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Children: What is known about the medical use of cannabis in children?

Franjo Grotenhermen

There are only two clinical studies with cannabinoids in children, one with delta-8-THC and the other with the THC derivative nabilone, both investigating their benefits in side effects of cancer chemotherapy. Probably due to a different distribution of cannabinoid receptors in the brains of adults and children, children seem to tolerate relatively high doses without relevant psychic effects. To my knowledge cannabis or dronabinol (THC) is primarily used in neurological disorders, such as epilepsy, drowning accident, hyperactive disorders, etc.
 

Press article

An American judge has allowed the mother of a hyperactive child to carry on giving him cannabis. The judge dismissed a petition by social services to remove the child from his mother's home in Rocklin, California. The eight-year-old has a severe mental disorder. His mother gives him cannabis because she says conventional medicine doesn't work. Child Protective Services had accused her of being an unfit mother after learning of the treatment. The mother turned to cannabis after a paediatrician suggested she give it a try, and she reports her son's behaviour improved markedly, his mood swings levelled off and he developed friendships with other children. Initially, the mother prepared the boy's "medicine" in the form of muffins, which she fed him regularly.
WENN via COMTEX of 6 December 2001
 

Abrahamov and colleagues

Delta-8-tetrahydrocannabinol (delta-8-THC), a cannabinoid with lower psychotropic potency than the main Cannabis constituent, delta-9-tetrahydrocannabinol (delta-9-THC), was administered to eight children, aged 3-13 years with various cancers of the blood, treated with different anticancer drugs for up to 8 months. The dose was 18 mg oral THC per square meter of body surface in edible oily drops. (The body surface of a child of 30 kilos is about one square meter, the one of an adult of 75 kilos about 1.8 square meter). The total number of treatments with delta-8-THC so far is 480. The THC treatment started two hours before each anticancer treatment and was continued every 6 hrs for 24 hours. Vomiting was completely prevented. The side effects observed were negligible.
Modified according to: Abrahamov A, Abrahamov A, Mechoulam R. An efficient new cannabinoid antiemetic in pediatric oncology. Life Sciences 1995;56(23-24):2097-2102.
 

Dalzell and colleagues

A trial was conducted comparing the new synthetic cannabinoid nabilone with oral domperidone (an antiemetic drug) in a group of children receiving repeated identical courses of chemotherapy for a variety of cancers. Eighteen of 23 children, aged 10 months to 17 years, completed the trial. When taking nabilone they experienced significantly fewer vomiting episodes and less nausea, and two thirds preferred nabilone. The most common side effects of treatment with nabilone were somnolence and dizziness, with one patient being disturbed by hallucinations. The results indicate that nabilone is an effective antiemetic for children having chemotherapy, even for young children. It seems to be superior in this respect to domperidone, and although side effects occur more often, these are mostly acceptable to patients. It can be recommended as an alternative to conventional antiemetic treatment throughout childhood.
Modified according to: Dalzell AM, Bartlett H, Lilleyman JS. Nabilone: an alternative antiemetic for cancer chemotherapy. Archives of Disease in Childhood 1986;61(5):502-505.

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