Evaluating Marijuana's Legality, Efficacy in Pediatric Epilepsy
the Neurology Advisor take:
A session at the Child Neurology Society (CNS) 2014 Annual Meeting explored the many facets of medical marijuana as a treatment for epilepsy in children.
The CNS panel covered laws pertaining to cannabis use across the United States, the chemicals these products contain, how these substances might work to treat neurologic illnesses, and what evidence exists in terms of efficacy.
Earlier this year, the American Academy of Neurology determined that there is not currently enough evidence to prove that medical marijuana is helpful in treating epilepsy. Additionally, the American Epilepsy Society (AES) believes the risk/benefit ratio doesn’t support the use of marijuana as a seizure treatment.
However, more evidence is being accumulated: A new study indicated that 48.3% of children with refractory epilepsy saw some improvement in seizures with the use of an oral cannabis extract. Less than a third (31.0%) saw a reduction in seizures that was greater than 50%, but many families reported improvements in behavior, alertness, and language.
New cannabis drugs are being developed at a rapid rate, and forthcoming studies will provide more information on their effectiveness as a seizure treatment.
The variance in legal status throughout the United States is confusing, with some states decriminalizing marijuana altogether, others only allowing medical use, and still others not allowing any marijuana use at all. Additionally, state laws often don’t coincide with federal law, which state that marijuana can only be accessed by doctors for research purposes and with approval of the federal government. Because of this, some doctors are wary of prescribing marijuana even in states where it is legal.
Like other doctors, Kristen Park, MD, assistant professor of neurology and pediatrics at the University of Colorado, is waiting for more research.
"I'm not saying it's not effective in some patients; I'm saying that we need to define for whom it's effective, and whether it's at an appropriate risk/benefit ratio. It also needs to be monitored very carefully and studied in more depth because I think that's where we don't have the answers. There are quite a few questions and quite a few concerns, so it's still very uncharted territory," Park said.
Evaluating Legality, Efficacy of Marijuana in Pediatric Epilepsy
Pediatric neurologists are being bombarded with questions from patients and families about medical marijuana, but they're not convinced of the scientific evidence supporting its use in conditions such as intractable epilepsy. Even if they were, they're somewhat confused about where they stand legally.
But many think that the landscape is about to change.
Delegates attending a jam-packed session at the Child Neurology Society (CNS) 2014 Annual Meeting here learned more about laws pertaining to cannabis use across the United States, the chemicals these products contain, how these substances might work to treat neurologic illnesses, and what evidence exists in terms of efficacy.
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