Efficacy and adverse event profile of cannabidiol and medicinal cannabis for treatment-resistant epilepsy: Systematic review and meta-analysis

Reis, Renandro de Carvalho; Almeida, Kelson James; Lopes, Lawrence Gonzaga; Mendes, Cíntia Maria de Melo; Bor‐Seng‐Shu, Edson

doi:10.1016/j.yebeh.2019.106635

Cited by 42 publications

(40 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study from Israel showed that epilepsy in children can also be treated with a standardized preparation containing CBD and THC [23]. Finally, a recent systematic review and meta-analysis summarized results from intervention studies and concluded that CBD is more effective than placebo for treatment-resistant epilepsy, regardless of the aetiology of the epileptic syndrome [24].…”

Section: Discussionmentioning

confidence: 99%

Use and caregiver-reported efficacy of medical cannabis in children and adolescents in Switzerland

et al. 2021

View full text Add to dashboard Cite

Evidence on the use and efficacy of medical cannabis for children is limited. We examined clinical and epidemiological characteristics of medical cannabis treatment and caregiver-reported effects in children and adolescents in Switzerland. We collected clinical data from children and adolescents (< 18 years) who received Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), or a combination of the two between 2008 and 2019 in Switzerland. Out of 205 contacted families, 90 agreed to participate. The median age at the first prescription was 11.5 years (interquartile range (IQR) 6–16), and 32 patients were female (36%). Fifty-one (57%) patients received CBD only and 39 (43%) THC. Patients were more likely to receive THC therapy if one of the following symptoms or signs were present: spasticity, pain, lack of weight gain, vomiting, or nausea, whereas seizures were the dominant indication for CBD therapy. Improvements were reported in 59 (66%) study participants. The largest treatment effects were reported for pain, spasticity, and frequency of seizures in participants treated with THC, and for those treated with pure CBD, the frequency of seizures. However, 43% of caregivers reported treatment interruptions, mainly because of lack of improvement (56%), side effects (46%), the need for a gastric tube (44%), and cost considerations (23%).Conclusions: The effects of medical cannabis in children and adolescents with chronic conditions are unknown except for rare seizure disorders, but the caregiver-reported data analysed here may justify trials of medical cannabis with standardized concentrations of THC or CBD to assess its efficacy in the young. What is Known:• The use of medical cannabis (THC and CBD) to treat a variety of diseases among children and adolescents is increasing.• In contrast to adults, there is no evidence to support the use of medical cannabis to treat chronic pain and spasticity in children, but substantial evidence to support the use of CBD in children with rare seizure disorders. What is New:• This study provides important insights into prescription practices, dosages, and treatment outcomes in children and adolescents using medical cannabis data from a real-life setting.• The effects of medical cannabis in children and adolescents with chronic conditions shown in our study support trials of medical cannabis for chronic conditions.

show abstract

Section: Discussionmentioning

confidence: 99%

Use and caregiver-reported efficacy of medical cannabis in children and adolescents in Switzerland

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Another controversial point regards the adverse effects (AE) of CBD and its behavior on long-term administration. Recently, a review highlighted, through qualitative and meta-analytic data analysis, the efficacy of CBD and cannabis derivates in reducing both seizure frequency and severity, taking in account the AE in the treated patients [92]. From these data it was revealed that that CBD was significantly effective at reducing both seizure frequency and severity in pharmaco-resistant epileptic patients, while the AE were rare and often temporary.…”

Section: Epilepsymentioning

confidence: 99%

“…From these data it was revealed that that CBD was significantly effective at reducing both seizure frequency and severity in pharmaco-resistant epileptic patients, while the AE were rare and often temporary. Indeed, the most common AE reported were in the order: drowsiness, diarrhea, and pyrexia, and all of them were reversible when CBD therapy was withdrawn [92]. Despite its approval for only two forms of pharmaco-resistant epileptic conditions, preclinical studies were conducted also for other epileptic syndromes.…”

Section: Epilepsymentioning

confidence: 99%

Phytocannabinoids in Neurological Diseases: Could They Restore a Physiological GABAergic Transmission?

