The Evidence Behind the Medical Use of Cannabinoids for Pediatric Epilepsy

Medical | November 14, 2018

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Various chronic conditions are reported to respond favorably to medical marijuana (cannabinoids); among these conditions is pediatric epilepsy. DynaMed Plus Editor and Nemours Children’s Hospital Chief of Epilepsy Services, Laufey Yr Sigurdardottir, MD discusses the evidence behind this new treatment.

While some states have passed legislation to allow the use of medical marijuana (cannabinoids), the lack of evidence regarding efficacy for different indications, dosing, and side effect profile, along with it being federally illegal, have been deterrents for conventional physicians. Since marijuana is classified as a schedule 1 substance, its production, distribution, and possession (including the nonpsychoactive component cannabidiol) has been considered illegal under federal law. That is, until earlier this year.

In the spring of 2018, two randomized trials published in New England Journal of Medicine and Lancet established that cannabidiol was beneficial in patients with Dravet or Lennox-Gastaut syndromes. Children and adults with these severe, debilitating epilepsies experienced about 40% reduction in seizure frequency with cannabidiol, and some patients were entirely seizure-free. Cannabidiol also had other beneficial effects, such as improvements in behavior and cognition.

In June 2018, cannabidiol (Epidiolex) was approved by the FDA for the treatment of Dravet and Lennox-Gastaut syndromes in patients at least two years old in the United States. This was shortly followed by de-scheduling of cannabidiol by the Drug Enforcement Administration (DEA) to schedule V. And it is likely that it will be available by prescription in doses specific for seizure management by the end of 2018.

In June 2018, cannabidiol (Epidiolex) was approved by the FDA for the treatment of Dravet and Lennox-Gastaut syndromes.

It has taken a village of dedicated researchers, courageous patients and their families to gather the necessary data to make this remarkable shift in the scheduling of a marijuana-related substance. There are likely more hurdles to come such as ensuring the participation of health insurance plans in the high cost of a novel and controversial drug. Further, studies looking at the efficacy of cannabidiol and other cannabinoids in autism, alternating hemiplegia of childhood, chronic pain, and migraine, are currently being conducted.

The grim reality of intractable epilepsy continues to change the lives of families around the world. Cannabidiol will hopefully become an important option in the treatment of epilepsy, while also having positive additional benefits on behavior, cognition, and autistic characteristics.

To take a deeper dive into the medical use of cannabinoids for various conditions, explore the latest clinical evidence compliments of DynaMed Plus® - the next-generation clinical information resource designed to decrease time to answer.

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