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Medicnal Marjuana, Cerebral Palsy, Treatment, Benefits
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McDonough D, Charles J and Shaw T. The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.12688/f1000research.150792.2)
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Systematic Review
Revised
The use of medicinal marijuana for treating Cerebral Palsy: a literature review
[version 2; peer review: 1 approved, 1 approved with reservations]
PUBLISHED 06 Feb 2025
OPEN PEER REVIEW
REVIEWER STATUS
Abstract
Corresponding author:
Daniel McDonough
Competing interests:
No competing interests were disclosed.
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The author(s) declared that no grants were involved in supporting this work.
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© 2025 McDonough D et al.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: McDonough D, Charles J and Shaw T. The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.12688/f1000research.150792.2)
First published: 23 Jul 2024, 13:825 (https://doi.org/10.12688/f1000research.150792.1)
Latest published: 06 Feb 2025, 13:825 (https://doi.org/10.12688/f1000research.150792.2)
Revised Amendments from Version 1
The main change to the new version is that we have a far more in depth result section, detailing the types of MM administration, dose, side effects used to treat pain, spasticity and sleep disorders. Also, we have explained in more detail of the types of studies included with the review.
See the authors' detailed response to the review by Mê-Linh Lê
See the authors' detailed response to the review by Natalia Szejko
Introduction
Adults with Cerebral Palsy (CP) are at a higher risk of non-communicable diseases such as cancer, stroke, and chronic obstructive pulmonary disease. This is believed to be related to a lack of medical screening and insufficient services when they transition into adult healthcare service environments (Murphy, 2018). A recent report showed that a patient with CP aged > 18 years is 72% more likely to develop advanced CKD after adjusting from cardiometabolic diseases compared to those without CP (Whitney et al., 2020). It is common for people suffering with CP to have coexisting conditions that are outside of age-based developmental stages such as pain 75%, intellectual disability 50%, hip replacement 33%, incontinence 25%, epilepsy 25%, inability to speak 25%, sleep disorders 20-25%, and behaviour problems 20-25% (Vitrikas et al., 2020). People with CP entering adult life have difficulty swallowing, as many muscles are affected in the oral cavity, making eating solid foods a challenge (Speyer et al., 2019).
Several studies have investigated the benefits of Medicinal Marijuana (MM) in the treatment of muscle spasms (Nielsen et al., 2019; Singh & Singh, 2019; Stang et al., 2019), pain (Campbell et al., 2019; Clem et al., 2020; Dzierżanowski, 2019; Wildes et al., 2020), sleep disturbance (Skobic et al., 2020; Sznitman et al., 2020), quality of life (QOL), and social and emotional wellbeing (SEWB) (Capano et al., 2020; Palace & Reingold, 2019). In addition, spasticity commonly occurs with neurological conditions including Cerebral Palsy, multiple sclerosis, stroke and spinal cord injuries. There is some evidence MM can be an effective treatment of adults with multiple sclerosis suffering from spasticity, with modest efficacy reducing spasticity (Nielsen et al., 2019). However, there is limited evidence of MM reducing spasticity effectively with other neurological conditions (Nielsen et al., 2019). The use of MM can provide better relevant resistance of spasticity compared to anti spasticity medications alone (Markovà et al., 2019).
However, MM has rarely been used to treat CP complications in adults. This literature review explored MM interventions globally, with a focus on identifying the best practices with MM for the treatment of complications in adults with CP.
CP effects two–three people per 1,000 live births, and its diagnosis is usually determined between 12 and 24 months of age (Vitrikas et al., 2020). There are many symptoms of CP such as poor posture, balance and movement resulting from brain disfunction and restricted movement known as spasticity, which is caused by compression of the brain and spinal cord, due to reduced blood flow reducing oxygen levels (Stang et al., 2019). Patients with CP have numerous complications and problematic health-related experiences that continue to develop into adulthood such as high muscle tone, spasms, and motor skills, which often contribute to brain injury and developmental problems, seizures, cognitive dysfunction, osteoporosis, pressure ulcers, speech impairment, and hearing impairment (Gulati & Sondhi, 2018; Vitrikas et al., 2020). CP is the most common form of spasticity resulting from a damaged non-progressive central nervous system that can inhibit motor function capacity development leading to low performance, and retardation (Singh & Singh, 2019).
