Epilepsy
Experts publish advice on prescribing medical cannabis for epilepsy
UK experts have welcomed the guidance as a “step in the right direction”
Estimated reading time: 3 minutes
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.
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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