Background: Chronic epilepsy can cause severe impairments with respect to physical, mental, and social aspects of a child’s life leading to low self-esteem, anxiety, depression, impaired memory and attention, lack of independence, and social stigma. Controlling seizures and their negative sequelae can be challenging in those with early onset epilepsy as they are often refractory to standard therapies. A further challenge is that all currently available anti-epileptic drugs have been shown to cause adverse cognitive effects and a certain degree of toxicity. However, cannabidiol (CBD), an agent found in cannabis, has been proven effective in reducing seizures in those with severe epilepsy, and has a lower side effect profile than standard treatments. This systematic literature review explores the potential impact of cannabidiol in improving quality of life (QOL) factors among pediatric patients with severe forms of epilepsy with respect to seizure control, alertness, mood/behavior, and language.
Methods: An exhaustive literature search was performed using MEDLINEOvid, Web of Science, and Clinical Key. Keywords included: cannabidiol, epilepsy, child, and quality of life. Eligible studies assessed changes in quality of life factors among pediatric patients with epilepsy since incorporating cannabinoids as a part of their treatment, and were assessed using the GRADE criteria.
Results: Three articles met eligibility criteria. Each cohort study had a different design: observational; retrospective; and prospective. All studies found cannabidiol to effectively reduce seizure frequency and improve alertness, mood/behavior, and language. Unfortunately, however, the overall quality of each reviewed study is very low due to design limitations. Further randomized double-blind control studies can minimize these limitations, and so enhance the quality of evidence available for demonstrating the impact cannabidiol may have on improving quality of life in patients with severe epilepsy.
Conclusion: There is weak evidence to suggest that cannabidiol use in those with severe epilepsy can contribute to improvements in QOL and reduce seizure frequency. Randomized control trials or double-blind case-control studies are needed to more effectively discern CBD’s potential impact in improving quality of life in those with severe epilepsy.
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