Throughout history, cannabinoids have been used to treat various medical conditions worldwide and have been used medically for thousands of years in various cultures (Crowder, 2019), including to manage spasms (Fairhurst et al., 2020). In the human body, the endocannabinoid system has two key primary cannabinoid receptors, CB1 and CB2, that are linked to the central and peripheral nervous systems (Rosi & Sorbello, 2019). CB1 receptors are found in the nervous system, organs, connective tissue, glands, immune cells, and the brain (Rosi & Sorbello, 2019). CB2 receptors are primarily found in the immune system and can be non-responsive to anti-inflammation in certain parts of the human body during injury (Rosi & Sorbello, 2019). Through the anandamide system, the body produces its own cannabinoids and cannabinoid receptors to produce several psychological effects and activities.
Cannabidiol (CBD) and tetrahydrocannabinol (THC) both originate from the cannabis sativa plant and have the potential to modify muscle tone (Fairhurst et al., 2020). THC is an active element and is known to have the most profound effect on pain relief and relaxation (Rosi & Sorbello, 2019). The primary medicinal effects of THC include psychoactive properties, such as stimulation of appetite, muscle relaxation, analgesia, and antiemesis (Fairhurst et al., 2020) However, a higher volume dose of THC can trigger paranoia (Rosi & Sorbello, 2019). CBD also affects antipsychotic activity, muscle relaxants, antioxidants, anticonvulsants, and anxiolytic but does not cause intoxication (Fairhurst et al., 2020; Rosi & Sorbello, 2019) CBD can increase the THC pain relief potential and limit psychoactive effects by working together to increase anti-inflammatory, antioxidant, and antiviral effects (Rosi & Sorbello, 2019). Scientific techniques have been developed to extract oils and provide additional delivery systems for MM, which are grouped into four delivery methods to determine the best possible outcome for each individual ( Table 1) (Rosi & Sorbello, 2019).
Table 1. MM Methods.
| Method | Description |
|---|---|
| Inhalation | Inhalation, vaporizing, or smoking, when looking for immediate relief taking effects within minutes or seconds, achieving maximum affect after 15 minutes, and lasting two–four hours. Psychoactive response is high due to the high concentrate of 25-30 %, of the traditional flower cannabinoid. |
| Ingestion | After ingestion, patients who report regular cannabis use can have a systematic relief effect. |
| Sublingual | Sublingual Medicated Edibles take 45-60 minutes to affect and are the most common practice for ingestible methods. The ingestible method can be difficult for patients who are new to administering cannabis; a low accurate dose at the beginning is important to achieve the best possible relief. |
| Transdermal | Topical administration is most effective for treating pain and joints that are closer to the skin surface and can be used as a slave patch. Relief can take between 15-60 minutes and last several hours depending on the area being treated. For topical administration, it is very important to individualize each patient and start at a low dose, recommended between 5 and 10 mg. In patients with severe pain, topical administration is not as effective as oral administration and inhalation of cannabis (Rosi & Sorbello, 2019). |
Pain is one of the most common reasons for therapeutic use of MM. Recent studies on patients who use cannabis for pain have mainly used opioids to help control pain management previously (Cooke et al., 2020). MM has also been extensively used to treat sleep disruption and improve relaxation in a variety of patients (Skobic et al., 2020). In the last twenty years medical cannabis has been used to reduce pain for patients who have conditions such as spasticity and multiple sclerosis (Fairhurst et al., 2020). In 2016, Australia passed legislation allowing registered health professionals the capacity to prescribe MM for their patients (Lintzeris et al., 2020). Currently, MM is prescribed in some Australian states for the treatment of various medical conditions and health issues, such as pain, anxiety, and sleep disorders (Albee & Penilton, 2019).
Method
Literature search methodology
A literature search methodology was undertaken ( Figure 1) to identify interventions related to MM and the various types of MM use and methods amongst populations globally by adopting keywords and synonyms related to the topic ( Table 2). A set of inclusions and exclusions ( Table 3) were applied so the search scope was limited to relevant scholarly peer-reviewed literature publications from 2019 to 2021 that were available from the Deakin Library collection across five different databases ( Table 4).
Figure 1. PRISMA flow diagram.
Table 2. Search keywords and terms.
