Clinical Takeaway
Cannabinoids have been studied across a range of pediatric medical conditions, with the current evidence base drawing from hundreds of studies using both plant-derived and pharmaceutical formulations. The review spans interventional, observational, and survey data, reflecting the breadth but also the variability in research quality available to guide clinical decisions. Clinicians considering cannabinoid therapy in patients under 18 should prioritize pharmaceutical-grade preparations and monitor both safety and outcomes carefully given the ongoing and evolving nature of this evidence.
#2 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 provides clinicians with continuously updated evidence on cannabinoid safety and efficacy in pediatric patients, addressing a critical knowledge gap as off-label cannabinoid use in children increases without robust clinical guidance. By systematically synthesizing data across multiple databases on plant-derived and pharmaceutical cannabinoids in patients under 18 years, the review establishes an evidence foundation necessary for informed prescribing decisions and identification of adverse events in this vulnerable population. The living review methodology ensures that emerging clinical trial data will be incorporated in real-time, enabling practitioners to access the most current evidence as the pediatric cannabinoid literature expands.
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 identifies a modest evidence base for cannabinoid use in pediatric populations, with most high-quality data concentrated in childhood epilepsy, particularly Dravet and Lennox-Gastaut syndromes, where cannabidiol has shown meaningful seizure reduction. However, the broader pediatric cannabinoid literature remains heterogeneous and largely composed of observational studies and case series, limiting causal inference for other indications such as chemotherapy-related nausea, chronic pain, or behavioral conditions. Clinicians should be aware that long-term safety data in developing brains remain incomplete, and that regulatory pathways vary substantially by jurisdiction, potentially creating discordance between what families encounter in dispensaries versus pharmaceutical-grade formulations studied in trials. The absence of robust comparative effectiveness data means individualizing risk-benefit discussions with families requires honest acknowledgment of uncertainty regarding both efficacy and adverse events. Until higher-quality evidence emerges for non-seizure indications, cannabinoid use in children outside epilepsy should