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. 2022 Jan;181(1):335-347.
doi: 10.1007/s00431-021-04202-z. Epub 2021 Jul 26.

Use and caregiver-reported efficacy of medical cannabis in children and adolescents in Switzerland

Kathrin Zürcher  1 , Carole Dupont  1 , Peter Weber  2 , Sebastian Grunt  3 , Ilca Wilhelm  4 , Daniela E Eigenmann  5 , Martina L Reichmuth  1 , Manfred Fankhauser  5 , Matthias Egger  1   6 , Lukas Fenner  7
Affiliations

Use and caregiver-reported efficacy of medical cannabis in children and adolescents in Switzerland

Kathrin Zürcher et al. Eur J Pediatr. 2022 Jan.

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.

Keywords: Cannabidiol; Children; Chronic conditions; Medical cannabis; Seizures; Tetrahydrocannabinol; Treatment.

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Conflict of interest statement

MF is the owner of the Bahnhof Apotheke Langnau AG, which produces and distributes medical cannabis-based preparations to patients upon medical prescription. DE works as a pharmacist in the same pharmacy and is a board member of the Swiss Society of Cannabis in Medicine. MF and DE had no role in study design and data analysis. All other authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow of inclusion of study participants
Fig. 2
Fig. 2
Changes of the prescribed medical cannabis preparation from initial to current dosage by patients for whom initial and current dosage was available
Fig. 3
Fig. 3
Reported treatment effects of medical cannabis use in children and adolescents from the caregivers’ perspective. The number indicates the number of responses. Detailed results are presented in additional Table 3
See this image and copyright information in PMC

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