ירחון החברה הישראלית לפדיאטריה אמבולטורית (חיפ"א) גיליון 2018-2

28 Medical Cannabis for the treatment of epilepsy and other illnesses. Medical cannabis has become the focus of many studies as a novel treatment for various ailments. Famous for its psychoactive effects, the marijuana plant is notoriously associated with illicit drug use, addiction and altered mental status. However, the term cannabis refers to 3 species of plants, all of which contain dozens of different cannabinoids, bio-active chemicals, varying in their effect and psychoactivity. THC (delta-9-tetrahydroncannabinol) is the cause of marijuana's most well known psychoactive effects, resulting in a “high,” if inhaled. However, other substances found in the plant, such as cannabidiol (CBD) are far less psychoactive and have beneficial medicinal effects. In this study, Devinsky, et al, report the efficacy of cannabidiol for the treatment of drug-resistant seizures in the Dravet Syndrome. Dravet Syndrome is a rare genetic form of epileptic encephalopathy. Previous small trials showed mixed results. In this study, randomized, double-blind, placebo- controlled trial involving 214 children and young adults (ages ), CBD proved beneficial. A 14-k trial period was compared to baseline. 43% of those who received CBD had a reduction of at least 50% of convulsive seizures (vs. 27% with placebo, OR 2, 95% CI, P=0.08) . No significant effect was seen in preventing non-convulsive seizures. The authors disclose pharmaceutical funding for this trial. The results are not conclusive, but certainly demonstrate a reasonable basis to attempt treatment for a recalcitrant and difficult to treat illness. But more so, this study is another that proves that bioactive chemicals in cannabis hold hope for the treatment of illness. In a review 21 articles by Wong and Wilens in Pediatrics, benefit was found in the treatment of epilepsy and chemotherapy-induced nausea and vomiting. Other indications held less promise. To date, far more progress has been made in adult medicine. But we need to put stigmas aside, look beyond the illicit benefits of marijuana and harness it's innate properties to heal and alleviate suffering. Bottom line: Medical cannabis holds promise in the treatment of pediatric illnesses, including epilepsy.