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. 2025 Sep;114(9):2148-2159.
doi: 10.1111/apa.70140. Epub 2025 May 28.

Cannabinoids for Medical Purposes in Children: A Living Systematic Review

Manik Chhabra  1 , Arun Paul  1 , Omaymah Abulannaz  1   2 , Mê-Linh Lê  3 , Holly Mansell  4 , Yaron Finkelstein  5 , Richard J Huntsman  6 , Lauren E Kelly  1   7
Affiliations

Cannabinoids for Medical Purposes in Children: A Living Systematic Review

Manik Chhabra et al. Acta Paediatr. 2025 Sep.

Abstract

Aim: We developed a living systematic review (LSR) that will continuously map the safety and reported benefit data related to cannabinoid use for medical purposes in children.

Methods: MEDLINE, Embase, PsycInfo, and the Cochrane Library were searched from inception to April 2023. Studies involving at least one child < 18 years who was administered plant-derived or pharmaceutical cannabinoids as an intervention or treatment for medical conditions were included.

Results: Of 37 189 identified citations, 276 studies were included: 84 interventional, 131 observational, 54 surveys, and 7 qualitative studies. Among interventional and observational studies, common indications for cannabinoids in children were refractory epilepsy (n = 146 studies, 188 726 participants), cancer and cancer symptoms (n = 30 studies, 208 753 participants), and autism spectrum disorder (n = 18 studies, 1285 participants). Common cannabinoids identified in interventional studies were purified cannabidiol (CBD) (78.6%, n = 66 studies, 5235 participants) with dose range of 2-50 mg/kg/day, tetrahydrocannabinol (6%, n = 5 studies, 148 participants) with dose range of 2.5-10 mg/day (max dose of tetrahydrocannabinol in nabiximols 32.4 mg) and nabilone (6%, n = 5 studies, 267 participants) with dose range of 0.5-2 mg/day. In randomised controlled trials, purified cannabidiol was reported to reduce seizure frequency ranging between 30% and 50%. Common adverse events (> 20% studies) in studies enrolling children were somnolence, diarrhoea, vomiting, and decreased appetite.

Conclusion: These findings will continue to be updated to inform practice and reveal knowledge gaps for future research.

Keywords: autism spectrum disorder; cannabidiol; cannabinoids; chemotherapy‐induced nausea and vomiting; children; chronic pain; adverse events; medical cannabis; refractory epilepsy.

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Conflict of interest statement

L.E.K. is the Scientific Director for The Canadian Collaborative for Childhood Cannabinoid Therapeutics (C4T) academic research team. She holds funding from the Canadian Institutes of Health Research, Canadian Cancer Society, Research Manitoba, the Sick Kids Foundation, the Children's Hospital Research Institute of Manitoba, the University of Manitoba and a Mitacs Accelerate award in partnership with Canopy Growth. Dr. Kelly is also a member of the Scientific Advisory Board for Health Products Containing Cannabis at Health Canada. L.E.K. is a member and President‐Elect of the Board of Directors for the Canadian Consortium for the Investigation of Cannabinoids (CCIC). R.J.H. is a clinical lead for both the Cannabinoid Research Initiative of Saskatchewan and C4T. He is developing a research protocol in which cannabis products will be purchased from MediPharm Labs. He previously acted as co‐chair of the Scientific Advisory Committee for Health Products Containing Cannabis at Health Canada. M.C. was granted the 2022 Research Manitoba–George & Fay Yee Centre for Healthcare Innovation in Health Research PhD Studentship Award. Y.F. Holds a Canada Research Chair in Paediatric Drug Safety and Efficacy (Tier I). M.‐L.L., H.M., A.P., and O.A. have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
The PRISMA flow diagram of the studies included in the living systematic review.
See this image and copyright information in PMC

References

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