Autism
Children And Adolescents With ASD Treated With CBD-Rich Cannabis Exhibit Significant Improvements Particularly In Social Symptoms: An Open Label Study
Micha Hacohen, Orit E. Stolar, Matitiahu Berkovitch, Odelia Elkana, Elkana Kohn, Ariela Hazan, Eli Heyman, Yael Sobol, Danel Waissengreen, Eynat Gal, Ilan Dinstein (September 2022)
Accumulating evidence, mostly from open-label uncontrolled studies suggest that CBD-rich cannabis may yield benefits for some individuals with ASD. In this study we demonstrate that this benefit includes improvement in social communication abilities, particularly for participants with high initial severity of core ASD symptoms. Moreover, this is the first study to examine the efficacy of cannabis treatment using both standardized clinical assessments (i.e., ADOS), parent interviews (i.e., Vineland) and questionnaires (i.e., SRS). Despite differences in individual scores reported by parents and clinicians (Fig. 6), the convergence of evidence regarding overall improvements following treatment strengthens the conclusions. These positive findings motivate further double-blind placebo-controlled studies for determining the efficacy of treatment with specific cannabis strains and/or synthetic cannabinoids.
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Cannabidiol In Treatment Of Autism Spectrum Disorder: A Case Study
Lucy Ma, Sofia Platnick, Howard Platnick (August 2022)
This case study aims to demonstrate the use of cannabidiol (CBD) with low-dose tetrahydrocannabinol (THC) in managing symptoms associated with autism spectrum disorder (ASD) to increase the overall quality of life for these individuals and their families.
In this case, the child patient responded positively to the introduction of CBD oil treatment with reduced negative behaviors, better sleep, and improved communication. With the increasing clinical studies on the use of cannabidiol in treating patients with mood disorders, anxiety, chronic pain conditions, and other behavioral problems, it should be considered as a treatment option in managing symptoms related to autism. In the case study presented, the child patient has shown behavioral and cognitive improvements with no side effects reported. Altogether, this study presents a case that motivates further research and clinical studies to understand the molecular mechanism of CBD as well as the dosing regimes for pediatric populations, the etiology of ASD, and how various dosing affect different demographics.
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Evaluation Of The Efficacy And Safety Of Cannabidiol-Rich Cannabis Extract In Children With Autism Spectrum Disorder: Randomized, Double-Blind And Controlled Placebo Clinical Trial
Estácio Amaro da Silva Junior, Wandersonia Moreira Brito Medeiros, João Paulo Mendes dos Santos, João Marçal Medeiros de Sousa, Filipe Barbosa da Costa, Katiúscia Moreira Pontes, Thaís Cavalcanti Borges, Carlos Espínola Neto Segundo, Ana Hermínia Andrade e Silva, Eliane Lima Guerra Nunes, Nelson Torro, Marine Diniz da Rosa, Katy Lísias Gondim Dias de Albuquerque (May 2022)
This was a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of a cannabis extract rich in cannabidiol (CBD) in autistic children. Sixty children, aged between 5 and 11 years, were selected and divided into two groups: the treatment group, which received the CBD-rich cannabis extract, and the control group, which received the placebo, both used the product for a period of 12 weeks. Statistical analysis was done by two-factor mixed analysis of variance (ANOVA two way).
Significant results were found for social interaction, anxiety, psychomotor agitation , number of meals a day and concentration, the latter being significant only in mild autism spectrum disorder. Regarding safety, it was found that only three children in the treatment group (9.7%) had adverse effects, namely dizziness, insomnia, colic and weight gain.
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CBD-Enriched Cannabis For Autism Spectrum Disorder: An Experience Of A Single Center In Turkey And Reviews Of The Literature
Serap Bilge, Baris Ekici (December 2021)
The study included 33 (27 males, six females) children diagnosed with autism spectrum disorder who were followed up between January 2018 and August 2020. The mean age was 7.7 ± 5.5 years. The average daily dosage of cannabidiol (CBD) was 0.7 mg/kg/day (0.3–2 mg/kg/day). The median duration of treatment was 6.5 months (3–28 months). The preparations used in this study contained full-spectrum CBD and trace elements tetrahydrocannabinol (THC) of less than 3%.
The outcomes were evaluated before and after treatment based on clinical interviews. At each follow-up visit, parents were asked to evaluate the effectiveness of the CBD-enriched cannabis treatment. According to the parents’ reports, no change in daily life activity was reported in 6 (19.35%) patients. The main improvements of the treatment were as follows: a decrease in behavioral problems was reported in 10 patients (32.2%), an increase in expressive language was reported in 7 patients (22.5%), improved cognition was reported in 4 patients (12,9%), an increase in social interaction was reported in 3 patients (9.6%), and a decrease in stereotypes was reported in 1 patient (3.2%).