Cifelli

Ruffolo

Felice

et al. 2020

IJMS

View full text Add to dashboard Cite

γ-Aminobutyric acid type A receptors (GABAARs) are the main inhibitory mediators in the central nervous system (CNS). GABAARs are pentameric ligand gated ion channels, and the main subunit composition is usually 2α2βγ, with various isotypes assembled within a set of 19 different subunits. The inhibitory function is mediated by chloride ion movement across the GABAARs, activated by synaptic GABA release, reducing neuronal excitability in the adult CNS. Several studies highlighted the importance of GABA-mediated transmission during neuro-development, and its involvement in different neurological and neurodevelopmental diseases, from anxiety to epilepsy. However, while it is well known how different classes of drugs are able to modulate the GABAARs function (benzodiazepines, barbiturates, neurosteroids, alcohol), up to now little is known about GABAARs and cannabinoids interaction in the CNS. Endocannabinoids and phytocannabinoids are lately emerging as a new class of promising drugs for a wide range of neurological conditions, but their safety as medication, and their mechanisms of action are still to be fully elucidated. In this review, we will focus our attention on two of the most promising molecules (Δ9-tetrahydrocannabinol; Δ9-THC and cannabidiol; CBD) of this new class of drugs and their possible mechanism of action on GABAARs.

show abstract

“…These studies con rmed that CBD reduces seizure frequency (8-11). A recent systematic review and meta-analysis summarized results from intervention studies and concluded that CBD is more effective than placebo for treatment-resistant epilepsy, regardless of the aetiology of the epileptic syndrome (24).…”

Section: Discussionmentioning

confidence: 99%

Medical Cannabis in Children and Adolescents in Switzerland: a Retrospective Study

Zürcher¹,

Dupont

Weber³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Evidence on use and efficacy of medical cannabis for children is limited. We examined clinical and epidemiological characteristics of medical cannabis treatment and caregiver-reported effects in children and adolescents in Switzerland.Methods: We collected clinical data from children and adolescents (<18 years) who received Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), or a combination of the two between 2008 and 2019 in Switzerland. Results: Out of 205 contacted families, 90 agreed to participate. The median age at the first prescription was 11.5 years (interquartile range (IQR) 6-16), and 32 patients were female (36%). Fifty-one (57%) patients received CBD and 39 (43%) THC. Patients were more likely to receive THC therapy if one of the following symptoms or signs were present: spasticity, pain, lack of weight gain, vomiting, or nausea, whereas seizures were the dominant indication for CBD therapy. Improvements were reported in 59 (66%) study participants. The largest treatment effects were reported for pain, spasticity, and frequency of seizures in participants treated with THC, and for those treated with pure CBD, the frequency of seizures. However, 43% of caregivers reported treatment interruption, mainly because of lack of improvement (56%), side effects (46%), the need for a gastric tube (44%), and cost considerations (23%).Conclusions: The effects of medical cannabis in children and adolescents with chronic conditions are unknown, but the caregiver-reported data reported here may justify trials of medical cannabis with standardized concentrations of THC or CBD to assess its efficacy in the young.

show abstract

Efficacy and adverse event profile of cannabidiol and medicinal cannabis for treatment-resistant epilepsy: Systematic review and meta-analysis

Cited by 42 publications

References 57 publications

Use and caregiver-reported efficacy of medical cannabis in children and adolescents in Switzerland

Use and caregiver-reported efficacy of medical cannabis in children and adolescents in Switzerland

Phytocannabinoids in Neurological Diseases: Could They Restore a Physiological GABAergic Transmission?

Medical Cannabis in Children and Adolescents in Switzerland: a Retrospective Study

Contact Info

Product

Resources

About