Clinical Takeaway
Systematic review evidence supports cautious, condition-specific use of cannabinoids in pediatric patients, with the strongest data in epilepsy and certain pain or palliative conditions. Safety and efficacy profiles vary considerably depending on the cannabinoid formulation, dose, and underlying diagnosis. Clinicians should rely on current evidence summaries while recognizing this is an actively evolving literature requiring ongoing reassessment.
#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 establishes a critical evidence base for cannabinoid use in pediatric populations, addressing a significant clinical gap where prescribing decisions often occur without robust safety and efficacy data. The continuous update mechanism ensures clinicians have access to the latest evidence on cannabinoid safety profiles and therapeutic outcomes in children, enabling more informed treatment decisions across conditions where cannabinoids are being investigated. Given the expanding legal and clinical interest in pediatric cannabinoid therapy, this systematized evidence synthesis is essential for developing evidence-based prescribing guidelines and identifying priority areas for future pediatric research.
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 provides a timely synthesis of cannabinoid safety and efficacy data in pediatric populations, addressing a significant evidence gap as clinical interest in cannabis medicine grows. While the methodology is rigorous, practitioners should recognize that pediatric cannabinoid literature remains sparse and heterogeneous, with most studies involving small sample sizes, variable dosing protocols, and limited long-term follow-up data, particularly regarding neurodevelopmental outcomes in this vulnerable population. The distinction between plant-derived and pharmaceutical cannabinoids is important but often conflated in clinical discussions, and this review’s ongoing nature means conclusions may shift as new evidence emerges. Current evidence appears strongest for specific indications like treatment-resistant epilepsy, though even here the quality of evidence varies considerably across age groups and formulations. Clinicians considering cannabinoid therapy in children should use this resource to inform shared decision-making conversations with families while maintaining appropriate caution about extrapolating adult efficacy data and remaining vigilant about potential neurodevelopmental risks that warrant closer monitoring.