Use of cannabidiol in the treatment of drug-refractory epilepsy in children and young adults: A systematic review

Abstract

Objectives: Epilepsy poses a significant challenge in pediatric and adolescent populations, impacting not only seizures but also psychological and cognitive comorbidities, leading to higher mortality rates than the general population. Drug-refractory epilepsy, resistant to conventional treatments, affects a range of 7-20% of pediatric patients. The search for alternative therapies has led to exploring the therapeutic potential of Cannabis sativa L. compounds, particularly cannabidiol (CBD). Examine the use of CBD for treating drug-refractory epilepsy in children and young adults, summarizing existing evidence on its efficacy.

Materials and methods: A systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, assessed studies from 2018 to 2023, focusing on CBD's efficacy and safety for treatment-resistant epilepsy in pediatric and juvenile populations. The search spanned seven databases, and the studies underwent rigorous screening and data extraction.

Results: Out of 6351 identified articles, eight were selected for review. The included studies reported positive outcomes, with CBD leading to a reduction in seizure frequency ranging from 50% to complete seizure freedom. Adverse effects were mostly mild and reversible, including drowsiness, diarrhea, and loss of appetite.

Conclusion: The CBD emerges as a promising tool for refractory epilepsy in pediatric patients, showing efficacy in reducing seizure frequency and improving overall quality of life. Despite mild and reversible adverse effects, CBD's benefits outweigh the risks. However, more research on long-term effects is needed to fully understand its implications.

Keywords: Cannabidiol; Cannabis; Children; Refractory epilepsy; Young.

Figure 1:

Preferred reporting items for systematic reviews and meta-analyses flowchart on the strategy for selecting eligible studies about refractory epilepsy (RE) in pediatric and young people treated with cannabidiol.

Figure 2:

Evaluation of quality of included studies by Joana Briggs Institute checklist. Green: 1 point, Yellow: 0.5 points, Red: No point. In order to evaluate the quality of the included studies, these were evaluated with items that allow to know their quality. Each item has a question. Each question answered correctly is equivalent to 1 point and is colored green, answered partially is equivalent to 0.5 point and is colored yellow, and not answered is equivalent to no point and is colored red.