Parents are using the CBD for children to manage hard-to-treat ailments in kids
When a child is sick and conventional medicine isn’t helping, parents understandably often turn to alternative treatments. Recently, that includes cannabidiol, aka CBD, which is a cannabis compound found in marijuana and hemp that’s being touted as a remedy for everything from pain and arthritis to seizures and sleep problems. Unlike the cannabis plant’s other well-known compound, THC (tetrahydrocannabinol), CBD does not get users high, it’s nonaddictive, and it has a low risk of side effects—which makes CBD for children seem like an appealing option.
While CBD is being used widely by adults, the best evidence for it comes from studies focusing on children with certain kinds of epilepsy. And increasingly, parents are giving CBD to their children to manage a range of other conditions, such as autism and anxiety.
“CBD has become a very popular over-the-counter type of treatment that parents get on their own and give their children, and some say they see a big improvement,” says Doris Trauner, M.D., distinguished professor of neurosciences and pediatrics at the University of California San Diego School of Medicine and a physician at San Diego’s Rady Children’s Hospital. “Every other patient I see is asking about it.”
But she cautions that for many health problems the research is still in its infancy. And while CBD doesn’t pose many clear risks, “it’s also not totally benign,” says Trauner, who is launching a clinical study examining the benefits and risks of CBD on children with autism. “People tend to think that because it’s natural and plant-based that it’s safe,” she says. But CBD can cause side effects, such as diarrhea, changes in appetite, fatigue, and interactions with some medications.
In addition, CBD products sold online and in retail stores are mostly unregulated, making it difficult to know whether the tinctures, balms, gelcaps, and gummies available contain what the label claims.
Still, many experts are hopeful about CBD’s potential. Though much research has been in animals, three recent randomized placebo-controlled double-blind trials in humans (the gold standard for scientific studies), found that a CBD-based drug called Epidiolex was effective in reducing seizures in people with Dravet syndrome and Lennox-Gastaut syndrome, two rare but devastating forms of epilepsy. The landmark studies led the Food and Drug Administration to approve Epidiolex in June 2018, making it the first (and only) prescription CBD-based medication.
The emergence of Epidiolex has helped legitimize CBD for children, but using it (and other cannabinoid-based products) to manage childhood conditions remains controversial and is largely uncharted territory. Here’s what you need to know if you are thinking about using CBD for children.
CBD for Seizures
What parents say: Adam Adache, of Fort Lauderdale, Fla., says that Epidiolex has been life-changing for his daughter Maya. Now 11 years old, she began having seizures as a baby and was later diagnosed with Dravet syndrome. For most of her life, she endured multiple seizures each day, and none of the medications she’d been given provided long-term help. “Some were scarier than others, but they were all scary,” Adache says.
On Epidiolex, Maya has gone from having up to 20 seizures a day to having only about one seizure every few weeks or month. “It’s been amazing,” Adache says. “Occasionally we’ll see the small partial seizures, but they’re very few and far between . . . it was a dramatic change, night and day.”
What research says: Orrin Devinsky, M.D., director of NYU Langone’s Comprehensive Epilepsy Center in New York City and a principal investigator in the Epidiolex trials, says it’s clear that CBD can reduce “the most important and disabling seizures” in people with Dravet or Lennox-Gastaut syndrome. But he acknowledges that it doesn’t work for everyone with those forms of epilepsy, and some research has shown that CBD may not be effective for other types of seizure disorders.
What’s more, Epidiolex differs in important ways from the CBD sold online or in retail stores. For one thing, as an FDA-approved prescription drug, it comes in a highly purified form, with numerous safeguards in place to ensure that it contains what its manufacturer claims, in the proper amounts, and is produced in a facility that’s free of contaminants. Also, the dosages are higher than what is suggested on the labels of most over-the-counter CBD products.
Still, it’s not unreasonable to try over-the-counter CBD products to manage your child’s seizures, as long as you talk with your doctor and take safety precautions.
“Go slowly and try to be systematic and monitor,” Devinsky says. And because CBD is fat-soluble, give it to your child along with a food that contains fat. This will help the body absorb the CBD better and “maximize what you’re getting,” he says.
CBD for Autism
What parents say: Valerie Hoback, of Conestoga, Penn., says she tried a few brands of CBD before finding one—HempWorx CBD—that helped her 11-year-old son Wyatt, who has a mild form or autism. Since he started taking it in June 2018, Hoback says, Wyatt no longer experiences the “head explosions” or the “screaming in his brain,” as he used to describe the way he felt. Hoback emphasizes that CBD has not cured Wyatt’s autism, but it has helped him “to move forward with school, therapy, and life at home,” she says.
What research says: Animal studies suggest that CBD for children may affect autistic behaviors, and some scientists are beginning to investigate whether it has the same effect in humans. For instance, Trauner, in San Diego, will soon launch a first-of-its-kind double-blind placebo-controlled study examining the effect of a synthetic form of CBD—one created in a lab, not extracted from a plant—on children with severe autism. The research, Trauner says, is to see whether the drug “will improve the more negative symptoms associated with severe autism, such as aggressive behavior, self-injurious behavior, persistent repetitive behaviors, and hyperactivity.”
Several prescription drugs offer some help for people with autism, but they can have serious side effects. “If we can find something that doesn’t have those side effects and has a good safety profile that works, it could make a huge difference,” Trauner says. “It could allow these children to reach their potential.”
Devinsky is also hopeful that CBD may prove to be effective in treating autism, in part because of parallels between that condition and epilepsy. “Some genes that cause autism also cause epilepsy, and some of the physiologic changes in nerve cells in autism are also similar to those in epilepsy,” Devinsky says. “So it’s not a shock that we might get some benefit from drugs that might work on both disorders.”
CBD for ADHD
What parents say: Last October, Lindsey Elliott started giving her 11-year-old son Tyler about 15 mg of a CBD oil made by a company called Elixinol to see whether it would help his attention deficit hyperactivity disorder (ADHD). For years, Tyler’s inability to focus made it hard for him to pay attention in school and keep up with schoolwork. But after trying CBD for children, “Tyler has improved leaps and bounds,” Elliott says. “Both he and his teacher have noticed a big difference. Tyler feels like he can concentrate more, and he feels more part of the team because he’s not sitting there lost.”
But not all parents have had the same experience. This past summer, Jaime Cammack of Middlebury, Vt., bought a CBD product for her elementary-school-age son, who has ADHD. Fellow parents had mentioned that the compound had helped their son’s ADHD, and Cammack was seeking an alternative to prescription drugs. She chose organic gummies made by Upstate Elevator Supply and gave her son one 10-mg gummy three times a day from July through September. “I went into it hopeful that we’d found a more natural way to knock the edge off of [his] highs and lows, but we found there was very little difference,” Cammack says.
She decided to stop using the CBD, given that it was expensive and provided minimal help, and instead started her son on medication. “The prescription we are currently using is much more effective at enabling our son to curb his impulses and focus,” Cammack says. “Instead of taking 2 hours to do a single math worksheet, it takes roughly 10 minutes, and that is a big win for our daily routine.”
What research says: There’s not much research on CBD and ADHD directly, but there’s growing evidence that CBD can ease anxiety, a problem that sometimes accompanies ADHD, Devinsky says. Scott Shannon, M.D., assistant clinical professor of psychiatry at the University of Colorado School of Medicine, and author of “Mental Health for the Whole Child” (W.W. Norton, 2013), agrees. He says that while he does not routinely recommend CBD for ADHD, “Kids that have an anxious variety of ADHD may get some benefit.”’
By Rachel Rabkin Peachman
February 26, 2019