Results
Literature search results
The literature search results ( Figure 1) initially presented 409 publications as available for review although 71 duplicates were removed. Then a screening process based on a set of conditions ( Table 5) identified 25 papers aligned with the review aim. The reference lists of these 25 papers were then scanned using the same literature screening process and 2 more papers were added resulting in a total of 27 papers ( Table 6) selected for this literature review. The first and second authors of this paper both individually completed the entire search and screening process. If there were any conflicts for inclusion the third author was invited to resolve any conflicts. However, both the first and second author agreed with all inclusions, so the third author was not required to participate.
Table 5. Literature screening process.
| Conditions | Criteria |
|---|---|
| 1 |
|
| 2 |
|
| 3 |
|
Table 6. Papers selected for review.
|
Main results
The literature search was conducted to investigate the use of MM for the treatment of adults with CP in relation to pain, sleep and improvement of quality of life. The search strategy found studies including randomized control trials, cross sectional studies, prospective cohort studies, placebo-controlled randomized clinical trials, cohort studies, and retrospective studies, meta-analysis and longitudinal observational studies. The results of this study demonstrated there was some evidence of MM being beneficial for the treatment of pain, sleep, spasticity and SEWB. For example, in A double-blind placebo controlled randomised trial using THC/CBD oromucosal spray (Sativex) for patients with spasticity, as a add on therapy to optimized standard spasticity with moderate to severe multiple sclerosis MS. Patients with moderate to severe MS spasticity after a 12-week period receiving THC/CBD oromucosal spray (Sativex) achieved 30% improvement for MS spasticity compared to the placebo for therapeutic gain for spasticity. Also THC/CBD spray showed some improvements for secondary measures including spasms, pain and sleep disruptions (Markovà et al., 2019). This study found the recommended dose, under these conditions, clinically meaningful for improvement of MS spasticity with a recommended average dose of 7 sprays, which was reported by more than three quarters of patients (Markovà et al., 2019). However, many studies did not specify the type of the MM used, the type of administration employed, and the exact dose used. This is likely due to the individual patients’ needs and requirements of relief of different levels of pain, sleep, spasticity and SEWB. This also is related to different types and levels of health conditions e.g. MS, cancer treatment. Although there were some studies were patients responded positively with a specific type off MM and dose, the results of this review indicate that it is very difficult to recommend a specific type of MM and precise dose that could be recommended for all patients. In addition, some studies found adverse side effects such as vomiting and hallucinations from the administration of MM, which varied between individual and patient condition. Although this review found no evidence of the use of MM for the treatment of adults with CP, there is evidence that MM could be used for the treatment of some of the conditions e.g. pain, sleep, spasticity and SEWB which is related to adults suffering from CP.
Analysis of selected papers
Various appraisal and evaluation tools ( Table 7) were utilised to determine the paper’s quality and credibility as well as ensuring the review was without perceived or actual bias. Each paper was then scanned to confirm topic relevance and appropriate coverage of topics ( Table 8) towards objectively validating findings. The process revealed there was no literature or study on the use of MM for adults with CP to treat common health-related symptoms and conditions.
Table 7. Appraisal and evaluation tools.
| Tool | Purpose |
|---|---|
| Critical Appraisal Skills Programme (CASP, 2014) | qualitative and quantitative appraisal tool |
| Joanna Briggs Institute (JBI) (Aromataris, 2017) | checklist for text and opinion |
| Scimago Journal & Country Rank (SJR) (SCImago, 2007) | evaluate the strength and quality of each selected paper |
| National Health and Medical Research Council (NHMRC) hierarchy of evidence (NHMRC, 2000) | rank the selected papers’ rigour, quality, and credibility of the research |
Table 8. Coverage of review topics in selected papers.
