Whole plant cannabis treatment reduces the incidence of epileptic seizures in children

The incidence of epileptic seizures has decreased by an average of 86% among 10 children treated with curative cannabis, reveals a series of cases published in the open access journal BMJ Pediatrics Open.

None of the children responded to other treatments, including the only cannabidiol (CBD) product licensed for their condition.

The findings prompt researchers to call for further research into the potential therapeutic benefits of whole herbal cannabis products.

Substantial anecdotal evidence of the value of medical cannabis in treating childhood epilepsy has been accumulating since the 1800s, researchers say. But there is not much recent scientific evidence for the effectiveness of extracts from whole cannabis plants.

Whole-plant cannabis includes tetrahydocannabinol, or THC for short, the main active ingredient of the plant, which is responsible for the characteristic “high” associated with recreational use, plus cannabidiol, other neuroactive cannabinoids and molecules such as terpenes.

Both entertainment cannabis and medical cannabis were outlawed in the UK under the 1971 Drug Abuse Act, so research on cannabis has largely ceased, the researchers said.

But prompted by parents whose children have responded well to whole herbal cannabis extracts but not to conventional antiepileptic drugs or purified cannabidiol (CBD oil), medical (whole-plant) cannabis has been identified as a prescription drug for severe childhood epilepsy. 2018.

But doctors in the UK are extremely reluctant to prescribe this to children with severe epilepsy, largely due to the lack of confirmatory data from clinical trials.

The UK’s National Institute of Health and Clinical Achievement (NICE), which provides guidance on which treatments and therapies should be accepted by the UK Health Service, has acknowledged that real-world data, including case series, are valid sources of evidence. especially when it is difficult to conduct clinical trials – in children, for example.

In light of this, the researchers evaluated the use of whole medicinal cannabis in 10 children whose severe epilepsy did not respond to conventional treatment, and two of whom did not meet the only pharmaceutical grade, purified CBD oil licensed for the condition in children (Epidyolex ).

The researchers wanted to assess the percentage change in the monthly frequency of seizures and the impact of medical cannabis on changes in the conventional use of epilepsy drugs. They also wanted to report on strengths and doses used and costs incurred.

All participants were hired by two charities representing children who use medical cannabis to treat their severe epilepsy. The average age of children is 6, but varies from 1 to 13 years. They had a number of epilepsies, and three had other concomitant problems, including infantile spasms, learning disabilities, and global developmental delays.

Data were collected from their parents or caregivers through telephone or video conferencing between January and May 2021.

Children have tried an average of 7 conventional drugs for epilepsy. After they started taking medical cannabis, it dropped to an average of 1 each, with 7 of the children stopping them altogether.

The monthly frequency of seizures was reduced for all 10 children with a total average of 86%.

The full chemical analysis of the whole herbal cannabis medicinal products used continues, but the researchers were able to assess the content of THC and CBD. This shows that children take an average of 5.15 mg of THC and 171.8 mg of CBD each day.

The average monthly price of cannabis medicines is £ 874. One child received his prescription for free at the NHS.

Parents and caregivers report significant improvements in their children’s health and well-being, including sleep, nutrition, behavior and knowledge, after taking whole herbal cannabis medicines. Only a few minor side effects, such as fatigue, have been reported.

This is an observational study involving a small number of participants. And researchers acknowledge that this is retrospective and relies on parental recollection, without a comparison group. And it is possible that only those parents with whom medicinal cannabis has worked well have decided to participate.

But the researchers emphasize that their findings are consistent with several observational and controlled intervention studies showing a significant reduction in seizure rates after medical cannabis treatment.

Moreover, new data suggest that whole plant cannabis remedies are more effective than CBD products.

“Further research is needed to elucidate the mechanisms by which the relevant additives of whole plant products lead to superior clinical results,” the researchers wrote.

And that should include comparing the side effects of all herbal cannabis with the known side effects of conventional epilepsy drugs, they say.

But they conclude: “We believe that our data on whole-plant medical cannabis in severe treatment-resistant childhood epilepsy provide evidence to support its inclusion in the NHS under the current NICE prescribing guidelines.

“Such a move would be extremely useful for families who, in addition to experiencing psychological suffering from caring for their chronically ill children, must also cover the crippling financial burden of their medicines.


Reference in the magazine:

Zafar, R., et al. (2021) Medical cannabis for severe treatment-resistant epilepsy in children: a series of cases in 10 patients. BMJ Pediatrics Open. doi.org/10.1136/bmjpo-2021-001234.

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