Uso do canabidiol para o tratamento complementar da epilepsia em crianças e adolescentes: uma revisão sistemática com metanálise

Abstract

Epilepsy is a neurological disease that affects around 1 to 2% of pediatric patients. It can be caused by genetic diseases or by injuries such as trauma or strokes, which can lead to children suffering impaired motor, cognitive and behavioral functions and quality of life. The treatment of seizures is essential to optimize the quality of life of these children and minimize long-term damage. This systematic review (SR) aimed to verify the efficacy and safety of the use of cannabidiol (CBD), understand the best effects of therapeutic use and monitor the improvement of signs and symptoms in pediatric patients affected by epileptic seizures. The study followed the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Metanalyses) checklist. The search was carried out in the scientific databases Pubmed, Cochrane Library, Embase, Lilacs, Scopus and the gray literature Google Scholar, with no language or date restrictions. Studies on children aged between 0 and 12 years that answered the main question of this SR were included. Protocol-based guidelines recommend the administration of CBD in severe cases, where conventional therapy does not show satisfactory results, with many adverse effects, which impairs the child's development. The use of CBD-enriched medical cannabis as an alternative to anti-seizure medication appears to be safe and effective in reducing the frequency and duration of epileptic seizures. Exposure to CBD ranged in dosage from 5-25 mg/kg/day and long-term follow-up found satisfactory results in patients with Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS). CBD is an important alternative to conventional treatment in terms of efficacy and tolerance in refractory epilepsies of immediate onset and in other epilepsies in the future.