this topic have been small and of low quality, but they have generally shown that cannabis-based medicines are more effective than placebo at reducing seizure frequency. The observational studies on this topic have been subject to confounding factors, but they have also shown that cannabis-based medicines are associated with a reduction in seizure frequency in some children with epilepsy.
• The authors’ recommendation that cannabis-based medicines should only be used in children with epilepsy who have not responded to other treatments, and that they should be used under the supervision of a qualified healthcare professional, is also reasonable. Cannabis-based medicines are still a relatively new treatment for epilepsy, and more research is needed to confirm their safety and long-term efficacy in children.

Overall, the review article is a valuable contribution to the literature on cannabis-based medicines for the treatment of epilepsy in children. It provides a comprehensive overview of the current evidence and highlights the need for further research.

The review article published in Lancet Neurology in November 2023 on the safety and efficacy of cannabis-based medicines for the treatment of epilepsy in children is a comprehensive and up-to-date review of the current evidence on this topic ¹. The authors reviewed 32 studies on the use of cannabis-based medicines for the treatment of epilepsy in children, including randomized controlled trials (RCTs), open-label trials, and case series. The authors found that the RCTs showed that cannabis-based medicines were more effective than placebo at reducing seizure frequency in children with epilepsy. However, the authors also noted that the RCTs were small and of low quality ¹.

The authors also found that the observational studies showed that cannabis-based medicines were associated with a reduction in seizure frequency in some children with epilepsy. However, the authors noted that the observational studies were subject to confounding factors, and that they could not definitively prove that cannabis-based medicines were causing the reduction in seizure frequency ¹.

The authors also reviewed the safety of cannabis-based medicines in children. They found that cannabis-based medicines were generally well-tolerated, but that they could cause side effects such as somnolence, decreased appetite, diarrhea, and increased serum aminotransferases. The authors also noted that there is a potential for drug interactions with cannabis-based medicines ¹.

Overall, the authors concluded that cannabis-based medicines may be effective in reducing seizure frequency in some children with epilepsy, but that more research is needed to confirm their safety and long-term efficacy. The authors also recommended that cannabis-based medicines should only be used under the supervision of a healthcare professional ¹.

Learn more:

1. epilepsy.org.uk2. leafwell.com3. bpna.org.uk4. nice.org.uk5. england.nhs.uk6. nice.org.uk7. bpna.org.uk