All-plant medical marijuana in the treatment of severe and refractory epilepsy in childhood

A case series published in the open-access BMJ pediatrics open revealed that the frequency of seizures dropped by an average of 86% in 10 children treated with whole-plant medicinal cannabis

None of the children responded to other treatments, including the only cannabidiol (CBD) product

This discovery prompted researchers to call for further exploration of the potential therapeutic benefits of all-plant medicinal cannabis products

Researchers say that since the 19th century, a large amount of anecdotal evidence about the value of medicinal cannabis for treating epilepsy in children has been accumulating

The whole cannabis plant includes tetrahydrocannabinol (THC for short), the main active ingredient of a plant that produces the "high" properties associated with recreational use, as well as cannabidiol, other neuroactive cannabinoids and terpenes And other molecules

Researchers pointed out that in the United Kingdom, under the Drug Abuse Act of 1971, both recreational and medical marijuana are illegal, so marijuana research has basically ceased

However, because the children of the parents responded well to the whole plant medicinal cannabis extract, but did not respond to conventional anti-epileptic drugs or purified cannabidiol (CBD oil), in 2018 medicinal (full plant) cannabis was designated for the treatment of severe childhood epilepsy Prescription drugs

But British doctors have been very reluctant to prescribe this drug to children with severe epilepsy, mainly because of the lack of confirmatory clinical trial data

The National Institute of Health and Clinical Optimization (NICE) in the United Kingdom provides guidance on the treatments and therapies that should be used in medical services in England.

In view of this, the researchers evaluated the use of whole plant medicinal cannabis in 10 children with severe epilepsy who did not respond to conventional treatment.

Researchers hope to assess the percentage change in the frequency of seizures per month and the effect of medicinal cannabis on changes in the use of conventional epilepsy medications

All participants are from two charities, representing the use of medicinal cannabis to treat children with severe epilepsy

The data was collected from their parents or caregivers via phone calls or video conferences between January and May 2021

These children took an average of 7 conventional epilepsy drugs

The monthly frequency of attacks for all 10 children was reduced by an average of 86%

A comprehensive chemical analysis of the entire medicinal cannabis product is underway, but researchers are able to assess the content of THC and CBD

The average monthly cost of medicinal cannabis products is £874
.
A child received a free prescription on the British National Health Service (NHS)
.

Parents and caregivers report that their children's health and well-being in sleep, diet, behavior, and cognition have improved significantly after starting to consume whole plant medicinal cannabis products
.
There are only minor side effects, such as fatigue
.

This is an observational study involving a small number of participants
.
The researchers admitted that this was retrospective and relied on parental memories, and there was no comparison group
.
It is possible that only those parents who are effective for medicinal cannabis decide to participate
.

However, the researchers emphasized that their findings are consistent with several observational and controlled interventional studies, which showed that the frequency of seizures was significantly reduced after treatment with medical marijuana
.

More importantly, new data shows that all-plant medicinal cannabis products are more effective than CBD products
.

The researchers wrote: "Further research is needed to clarify the mechanism by which the respective additive components in whole plant products lead to superior clinical results
.
"

They say this must include comparing the harmful effects of the whole plant of medicinal cannabis with the harmful effects of known conventional epilepsy drugs
.

But their conclusion is: "We believe that our data on all-plant medical marijuana treatment of severe intractable childhood epilepsy provides evidence to support its introduction into the NHS in the current NICE prescribing guidelines
.
"

"This move will bring huge benefits to these families.
In addition to taking care of children who have been ill for a long time, they also have to bear a heavy medical burden
.
"

BMJ Paediatrics Open

DOI

10.
1136/bmjpo-2021-001234