Ep 1. Cannabinoids in neurology: old and new indications

06 January 2024

Dr Ram Kumar and Professor Anil Israni

The situation with cannabinoids for pharmacotherapy of childhood neurological conditions is not settled as yet at least in the UK and NHS. I do take a mainstream position on this – which is to rely on information from randomised controlled trials – in line with the British Paediatric Neurology Association. However I think it is important to remain aware of non-trial information, not least because the RCT may not have been appropriately designed to answer the most relevant clinical questions.

This is a long-winded way of saying that I do not recommend cannabinoids that have not been studied as investigational medical products, but I will listen to alternative viewpoints.

There are evolving indications for use of cannabinoids, some of which are older than I realised. A parent of a teenager with generalised dystonic cerebral palsy recently asked me about the use of cannabinoids in treating dystonia. On reviewing the literature, there does appear to have been at least one open trial about 30 years ago suggesting a beneficial response at least with cannabidiol. Presumably the time was not right to take things further in terms of undertaking a randomised controlled trial.