Cannabinoid treatment for the symptoms of autism spectrum disorder

ABSTRACT

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting approximately 3% of school-age children. The core symptoms are deficits in social communication and restricted and repetitive patterns of behavior. Associated problems in cognition, language, behavior, sleep and mood are prevalent. Currently, no established pharmacological treatment exists for core ASD symptoms. Risperidone and aripiprazole are used to manage associated irritability, but their effectiveness is limited and adverse events are common.

Areas covered

This mini-review summarizes existing scientific literature and ongoing clinical trials concerning cannabinoid treatment for ASD. Uncontrolled case series have documented improvements in both core ASD symptoms and related behavioral challenges in children treated with cannabis extracts rich in cannabidiol (CBD). Placebo-controlled studies involving CBD-rich cannabis extracts and/or pure CBD in children with ASD have demonstrated mixed efficacy results. A similar outcome was observed in a placebo-controlled study of pure CBD addressing social avoidance in Fragile X syndrome. Importantly, these studies have shown relatively high safety and tolerability.

Expert opinion

While current clinical data suggest the potential of CBD and CBD-rich cannabis extract in managing core and behavioral deficits in ASD, it is prudent to await the results of ongoing placebo-controlled trials before considering CBD treatment for ASD.

KEYWORDS:

• Autism
• cannabis
• cannabinoids
• CBD
• THC
• pharmacological treatments
• review
• endocannabinoid system

Article highlights

• This review provides a comprehensive overview of the existing rationale, current empirical evidence, and ongoing clinical trials related to cannabinoid therapy for Autism Spectrum Disorder (ASD).

Article highlights

• This review provides a comprehensive overview of the existing rationale, current empirical evidence, and ongoing clinical trials related to cannabinoid therapy for Autism Spectrum Disorder (ASD).

Declaration of interest

A Aran reports receiving personal fees and stock options for advisory roles at BOL Pharma (2017–2019) and stock options for advisory roles at GCANRx (2021). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has been recruited by Research Square. Reviewers with declared or apparent competing interests are not utilized for these reviews. This reviewer was paid a small honorarium for completing the review within a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.

Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.