| Review Paper | CP | MM | MM Treatments | |||
|---|---|---|---|---|---|---|
| Sleep | Pain | Spasticity | QOL / SEWB | |||
| Albee & Penilton (2019) | ⊠ | ⊠ | ⊠ | ⊠ | □ | □ |
| Babson et al. (2017) | □ | ⊠ | ⊠ | □ | □ | □ |
| Campbell et al. (2019) | □ | ⊠ | □ | □ | □ | □ |
| Capano et al. (2020) | □ | ⊠ | □ | ⊠ | □ | ⊠ |
| Clem et al. (2020) | □ | ⊠ | □ | ⊠ | □ | □ |
| Cooke et al. (2020) | □ | ⊠ | □ | ⊠ | □ | □ |
| Crowder (2019) | □ | ⊠ | □ | □ | □ | ⊠ |
| Dzierżanowski (2019) | □ | ⊠ | ⊠ | ⊠ | ⊠ | □ |
| Fairhurst et al. (2020) | ⊠ | ⊠ | □ | □ | ⊠ | □ |
| Gulati & Sondhi (2018) | ⊠ | □ | □ | □ | □ | □ |
| Lintzeris et al. (2020) | □ | ⊠ | ⊠ | ⊠ | □ | □ |
| Markovà et al. (2019) | □ | ⊠ | □ | □ | ⊠ | □ |
| Murphy (2018) | ⊠ | □ | □ | □ | □ | □ |
| Nielsen et al. (2019) | □ | ⊠ | □ | □ | ⊠ | □ |
| Palace & Reingold (2019) | □ | ⊠ | □ | □ | □ | ⊠ |
| Pham et al. (2020) | □ | ⊠ | □ | ⊠ | □ | □ |
| Rosi & Sorbello (2019) | □ | ⊠ | □ | ⊠ | □ | □ |
| Singh & Singh (2019) | ⊠ | □ | □ | □ | ⊠ | □ |
| Skobic et al. (2020) | □ | ⊠ | ⊠ | □ | □ | □ |
| Speyer et al. (2019) | ⊠ | □ | □ | □ | □ | □ |
| Stang et al. (2019) | ⊠ | □ | □ | □ | □ | □ |
| Sznitman et al. (2020) | □ | ⊠ | ⊠ | □ | □ | □ |
| Tawfik et al. (2019) | □ | ⊠ | □ | ⊠ | □ | ⊠ |
| Vitrikas et al. (2020) | ⊠ | □ | □ | □ | □ | □ |
| Whitney et al. (2020) | ⊠ | □ | □ | □ | □ | □ |
| Wildes et al. (2020) | □ | ⊠ | □ | ⊠ | □ | □ |
| Zhand & Milin (2018) | □ | ⊠ | ⊠ | □ | □ | □ |
Discussion
A follow-up survey conducted 2018-2019 on the self-identified therapeutic reasons for the use of medical cannabis, 2-years after the initial survey following the introduction the legal access of medical cannabis in Australia, demonstrated to close similarity across both surveys that pain, mental health/substance use, sleep or other conditions as the main condition for the use of medical cannabis (Lintzeris et al., 2020). The most recent survey report identified the overwhelming majority of 1388 respondents believed their symptoms improved from the use of MM (Lintzeris et al., 2020). Alarmingly, in the same survey period, 25.8% (284/1103) of the respondents reported they were unaware of the CBD/THC composition of their medical cannabis or that compositions between batches varied 23.9% (264/1103) (Lintzeris et al., 2020). Unfortunately, the potential concern raised for the ill-formed user of medical cannabis is also apparent in other studies that suggest more research is needed on the appropriate composition, dosage, and timing of MM when treating and managing specific medical conditions and symptoms (Babson et al., 2017; Skobic et al., 2020; Sznitman et al., 2020).
Internationally, there are many reasons why individuals pursue the use medical cannabis including but not limited to pain, anxiety, spasticity, and sleep disorders (Albee & Penilton, 2019). There is some evidence that MM has beneficial effects for adults in relieving spasticity symptoms, pain management, and sleep apnoea (Tawfik et al., 2019). A review of evidence for the effectiveness of cannabinoids in Oncology and palliative care practice acknowledged the limited and contradictory results on the effects of MM treatment for symptoms, including pain, sleep, and spasticity, though determined with consideration of finding the appropriate dosage then the benefits overweighed the possible risk for palliative care patients, especially in the earlier phases of progressive disease (Dzierżanowski, 2019). The following sections presents more results in relation to MM treatments for sleep, pain, spasticity, QOL, and SEWB.
