Most evidence for medical cannabis in children is for epilepsy, with CBD reducing seizures by 30-50% | Research

The takeaway

A living systematic review of 276 studies found purified CBD is the most studied cannabinoid in children, primarily for epilepsy, with RCTs showing 30-50% seizure reduction and common side effects of drowsiness and GI symptoms.

Pediatricians, epilepsy specialists, parents researching medical cannabis for children

276 studies mapped, with 146 focused on epilepsy and CBD doses of 2-50 mg/kg/day

What the researchers found

276 studies included; most common indication was refractory epilepsy (146 studies); purified CBD was most studied (78.6% of interventional); RCTs showed 30-50% seizure reduction; common adverse events were somnolence, diarrhea, vomiting, and decreased appetite.

Why it matters

This provides the most comprehensive map of what is and is not known about cannabinoid use in children, revealing evidence concentrated in epilepsy with large gaps elsewhere.

The numbers in context

276 studies from 37,189 citations; epilepsy (146 studies, 188,726 participants), cancer (30 studies, 208,753 participants), autism (18 studies, 1,285 participants); CBD doses 2-50 mg/kg/day.

How the study worked

Living systematic review searching MEDLINE, Embase, PsycInfo, and Cochrane Library from inception to April 2023; included studies with at least one child under 18 receiving cannabinoids.

What this study cannot tell us

Living review with data through April 2023; heterogeneous study quality; most evidence for CBD/epilepsy; publication bias possible.

How to read the evidence

Comprehensive living systematic review revealing both the depth of epilepsy evidence and breadth of gaps elsewhere.

When this study was published

Published 2025, search through April 2023

The bigger picture

While CBD for pediatric epilepsy has substantial evidence, cannabinoid use in children for other conditions remains largely unsupported by high-quality evidence.

Questions still open

When will sufficient evidence exist for non-epilepsy pediatric uses? Are the adverse effects dose-dependent? How do children metabolize cannabinoids differently?

Common questions

What is medical cannabis most used for in children?

Refractory epilepsy, by far. Of 276 included studies, 146 focused on epilepsy. Cancer symptoms and autism were distant second and third.

How effective is CBD for childhood seizures?

In randomized controlled trials, purified CBD reduced seizure frequency by 30-50%. Common side effects included drowsiness, diarrhea, vomiting, and decreased appetite.

Read the original research

Cannabinoids for Medical Purposes in Children: A Living Systematic Review.

Acta paediatrica (Oslo, Norway : 1992), 114(9), 2148-2159

View on PubMed ↗Publisher’s paper ↗

Citation

Chhabra, Manik; Paul, Arun; Abulannaz, Omaymah; Lê, Mê-Linh; Mansell, Holly; Finkelstein, Yaron; Huntsman, Richard J; Kelly, Lauren E. (2025). Cannabinoids for Medical Purposes in Children: A Living Systematic Review.. Acta paediatrica (Oslo, Norway : 1992), 114(9), 2148-2159. https://doi.org/10.1111/apa.70140