Medical cannabis may be particularly successful at treating severe epilepsy and the more harmful side effects of chemotherapy in children, but such treatments could also affect kids’ mental and physical health, according to a new study by Israeli researchers who say many more trials are urgently needed.
Scientists from the Hebrew University of Jerusalem (HU) completed a meta-analysis of pediatric patients treated with medical cannabis to better understand the risks and benefits of cannabis use among young patients and are presenting their findings this week at the 31st Annual International Cannabinoid Research Society Symposium (ICRS) being held in Jerusalem for the first time ever. The conference host is HU’s Multidisciplinary Center for Cannabinoid Research (MCCR), a leading research center on cannabinoids, endocannabinoids, and medicinal cannabis.
The team, led by Professor Ilan Matok at HU’s School of Pharmacy and the David R. Bloom Center for Pharmacy, along with and PhD candidate Nir Treves, wanted to check the quality of the studies because, as Matok tells NoCamels, because “there is not a lot of data on the use of medical cannabis for children.”
“There have been studies on the use of medical cannabis for epilepsy in children, for chemotherapy and cancer, and more and more on the effects of medical cannabis for children with autism,” he explains, “But since medical cannabis is not [globally] a licensed drug, people have been restrained to use it on children because of its negative connotation. There haven’t been enough studies to know whether it’s appropriate for children.”
The meta-analysis found that CBD (cannabidiol) is effective at decreasing the number of severe seizures in children with Dravet syndrome, a rare, drug-resistant epilepsy. Likewise, cannabis is successfully used to alleviate some of chemotherapy’s most pernicious side effects, reducing the severity of nausea and vomiting that often accompany this treatment.
“Within this systematic review of these seven studies, we found that [with the use of ingredients found in medical cannabis,] there was a 40 percent reduction in the number of epileptic seizures in children with refractory epilepsy,” Prof. Ilan Matok tells NoCamels. “This is especially significant for children where no other epileptic drug is helping them.”
There was also a “very substantial decrease” in episodes of vomiting and nausea, he adds.
But CBD also greatly suppresses children’s appetites and studies have shown that several cannabis plant ingredients used in medical treatments adversely affect children’s mental state, causing fatigue, apathy, dizziness, and lethargy.
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“This is important to note because loss of appetite puts a child’s physical development in jeopardy,” Prof. Matok says, “Pediatricians have to know this and be aware of it in order to follow up.”
“Children aren’t small adults,” he adds, “Medical cannabis has some good effects, but also has a number of side effects so they need to be aware.”
For their meta-analysis, Matok and his team screened thousands of studies involving patients 18 years and younger and honed in on seven studies with 486 patients. They found that although CBD was associated with a 50 percent reduction in seizure rates in patients with Dravet syndrome, there was also a dose-response association (between 10mg/kg/d and 20mg/kg/d) decreased appetite and mental state changes.
Matok and the team urged that more studies were warranted to effectively examine other epilepsy syndromes as well as other indications.
The study of medical cannabis in children is still in its infancy, explains Matok. Parents and doctors are often afraid to give it to children because it is not a regulated or accepted drug.
“This is why we wanted to do this study,” Prof. Matok says, “There isn’t enough data out there and we wanted to put the data that is there in literature. It should be more studied on children so it can be considered evidence-based medicine and there can be more of a balance of risk vs. benefit.”
“Whereas Pfizer and Moderna were able to conduct clinical trials for their COVID-19 vaccine on kids, few top-notch clinical trials exist for cannabis use in children. The goal of our meta-analysis is to shed light on this area and provide doctors and parents with a more informed view of the potential of cannabis to help or harm their young patients,” Matok said in a university statement.
Matok says his next project will be a “data-based study” with Israeli kids who have a license to use medical cannabis through the Ministry of Health. The research project will study the effect of medical cannabis on young patients, looking specifically at whether it raises their rates of depression, cardiovascular incidents, and involvement in car accidents.