MM treatments for sleep
In recent years, research has shown an understanding on the effects of MM and cannabinoids derivatives that have been used for treating sleep disorders (Babson et al., 2017). It is known that MM with cannabidiol has different effects based on dose; for example, a lower dose has been shown to be stimulating and is related to sleep disorders, and a higher dose can have the effect of sedation (Babson et al., 2017). People with sleep disorders found that cannabidiol at medium to high doses can improve sleep (Babson et al., 2017). Recent clinical trials have suggested that the THC/CBD ratio (Sativex) at the right dose can improve sleep in people with chronic pain. A study comparing the self-reported use of marijuana to evidence-based treatments for sleep/relaxation concluded that differences in THC/CBD composition and timing of dosage changes results (Skobic et al., 2020). For instance, it was found that 160mg/day of CBD increased sleep time and reduced sleep disturbance, while a high dose (15mg) of THC at night could result in memory impairment, increased sleepiness, and mood changes in the day after (Skobic et al., 2020).
A study on the use of cannabis at a particular time to improve sleep presented the notion that the cannabis industry are making various unfounded claims on potential benefits of MM treatment for sleep leading to suggesting cannabis users be more informed and seek evidenced-based alternatives to improve sleep, such as, pharmacological and behavioural treatments (Sznitman et al., 2020). However, the study sample was of 802 frequent cannabis users, and it is not made clear whether or not the participants used cannabis for a sleep disorder nor that the cannabis used was medicinal or recreational (Sznitman et al., 2020). A literature review on the pharmacotherapeutic management of insomnia in cannabis withdrawal determined there is inconclusive evidence for treatment options due to the preliminary stages of the work (Zhand & Milin, 2018). There has been limited research on MM to improve sleep, with studies having limitations of small sample sizes. Therefore, caution must be exercised when interpreting presented results. There have also been limitations with follow-up, highlighting the importance of examining the long-term effects of MM as a treatment for improving sleep (Babson et al., 2017).
MM treatments for pain
Research by Cooke et al. (2020) was one of the first studies to evaluate the daily use of cannabis in comparison with the change in health status associated with pain severity (Cooke et al., 2020). They examined cannabis consumption patterns associated with chronic pain and the control of different types of pain as well as investigating the demographics of each patient, impact of cannabis use, and overall health of patients (Cooke et al., 2020). The research was a cross-sectional study design, which has limitations of conclusions about causation i.e. “cannabis might depress general health for people who have high pain” (Cooke et al., 2020). The sample size (n=295) included medical cannabis patients, and the evaluation was designed for patients with both low and high pain levels. They measured daily cannabis consumption and the difference between low and high pain levels with the significance of MM (Cooke et al., 2020). The relationship between cannabis use and the treatment of chronic pain can be dependent on route of administration and dose response effects. Given the complex nature of chronic pain, a myriad of causes and combinations of cannabis use have been identified. Therefore, it is difficult to determine the frequency of cannabis use among patients and how it affects the health of patients with chronic pain. Further research is needed to determine the frequency of cannabis use in patients with chronic pain (Cooke et al., 2020).
A review of 48 studies conducted by Pham et al. (2020) aimed to describe the role of MM and cannabinoids in lower urinary tract symptoms (LUTS) and dysfunction related to chronic pain, determined in clinical trials and preclinical studies (Pham et al., 2020). The review revealed mixed results and limited evidence though there was enough evidence to suggest MM could target the endocannabinoid system to treat LUTS and other bladder conditions (Pham et al., 2020). Unfortunately, the increased availability of legalised MM and cannabinoid derivatives will continue to outpace clinical investigations into the benefits of MM treatment for pain and as such will require physician-patient conversations to be held with a better understanding of how MM interacts with the human body (Pham et al., 2020).
Wildes et al. (2020) also concluded at the end of their study that more research is needed to better understand the effects of MM on the human body, in particular cognition and mood (Wildes et al., 2020). They attempted to unpack the complex interplay of variables of persistent pain and how CBD and THC could affect change leading to the determination more investigations are required in relation to THC/CBD composition and dosage (Wildes et al., 2020). A different study on the use MM for the treatment of persistent pain identified study participants were motivated to use MM to manage a variety of health-related symptoms such as pain, sleep, anxiety, and withdrawal instead of opioids (Clem et al., 2020). Even though the study had limitations restricting generalizable findings the study investigated the motivation of participants to use MM to treat pain and as such were able to recommend a better understanding of alternative therapies that could help reduce the overall use of opioids given the well-documented side effect complications and likely opioid dependency (Clem et al., 2020).
