Abstract
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.
Highlights
Cannabis sativa, commonly known as cannabis, contains more than 600 ingredients
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
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
Summary
Commonly known as cannabis, contains more than 600 ingredients. Among them are more than 100 phytocannabinoids, which include the substance1 3 Vol.:(0123456789)European Journal of PediatricsΔ9-tetrahydrocannabinol (THC) [1]. Drugs containing THC have been used to treat these symptoms in children with cancer, neurodegenerative diseases, cerebral palsy, traumatic brain injury, posttraumatic stress disorders, and Tourette syndrome [2,3,4,5]. In addition to THC, cannabis contains the phytocannabinoid cannabidiol (CBD), which has anti-inflammatory, antiepileptic, antipsychotic, and anxiety-relieving properties [6]. There is substantial evidence to support the use of CBD in children with rare seizure disorders, but the evidence is lacking for other types of seizures and medical conditions [2, 7,8,9,10]. Knowledge about the use and efficacy of medical cannabis is limited beyond these conditions. This study provides important insights into prescription practices, dosages, and treatment outcomes in children and adolescents using medical cannabis data from a reallife setting in Switzerland
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