Medicinal Cannabis

About

Medicinal cannabis (also called medical marijuana) is a medication derived from a substance called Cannabidiol (CBD) which is found in cannabis plants. Although medicinal cannabis is derived from a natural source, it should still be considered a MEDICATION, that is, it must be prescribed by a doctor and is not without side effects. Epidiolex, the compond used in the Compassionate Access Scheme (see below), is an oral cannabis medication containing Cannabidiol that has had the psychoactive components of cannabis removed.   

Usage, indications for, and access to trials of medicinal cannabis should be discussed with your treating neurologist. 

In NSW, there is a Compassionate Access Scheme: 

  • This scheme currently allows up to 66 NSW children at any one time with severe treatment-resistant epilepsy (such as Dravet or Lennox Gastaut Syndrome) to receive compassionate access to Epidiolex. 
  • For further information about the Compassionate Access Scheme for Epidiolex, see the NSW Health handout here.

For other pathways to obtain medicinal cannabis approved by the TGA, you should discuss this with your treating neurologist.

Side effects

Potential side effects of medicinal cannabis include:

  • Sleepiness / drowsiness
  • Fatigue / lack of energy
  • Decreased appetite
  • Diarrhoea
  • Vomiting 
  • Fever
  • Upper respiratory tract infection 
  • Increased seizures
  • Elevated liver enzymes

Interactions

It is important that children taking medicinal cannabis are regularly monitored by their usual treating paediatric neurologist to ensure that levels of other medicines are appropriately managed.  There may be significant interactions between medicinal cannabis and other anticonvulsants, for example:

  • Sodium valproate 
  • Clobazam
  • Phenytoin

Need-to-know

  • Regular monitoring of liver function and drug interactions by the child's treating doctor is important.
  • Epidiolex used in the Compassionate Access Scheme is different to 'street cannabis' or marijuana.
  • Street cannabis (or artisanal products) are not regulated and may contain pesticides and the psychoactive components of cannabis.
  • Use of 'street cannabis' by adolescents can cause psychiatric and mental health problems, impaired decision making, and have long-term cognitive impact.

Disclaimer

The information provided in this handout is limited and does not replace the need for a medical consultation. It is very important you speak to your doctor about all aspects of your medication including side effects when medication is first prescribed. Report any concerns to your doctor promptly.