MM treatments for spasticity
The study conducted by Fairhurst et al. (2020) was the only study that used MM as a treatment for CP. It was a prospective randomized placebo-controlled trial, which focused on 72 adolescents (8 to 18 years old) who suffered from spasticity and traumatic central nervous system (CNS) injury and investigated the efficacy, safety, and tolerance of MM (Fairhurst et al., 2020). The study investigated the benefits of sleep improvement with MM and although the results were not statistically significant, sleep scores showed some relevant numerical improvements (Fairhurst et al., 2020). It should be noted that the measures investigated in this study were designed and developed for adults (>30 years), and several adverse reactions were experienced by young people after receiving MM. These adverse reactions may have been related to doses designed for adults, regardless of the reason why the adverse reactions affected the progression of the trial (Fairhurst et al., 2020). A review of studies that included adults and paediatric participants in examining the effectiveness of cannabinoids in treating spasticity determined more favourable outcomes for adults than paediatric patients (Nielsen et al., 2019). The paediatric studies produced low quality evidence whereas the adult studies of randomized controlled clinical trials demonstrated cannabinoids have more efficacy in reducing muscle spasticity (Nielsen et al., 2019).
A study of 191 participants on the use of MM to treat spasticity with adult (18y+) multiple sclerosis patients did prove the trialled THC: CBD spray demonstrated a more efficacious alternative to readjusting underlying antispasticity drugs (Markovà et al., 2019). Markovà et al. (2019) conducted a randomized control trial to investigate a 12-week treatment program for using Sativex® as an add-on therapy vs. further optimized first-line ANTispastics (SAVANT) in a two-phase trial. Optimization of the underlying antispasticity medications was permitted in both groups across all study periods (Markovà et al., 2019). The study criteria included adult (18y+) multiple sclerosis patients that had encountered spasticity for at least 12 months and had co-existing symptoms of chronic pain, spasm, low mobility, sleep disturbance, depression, anxiety, and fatigue (Markovà et al., 2019). The criteria excluded who had taken THC, CBD spray in the past, or currently using cannabis or cannabinoid-based drugs of any form within 30 days prior to the study period and any family history of psychiatric disorders (Markovà et al., 2019).
MM treatments for QOL and SEWB
An 8-week prospective, single-arm cohort study of 97 chronic pain patients for the potential role of cannabinoids as an alternative for opioids concluded a significant effect on reducing opioid intake, reducing pain, and improving QOL (Capano et al., 2020). The study enrolled 30–65-year-old patients suffering from moderate to severe chronic pain for at least 3 years and had been stable on opioids for 1 year. Then they excluded participants if they had any history of substance disorder; any psychotic disorder; an abnormal drug screen in the previous 12-months; a history of non-fatal overdose; any epileptic activity in the previous 12-months; an incapacitating system disorder (cardiac, renal, or hepatic), or any known allergy to cannabis-based products (Capano et al., 2020). Analysis of results were evaluated with four indices - Pain Disability Index (PDI-4); Pittsburgh Sleep Quality Index (PSQI), Pain Intensity and Interference (PEG); and Patient Health Questionnaire (PHQ-4). The study found 53% of the participants who added CBD hemp extract reduced or eliminated opioids and 94% of all CBD users reported QOL improvements (Capano et al., 2020).
An evaluation of a MM symptom management program implemented in an American skilled nursing facility for the safe use of MM for chronic conditions, especially chronic pain, neuropathy, and Parkinson’s disease influenced the recommendation that clinicians should consider the historical experiences and contemporary findings in the potential benefits of MM as an alternative therapy (Palace & Reingold, 2019). Prior to the program implementation, an evaluation of meta-analysis from various trials, studies, and reviews found mixed results and relevant findings that aligned with the geriatric medical practice of focusing on simplifying medication regimes, avoiding polypharmacy, and eliminating medications with potentially harmful side effect profiles (Palace & Reingold, 2019). The innovative program ignored traditional options for symptom management guided by Food and Drug Administration (FDA) approved medications and created an approved program so residents were able to legally obtain and use MM for symptom management in the facility (Palace & Reingold, 2019). The program evaluation found most residents using MM to treat pain reported sustained improvement in chronic pain severity leading to opioid dosage reduction and an improved sense of SEWB (Palace & Reingold, 2019).
