Clinical experts offer advice on prescribing cannabis medicines to patients with epilepsy

Generalized 3 Hz spike and wave discharges in a child with childhood absence epilepsy. Credit: Wikipedia.

There's considerable interest in using cannabis-based medications to help treat drug resistant epilepsy, but clinicians have little guidance on how or when to prescribe these products. A working group comprised of pediatric and adult epilepsy specialists, clinical pharmacists, pharmacologists, and cannabis researchers from across Australia recently developed an interim "consensus advise" for prescribers and published it in the British Journal of Clinical Pharmacology.

The document provides an overview of the different cannabis medicines currently available for treating epilepsy in children and adults, with information on dose, drug interactions, toxicity, and type and frequency of symptom and seizure relief. The consensus advice will be updated as new evidence emerges and will provide the structure for a more definitive guideline in the future.

"In the absence of a registration dossier, and case reports are helpful to provide some guidance to optimized dosing. However as in this guidance, obtained from clinical practice—which often includes information not included in scientific experiments or even early clinical trial data, such as treating patients with other comorbidities, taking multiple medications, and patient diversity—can be very helpful to ," said senior author Jennifer H. Martin, MBChB, MA, Ph.D., FRACP, a researchers at the University of Newcastle and the Director of the Australian Centre for Cannabis Clinical and Research Excellence.

More information: John Lawson et al, Expert advice for prescribing cannabis medicines for patients with epilepsy—drawn from the Australian clinical experience, British Journal of Clinical Pharmacology (2022). DOI: 10.1111/bcp.15262

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