What to know about prescribing cannabis medicines to patients with epilepsy
There’s considerable interest in using cannabis-based medications to help treat drug resistant epilepsy, but clinicians have little guidance on how or when to prescribe these products. A working group comprised of paediatric and adult epilepsy specialists, clinical pharmacists, pharmacologists, and cannabis researchers from across Australia recently developed an interim “consensus advise” for prescribers and published it in the British Journal of Clinical Pharmacology [1].
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. The consensus advice will be updated as new evidence emerges and will provide the structure for a more definitive guideline in the future.
“In the absence of a registration dossier, scientific experiments and case reports are helpful to provide some guidance to optimized 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 comorbidities, taking multiple medications, and patient diversity, can be very helpful to clinical practice,” said senior author Jennifer H. Martin, MBChB, MA, PhD, FRACP, a researchers at the University of Newcastle and the Director of the Australian Centre for Cannabis Clinical and Research Excellence.
The authors write: “Although interim, this consensus advice addresses much of the current practice gap by providing an informed overview of the different cannabis medicines currently available for use in the treatment of epilepsy in paediatric and adult settings, with information on dose, drug interactions, toxicity, type of seizure and frequency of symptom relief.”
Reference:
[1] John Lawson, Terry O’Brien, Myfanwy Graham, et. al. Expert advice for prescribing cannabis medicines for patients with epilepsy – drawn from the Australian clinical experience. British Journal of Clinical Pharmacology. 8 March 2022.
https://doi.org/10.1111/bcp.15262
