Prescribing patterns of medicinal cannabis for epilepsy

Aims 

Evidence for the use of medicinal cannabis in epilepsy has emerged in recent years. Data on the prescribing practices of medicinal cannabis for epilepsy has not been collected to date in Ireland. This project aims to survey prescribers of medicinal cannabis for epilepsy in Ireland in 2019. 

Methods 

We sent an anonymous survey to all adult and paediatric consultant neurologists in the Republic of Ireland in 2019. The survey included questions regarding the product prescribed, indication, estimated efficacy, and adverse effects. 

Results 

62 consultant neurologists were surveyed with 23 respondents (37%). Five (23%) of the respondents had prescribed medicinal cannabis. The most common indication was Lennox-Gastaut syndrome (3) followed by Dravet syndrome (2) and Focal Epilepsy (2). Four (80%) of the prescribers had ceased a prescription; reasons cited included: side-effects (2), lack of effect (2) and cost (1). Side effects noted included drowsiness (2), lethargy (1) and nausea (1). Efficacy was estimated at ‘no improvement’ by 2 prescribers, ‘mild improvement’ by 2 prescribers; 1 prescriber noted ‘significant improvement’. 

Conclusion 

Our survey revealed a small number of medicinal cannabis prescribers for epilepsy in the Republic of Ireland, suggesting a limited clinical exposure in the country to date. Resurvey at future intervals is recommended as product availability and familiarity increases, to guide clinical use and prescription programs.