Ask the expert: Is it safe for my child to take THC for epilepsy?

Many patients with epilepsy find medicinal cannabis to be an effective treatment, but is THC safe to give children? An expert answers your questions. 

Whole-plant medicinal cannabis can be very effective for seizure reduction in cases of severe paediatric epilepsy, when used under the direction of an experienced clinician. 

However, the fact that we still don’t have a lot of scientific evidence on the long-term effects of medicinal cannabis can mean some may have concerns when it comes to giving it to their child, particularly around the use of THC, the psychoactive compound in the plant.

Cannabis Health expert, Dr Evan Lewis, a neurologist and founder of the Neurology Centre of Toronto (NCT), who has prescribed cannabis to hundreds of adults and children with epilepsy, addresses some of these concerns.

Q: Is it safe to use oils containing THC in children with epilepsy? Should I be worried about THC increasing seizures?

A: There are several uncontrolled trials, by which we mean lacking the use of a placebo group, where children with epilepsy were exposed to certain amounts of THC, and from these we can glean a lot of data on safety in terms of dosing, especially in the context of CBD.

We know that when THC is used in combination with CBD, it tends to ameliorate the unwanted side effects of THC. Unlike CBD, there have not been formalised trials that have explored the safety of THC in depth to the same degree. THC can have anti-seizure effects and the decision to add THC to any treatment plan ends up being a risk benefit decision at that time. There’s a fairly significant amount of data that can reassure experienced practitioners that THC can be relatively safe, given that risk benefit balance.

It’s important to recognise that we do not have any general short-term or long-term published data specifically on the use of THC in an appropriate and medically-supervised situation. The data showing long-term, adverse effects of THC all comes from recreational THC studies.

There is a possibility that THC could increase seizures, but any of the cannabinoids have the potential to increase seizures at high enough doses and this is a question that needs to be answered. We know at a preclinical level that THC has been found to be both anticonvulsant and pro-convulsant, so there’s certainly a risk there and from a personal clinical point of view I see THC both reduce seizures and decrease seizures similar to CBD. 

Q: Will it affect my child’s development?

There is a risk that THC without the presence of other cannabinoids would affect your child’s development. We know that the long-term effects of recreational use of high amounts of THC frequently used over a long period of time can show changes in behaviour, mood, IQ and can cause structural changes in the brain. Will THC when used in a medically-supervised situation with dosing that aligns with evidence affect your child’s development? That we still do not know, and the same goes for CBD.

Whenever we make a decision as a practitioner or a parent or a patient, about utilising cannabis, it must be taken into consideration that we don’t know the long-term outcomes. We have to establish what’s going on for that individual at the time and if it is worth the risk of uncertainty to get seizures under control. There are many situations in which I believe that it is, given the amount of short to medium term data we have about development and about the safety and tolerability of THC and other cannabinoids.

Dr Evan Cole Lewis is a neurologist and clinical neurophysiologist with expertise in paediatric neurology and epilepsy. He is the founder and medical director of the Neurology Centre of Toronto (NCT) and vice president of Psychedelic Neurology at Numinus. He is also an assistant professor with the Department of Pediatrics at the Hospital for Sick Children and the University of Toronto.

Got a question or a topic you would like him to discuss? Email us at editor@handwmedia.co.uk or contact us on Twitter @CannabisHNews or Instagram @cannabishealthmag 

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