Cannabinoid therapy for Epilepsy : A literature review and a survey among neuro-paediatricians

Abstract

Abstract Background: The aim for this thesis has been to investigate the use of cannabinoids in treatment of epilepsy. The topic is currently under a lot of discussion in many countries, and there is a high pressure on the health community to make these substances available from both patients, their families and politicians. This thesis consists of two parts. First, I aimed to review the literature on this topic over the last 5 years. Secondly, we performed an international survey to investigate how much knowledge, clinical experience or perhaps lack or experience caregivers have on this topic. Material and Methods: Clinical and medical databases were searched and the studies that matched inclusion/exclusion criteria were analysed. A web-based survey was sent out to neuro-paediatricians in Norway, Sweden, Denmark and Germany. Results: The results from the literature show that especially cannabidiol (CBD) has an effect on seizure reduction, mainly shown in people with treatment resistant epilepsy (TRE). We received response from 86 neuro-paediatricians, a low response rate (~14 % ). Therefore, one can question how representative the results of the survey results are. However, the results indicate that a majority of caregivers argue that they do not treat patients that are in need of this treatment. Another issue seems to be that there is no product available, but mostly they also warrant studies to prove safety and efficacy. However, a lot of caregivers have come into contact with patients/families that have requested CBD treatment. Conclusion: More placebo-controlled studies of CBD are needed, where it is also taken in account for these drug-drug interactions that have been shown and that there might be certain subgroups of epilepsy that benefit more than others. The low response rate in our survey may indicate low interest for the topic. Or perhaps it will take some more years for interest to grow with the accompaniment of more compelling evidence.