Q&A with Dr. Paul Mitrani, Clinical Director at the Child Mind Institute

Read below for my conversation with Dr. Paul Mitrani to get the ABCs on your CBD.

What are your major concerns about CBD for treating kids?  Is it more a matter of what’s not known than it is about any proven negative side effects?
The primary concern is that there is no evidence from large, randomized controlled trials to show that it is effective to treat the multitude of things that it is being advertised for. There is a lack of strong evidence for the treatment of mental health disorders from available studies and a greater lack of studies in children in general. Despite that, increasing anecdotal reports and the hope for a cure-all, has the effect of moving parents away from medications or other interventions that have good evidence for helping children. While CBD has a good safety profile and there are no serious side effects related to short-term use, more studies are needed to evaluate if there are any significant side effects with long-term use. CBD may also inhibit enzymes in the P450 system, which could result in altered metabolism of other medications (drug-drug interactions), but this needs to be further studied as well. Other concerns are related to the lack of oversight in the production/sale of CBD and the various delivery methods for administration, which can result in unpredictable and/or inconsistent dosing/effects.

Have the major studies on CBD included children?
No, there are no major studies on CBD in children except for epilepsy (specifically Lennox-Gastaut and Dravet Syndromes). The majority of studies with CBD are preclinical animal studies with some increasing studies in healthy adults or adults with Social Anxiety Disorder, with some more recent studies in Autism.

There has been some research on the effects of CBD for autism – what do we know of the findings?
There are studies looking at the ability of CBD to reduce disruptive behaviors (tantrums, aggression), anxiety, and communication problems in children with Autism that have showed promising results, but the evidence for efficacy is small and more information about safety is needed. They do, however, offer support that further studies are needed. Additional studies are underway.

What specific ailments do you think CBD would offer the most hope for kids?
Anxiety and autism are areas that would benefit from further research.

Epidiolex is the first (and only) marijuana-derived drug approved by the FDA – are others in the pipeline?
Not to my knowledge, but CBD is a growing area of interest and research.

Would you advise parents not give their children CBD at all? What is your recommendation?
I recommend against giving children CBD and that parents talk with a medical professional to discuss their concerns and specifically the areas in which their child may need help. This will allow them to get reliable information and to learn about interventions that have strong evidence for efficacy. It is better to try the treatments that we know work and can be reliably administered and monitored than to try something that is not evidence-based and unpredictable. When having these conversations, clinicians need to provide appropriate education while also hearing the concerns of parents and their hopes for something to help their children, so that they can guide them in the right direction.