Clinical Takeaway
Cannabinoids have been studied across a range of pediatric medical conditions, with evidence drawn from interventional trials, observational studies, and surveys. The current body of research supports cautious clinical consideration of cannabinoids in children, particularly for conditions like refractory epilepsy, where pharmaceutical formulations have the strongest evidence. Safety and efficacy data remain heterogeneous, and ongoing review of this literature is essential before broader pediatric recommendations can be made.
#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 continuously aggregating safety and efficacy data on cannabinoid use in the pediatric population, where clinical evidence remains sparse and practice patterns are increasingly diverging from available evidence. Given the expanding off-label use of cannabinoids in children with treatment-resistant epilepsy, chronic pain, and other conditions, this dynamic synthesis provides clinicians with an evolving evidence base to inform risk-benefit discussions and standardize pediatric dosing protocols. The systematic approach to adverse event documentation is particularly clinically relevant for identifying developmental vulnerabilities and long-term safety signals that may not emerge in single trials.
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 valuable framework for tracking cannabinoid safety and efficacy in pediatric populations, though the field remains substantially limited by heterogeneous study designs, small sample sizes, and a predominance of observational data rather than rigorous randomized controlled trials. The most robust evidence currently exists for cannabinoids in specific seizure disorders like Dravet syndrome, while evidence for other pediatric indications remains preliminary and often derived from case reports or uncontrolled series prone to reporting bias. Clinicians must grapple with the reality that parental demand and anecdotal testimonials frequently outpace the actual evidence base, creating tension between respecting family preferences and maintaining evidence-based practice standards. Key confounders including variable cannabinoid formulations, dosing protocols, concurrent medications, and underlying disease severity complicate efforts to draw clear conclusions about benefit and harm. When considering cannabinoids for pediatric patients, a cautious, individualized approach paired with robust documentation and family counseling about the evidence gaps remains prudent