In a recent case series published by the open access journal BMJ Paediatrics Open, seizure frequency fell by an average of 86% among 10 children with epilepsy treated with whole plant medicinal cannabis.
Parents and caregivers reported significant improvements in the children after they were put on whole plant medicinal cannabis products. The side effects, if at all, were minor.
The treatment was a godsend for the children because none of the children had responded to other treatments, including the cannabidiol (CBD) product licensed for their condition. This result is encouraging researchers to further explore the therapeutic benefits of whole plant medicinal cannabis products.
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Diseases have always been the bane of man and he has always sought release from it through healing agents – be they chemical compounds or natural products like cannabis. The pain-relieving qualities of cannabis have always been known and research is ongoing.
The positive effects of the use of medicinal cannabis in treating childhood epilepsies has been accumulating since the 1800s. But there has not been much recent scientific evidence on the effectiveness of whole plant cannabis extracts.
This is because since both recreational and medical cannabis was made illegal in the UK under the Misuse of Drugs Act 1971, there was limited interest in researching it.
But in 2018, medicinal (whole plant) cannabis was designated a prescription medicine for the treatment of severe childhood epilepsy because of the encouragement of parents whose children had responded well to whole plant medicinal cannabis extracts, but not to conventional antiepileptic drugs or purified cannabidiol (CBD oil).
Nevertheless, doctors in the UK were reluctant to prescribe this, because of the lack of satisfactory clinical trial data.
However, the UK’s National Institute for Health and Clinical Excellence (NICE), which provides guidance on which treatments and therapies the health service in England should adopt, has accepted that real world data, including case series, are valid sources of evidence, particularly where it’s difficult to carry out clinical trials as in the case of children.
It is in the light of this acceptance that researchers tested the effect of whole plant medicinal cannabis in 10 children whose epilepsy hadn’t responded to conventional treatment.
Whole plant cannabis includes tetrahydocannabinol or THC, the ingredient that provides the ‘high’ for recreational users, and cannabidiol, other neuroactive cannabinoids, and molecules such as terpenes.
The children who participated in the research were recruited from two charities, their ages ranging from 1 to 13 years, with an average age of 6. The participants had a range of problems that included different forms of epilepsy, infantile spasms, learning disabilities, and global developmental delay.
An average of 7 conventional epilepsy drugs had been tried on the children. But after taking medicinal cannabis, the average became 1, with the drugs being stopped for 7 of the children. Monthly seizure frequency was reduced for all by an overall average of 86%.
Full chemical analysis of whole plant medicinal cannabis products is not complete, but the analysis of THC and CBD content showed that the children took an average of 5.15 mg THC and 171.8 mg CBD daily. The average monthly cost of the products was £874.
The study may have its shortcomings because of the small number of participants, data collection through parental recall, and the possibility that only parents who saw some positive effect decided to cooperate.
Nevertheless, the researchers say that the findings are in line with other observational and interventional studies showing a reduction in seizure frequency after using medicinal cannabis. The data also suggest that whole plant medicinal cannabis products are more effective than CBD products.
More research, for comparing the unwanted effects of whole plant medicinal cannabis with the known harmful effects of conventional epilepsy medicines, is required to correctly understand the clinical results. Still, researchers believe that available evidence is enough to support its introduction into the NHS within current NICE prescribing guidelines.
The move would be beneficial to many families, which not only have to bear the emotional burden of caring for a sick child but also have to bear the heavy financial burden of the treatment.