Conclusion
There is no literature on the use of MM in adults with CP. This literature review found the evidenced-based potential benefits for the use of MM to treat spasticity, pain, and sleep symptoms and for improving QOL, and SEWB. However, from the findings of this review, further studies are needed on the appropriate composition, dosage and timing of MM when used as a treatment therapy. Furthermore, the review findings have established a need to study the use of MM treatment for adults with CP in relation to treating spasticity, pain, and sleep symptoms as well as improving QOL, and SEWB.
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McDonough D, Charles J and Shaw T. The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.12688/f1000research.150792.2)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Lê ML. Reviewer Report For: The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.5256/f1000research.177700.r364982)
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Reviewer Report 14 Feb 2025
Approved
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The authors have addressed my concerns related to the important distinctions and methodological rigour between a literature review and a systematic review. Their revised methods and description of their literature review process are now clear on the work that was
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Lê ML. Reviewer Report For: The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.5256/f1000research.177700.r364982)
The direct URL for this report is:
https://f1000research.com/articles/13-825/v2#referee-response-364982
https://f1000research.com/articles/13-825/v2#referee-response-364982
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Version 1
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PUBLISHED 23 Jul 2024
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How to cite this report:
Lê ML. Reviewer Report For: The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.5256/f1000research.165390.r330974)
The direct URL for this report is:
https://f1000research.com/articles/13-825/v1#referee-response-330974
https://f1000research.com/articles/13-825/v1#referee-response-330974
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 14 Nov 2024
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As an information professional, I have limited my comments below to those relating to the methodology and citations of the paper.
Methods
While the title of this article says it is a literature review, throughout the ... Continue reading
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HOW TO CITE THIS REPORT
Lê ML. Reviewer Report For: The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.5256/f1000research.165390.r330974)
The direct URL for this report is:
https://f1000research.com/articles/13-825/v1#referee-response-330974
https://f1000research.com/articles/13-825/v1#referee-response-330974
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Author Response 06 Feb 2025Daniel McDonough, Research, Telethon Kids Institute, Adelaide, Australia06 Feb 2025Author ResponseThank you for taking the time to review our paper we have found your suggestion and comments informative and helpful please see our responses below.
Reviewer
Methods: While the ... Continue reading
COMMENTS ON THIS REPORT
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Author Response 06 Feb 2025Daniel McDonough, Research, Telethon Kids Institute, Adelaide, Australia06 Feb 2025Author ResponseThank you for taking the time to review our paper we have found your suggestion and comments informative and helpful please see our responses below.
Reviewer
Methods: While the ... Continue reading
Views
19
How to cite this report:
Szejko N. Reviewer Report For: The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.5256/f1000research.165390.r330978)
The direct URL for this report is:
https://f1000research.com/articles/13-825/v1#referee-response-330978
https://f1000research.com/articles/13-825/v1#referee-response-330978
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 28 Oct 2024
Natalia Szejko,
University of Calgary, Calgary, Alberta, Canada
Approved with Reservations
VIEWS 19
Thank you for providing me the opportunity to review this interesting paper that concerns an interesting topic of CP and use of cannabis based medicine.
Overall the paper is interesting and relevant to the field. However, I ... Continue reading
Overall the paper is interesting and relevant to the field. However, I ... Continue reading
CITE
HOW TO CITE THIS REPORT
Szejko N. Reviewer Report For: The use of medicinal marijuana for treating Cerebral Palsy: a literature review [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2025, 13:825 (https://doi.org/10.5256/f1000research.165390.r330978)
The direct URL for this report is:
https://f1000research.com/articles/13-825/v1#referee-response-330978
https://f1000research.com/articles/13-825/v1#referee-response-330978
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
-
Author Response 06 Feb 2025Daniel McDonough, Research, Telethon Kids Institute, Adelaide, Australia06 Feb 2025Author ResponseThank you for taking the time to review our paper we have found your suggestion and comments informative and helpful please see our responses below.
Reviewer
- It is ... Continue reading
COMMENTS ON THIS REPORT
-
Author Response 06 Feb 2025Daniel McDonough, Research, Telethon Kids Institute, Adelaide, Australia06 Feb 2025Author ResponseThank you for taking the time to review our paper we have found your suggestion and comments informative and helpful please see our responses below.
Reviewer
- It is ... Continue reading
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