Clinical Takeaway
Cannabinoids have been studied across a broad range of pediatric medical conditions, with the current evidence base drawing from hundreds of studies including both interventional and observational designs. The strongest and most consistent data support the use of pharmaceutical cannabinoids, particularly CBD-based formulations, for certain childhood epilepsy syndromes. Parents and clinicians should understand that evidence quality varies significantly by condition, and ongoing updates to this living review will continue to refine the safety and efficacy picture for pediatric populations.
#3 Cannabinoids for Medical Purposes in Children: A Living Systematic Review.
Citation: Chhabra Manik et al.. Cannabinoids for Medical Purposes in Children: A Living Systematic Review.. Acta paediatrica (Oslo, Norway : 1992). 2025. PMID: 40437694.
Design: 5 Journal: 0 N: 2 Recency: 2 Pop: 3 Human: 1 Risk: 0
This living systematic review addresses a critical evidence gap by systematically consolidating safety and efficacy data for cannabinoid use in pediatric populations, where clinical evidence remains fragmented across small, heterogeneous studies. Given the increasing off-label use of cannabinoids in children with conditions like epilepsy and chemotherapy-induced nausea, a continuously updated evidence synthesis is essential for informing clinical decision-making and standardizing risk-benefit assessments. The systematic approach enables clinicians to identify which pediatric indications have sufficient evidence support versus those requiring further investigation before broader adoption.
Methodological Considerations:
- Small sample — underpowered for subgroup analysis
Abstract: AIM: We developed a living systematic review (LSR) that will continuously map the safety and reported benefit data related to cannabinoid use for medical purposes in children. METHODS: MEDLINE, Embase, PsycInfo, and the Cochrane Library were searched from inception to April 2023. Studies involving at least one child 20% studies) in studies enrolling children were somnolence, diarrhoea, vomiting, and decreased appetite. CONCLUSION: These findings will continue to be updated to inform practice and reveal knowledge gaps for future research.
💚 This living systematic review represents a crucial attempt to synthesize the sparse and evolving evidence base for cannabinoid use in pediatric populations, yet clinicians should approach the findings with appropriate caution given significant methodological limitations in the underlying literature. The heterogeneity of study designs, patient populations, cannabinoid formulations, and dosing regimens across the included studies makes generalization difficult, and many trials lack adequate sample sizes, control groups, or long-term safety data particularly regarding neurodevelopmental outcomes in this vulnerable age group. While cannabinoids show the most robust evidence for specific pediatric indications such as refractory epilepsy and chemotherapy-induced nausea, evidence for other conditions remains preliminary, and potential harms including effects on cognition, motivation, and psychiatric symptoms warrant serious consideration in children whose brains are still developing. This living review will be valuable as new data accumulates, but currently the practical message for most pediatric conditions should be cautious skepticism: reserve cannabinoid use for well-defined ind