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Experts publish advice on prescribing medical cannabis for epilepsy

UK experts have welcomed the guidance as a “step in the right direction”

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Experts publish advice on prescribing medical cannabis for epilepsy
New guidance has been published for doctors interested in prescribing cannabinoids.

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Experts based in Australia, have published new advice for doctors prescribing medical cannabis to patients with epilepsy.

A group of paediatric and adult epilepsy specialists, clinical pharmacists, pharmacologists, and cannabis researchers from across Australia, have published new guidance for doctors interested in prescribing cannabinoids.

While there is considerable interest in using cannabis-based medications to help treat drug resistant epilepsy, to date, clinicians have little guidance on how or when to prescribe these products.

The new advice published in the British Journal of Clinical Pharmacology, aims to provide some initial guidance for doctors on prescribing in the absence of robust clinical evidence.

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. 

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UK insight

UK experts have urged paediatric consultants and members of the British Paediatric Neurology Association (BPNA) to read the guidance, following updated recommendations from the BPNA published in October.

It continues to advise against the prescribing of unlicensed cannabis medicines in children with epilepsy.

The Medical Cannabis Clinicians Society (MCCS) has since published a response claiming the BPNA stance is “unethical” and fails to recognise the “downsides of not prescribing”, which could include a poorer quality of life, brain damage and even death for patients experience severe recurrent seizures. 

Chair of the MCCS Professor Mike Barnes, welcomed the guidance from Australia, which while “still cautious”, is a “step in the right direction”. 

Matt Hughes, co-founder of Medcan Support, an organisation which supports families living with epilepsy in the UK, also recognised that it was “more open” to the prescribing of unlicensed cannabis medicines that what has been published previously.

The consensus advice will be updated as new evidence emerges and will provide the structure for a more definitive guideline in the future.

Senior author Jennifer H. Martin, MBChB, MA, PhD, FRACP, a researcher at the University of Newcastle and director of the Australian Centre for Cannabis Clinical and Research Excellence, commented:  “In the absence of a registration dossier, scientific experiments and case reports are helpful to provide some guidance to optimised dosing. 

“However, as in this guidance, observational data 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 co-morbidities, taking multiple medications, and patient diversity—can be very helpful to clinical practice.”

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Sarah Sinclair is an award-winning freelance journalist covering health, drug policy and social affairs. She is one of the few UK reporters specialising in medical cannabis policy and as the former editor of Cannabis Health has covered developments in the European cannabis sector extensively, with a focus on patients and consumers. She continues to report on cannabis-related health and policy for Forbes, Cannabis Health and Business of Cannabis and has written for The i Paper, Byline Times, The Lead, Positive News, Leafie & others. Sarah has an NCTJ accreditation and an MA in Journalism from the University of Sunderland and has completed additional specialist training through the Medical Cannabis Clinicians Society in the UK. She has spoken at leading industry events such as Cannabis Europa.

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