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Cannabis-Responsive Biomarkers: A Pharmacometabolomics-Based Application To Evaluate The Impact Of Medical Cannabis Treatment On Children With Autism Spectrum Disorder
Michael Siani-Rose, Stephany Cox, Bonni Goldstein, Donald Abrams, Miesha Taylor, and Itzhak Kurek (December 2021)
Sixty-five potential cannabis-responsive biomarkers exhibiting a shift toward the TD (typically developing) physiological levels were identified in children with ASD after MC treatment. For each biomarker, the physiological levels were determined based on the values detected in the TD group. A similar qualitative improvement trend in children with ASD treated with MC was also observed in the behavioral surveys. Twenty-three potential Cannabis-Responsive biomarkers exhibiting change toward TD mean were categorized as anti-inflammatory, bioenergy associated, neurotransmitters, amino acids, and endocannabinoids. The changes in the levels of the Cannabis-Responsive biomarkers N-acetylaspartic acid, spermine, and dehydroisoandrosterone 3-sulfate have been previously linked to behavioral symptoms commonly observed in individuals with ASD.
Our results suggest Cannabis-Responsive biomarkers shift toward the TD mean after MC treatment and can potentially quantify benefit at the metabolic level. These changes appear to be similar to the trend described in behavior surveys. Larger trials are needed to confirm these preliminary findings.
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A Pediatric Patient With Autism Spectrum Disorder And Epilepsy Using Cannabinoid Extracts As Complementary Therapy: A Case Report
Juliana Andrea Ponton, Kim Smyth, Elias Soumbasis, Sergio Andres Llanos, Mark Lewis, Wilhelm August Meerholz, Robert Lawrence Tanguay (September 2020)
This case report provides evidence that a lower than previously reported dose of a phytocannabinoid in the form of a cannabidiol-based extract may be capable of aiding in autism spectrum disorder-related behavioral symptoms, core social communication abilities, and comorbid anxiety, sleep difficulties, and weight control.
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Cannabinoids For People With ASD: A Systematic Review Of Published And Ongoing Studies
Laura Fusar-Poli, Vito Cavone, Silvia Tinacci, Ilaria Concas, Antonino Petralia, Maria Salvina Signorelli, Covadonga M. Diaz-Caneja, Eugenio Aguglia (July 2020)
The etiopathogenesis of autism spectrum disorder (ASD) remains largely unclear. Among other biological hypotheses, researchers have evidenced an imbalance in the endocannabinoid (eCB) system, which regulates some functions typically impaired in ASD, such as emotional responses and social interaction. Also, cannabidiol (CBD), the non-intoxicating component of Cannabis sativa has been recently approved for treatment-resistant epilepsy. Seizures represent frequent medical comorbidities of ASD and could be responsible for the onset or worsening of behavioral problems.
Findings are promising, as cannabinoids appeared to improve problem behaviors, sleep, hyperactivity, and communication deficits, with limited cardiac and metabolic side effects.
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Effects of CBD-Enriched Cannabis sativa Extract on Autism Spectrum Disorder Symptoms: An Observational Study of 18 Participants Undergoing Compassionate Use
Paulo Fleury-Teixeira, Fabio Viegas Caixeta, Leandro Cruz Ramires da Silva, Joaquim Pereira Brasil-Neto and Renato Malcher-Lopes (November 2019)
Autism Spectrum Disorders comprise conditions that may affect cognitive development, motor skills, social interaction, communication, and behavior. This set of functional deficits often results in lack of independence for the diagnosed individuals, and severe distress for patients, families, and caregivers. There is a mounting body of evidence indicating the effectiveness of pure cannabidiol (CBD) and CBD-enriched Cannabis sativa extract (CE) for the treatment of autistic symptoms in refractory epilepsy patients. There is also increasing data support for the hypothesis that non-epileptic autism shares underlying etiological mechanisms with epilepsy. Here we report an observational study with a cohort of 18 autistic patients undergoing treatment with compassionate use of standardized CBD-enriched CE (with a CBD to THC ratio of 75/1). Among the 15 patients who adhered to the treatment (10 non-epileptic and five epileptic) only one patient showed lack of improvement in autistic symptoms. Due to adverse effects, three patients discontinued CE use before 1 month.
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Lower Circulating Endocannabinoid Levels In Children With Autism Spectrum Disorder.
Aran A, Eylon M, Harel M, Polianski L, Nemirovski A, Tepper S, Schnapp A, Cassuto H, Wattad N, Tam J. (January 2019)
Children with ASD had lower levels of AEA, OEA, and PEA, but not AA and 2-AG. Serum levels of AEA, OEA, and PEA were not significantly associated or correlated with age, gender, BMI, medications, and adaptive functioning of ASD participants. In children with ASD, but not in the control group, younger age and lower BMI tended to correlate with lower AEA levels. However, these correlations were not statistically significant after a correction for multiple comparisons.
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Brief Report: Cannabidiol-Rich Cannabis in Children With Autism Spectrum Disorder and Severe Behavioral Problems—A Retrospective Feasibility Study
Adi Aran, Hanoch Cassuto, Asael Lubotzky, Nadia Wattad, Esther Hazan (October 2018)
Anecdotal evidence of successful cannabis treatment in autism spectrum disorder (ASD) are accumulating but clinical studies are lacking. This retrospective study assessed tolerability and efficacy of cannabidiol-rich cannabis, in 60 children with ASD and severe behavioral problems (age = 11.8 ± 3.5, range 5.0–17.5; 77% low functioning; 83% boys). Efficacy was assessed using the Caregiver Global Impression of Change scale. Adverse events included sleep disturbances (14%) irritability (9%) and loss of appetite (9%). One girl who used higher tetrahydrocannabinol had a transient serious psychotic event which required treatment with an antipsychotic. Following the cannabis treatment, behavioral outbreaks were much improved or very much improved in 61% of patients. This preliminary study supports feasibility of CBD-based cannabis trials in children with ASD.
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Medical Cannabis For Paediatric Developmental–Behavioural And Psychiatric Disorders
Daryl Efron, Jeremy Freeman (April 2018)
There has been little drug discovery work in the field of child and adolescent mental health for many years, and there is an urgent need to develop safe and effective therapeutics for this vulnerable patient group. Medical cannabis (MC) may be one such treatment. MC has potential as a therapeutic option in the management of paediatric mental health symptoms; however, the evidence to support its use for these patients is not yet in. There is an urgent need to conduct well‐designed trials of pharmaceutical‐grade MC products in children with behavioural and psychiatric disorders. In the meantime, paediatricians should counsel caution in relation to MC treatment for these indications.
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Plasma Anandamide Concentrations Are Lower In Children With Autism Spectrum Disorder
Debra S. Karhson, Karolina M. Krasinska, Jamie Ahloy Dallaire, Robin A. Libove, Jennifer M. Phillips, Allis S. Chien, Joseph P. Garner, Antonio Y. Hardan and Karen J. Parker (March 2018)
These findings are the first empirical human data to translate preclinical rodent findings to confirm a link between plasma anandamide concentrations in children with ASD. Although preliminary, these data suggest that impaired anandamide signaling may be involved in the pathophysiology of ASD.
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Oral Cannabis Extracts As A Promising Treatment For The Core Symptoms Of Autism Spectrum Disorder: Preliminary Experience In Chilean Patients
G.Kuester, K.Vergara, A.Ahumada, A.M.Gazmuri (December 2017)
Preclinical studies and several anecdotal case reports suggest a dysfunctional endocannabinoid system implicated in Autism Spectrum Disorder (ASD).In this small series of ASD patients, oral cannabis extracts were dramatically more effective than conventional medicines. Large randomized controlled trials are needed to establish efficacy and safety of medicinal cannabis in ASD.
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Endocannabinod Signal Dysregulation In Autism Spectrum Disorders: A Correlation Link Between Inflammatory State And Neuro-Immune Alterations
Anna Lisa Brigida, Stephen Schultz, Mariana Cascone, Nicola Antonucci and Dario Siniscalco (July 2017)
Several studies highlight a key involvement of endocannabinoid (EC) system in autism pathophysiology. The EC system is a complex network of lipid signaling pathways comprised of arachidonic acid-derived compounds (anandamide, AEA) and 2-arachidonoyl glycerol (2-AG), their G-protein-coupled receptors (cannabinoid receptors CB1 and CB2) and the associated enzymes. In addition to autism, the EC system is also involved in several other psychiatric disorders (i.e., anxiety, major depression, bipolar disorder and schizophrenia). This system is a key regulator of metabolic and cellular pathways involved in autism, such as food intake, energy metabolism and immune system control.
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Role Of Endocannabinoids On Neuroinflammation In Autism Spectrum Disorder Prevention
Syed Shahid Habib, Khalid Al-Regaiey, Shahid Bashir and Muhammad Iqbal (June 2017)
Autism Spectrum Disorder (ASD) disease has become a mounting socio-economical alarm around the world. Neuroinflammtion had been shown in postmortem brain specimens from ASD patients. The Endocannabinoids System (ES) consists of a family of locally produced, short-lived, endogenous, phospholipid-derived agonists (endocannabinoids) that control energy balance and body composition. The growing number of medical benefits of ES, such as their ability to regulate processes like neuroinflammation, neurogenesis and memory, raise the question of their potential role as a preventive treatment of ASD.
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