CBD and Autism: Current Studies and Clinical Experience

On the occasion of World Autism Day, April 2, we offer a comprehensive overview of the therapeutic potential of cannabidiol (CBD) for the treatment of autism. It is excerpted from the Handbook of Principles of Clinical Cannabinology, an invaluable knowledge resource on medical cannabis that accompanies the scientific data with insights gleaned from the clinical experience of physicians and healthcare professionals.

Note: This is an informational article and is not intended to prevent, diagnose or treat any disease. Its content can complement, but should never replace, the diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines and are intended for external use. There may be new relevant scientific evidence since the date of publication. Consult your doctor before using CBD.

CBD and Autism Spectrum Disorder

Medical cannabis, particularly cannabidiol or CBD, has emerged as a promising option for people with Autism Spectrum Disorder (ASD). CBD’s interactions with the endocannabinoid system, neurotransmitter systems and its neuroprotective and anti-inflammatory properties offer potential therapeutic benefits for the treatment of ASD symptoms.

It is important to clarify that CBD is not currently an approved drug for ASD. Although the evidence and individual experiences are promising, strong scientific evidence is essential for the widespread adoption and integration of CBD-based therapies into routine medical practice. Let’s see what current research and data exist on CBD and autism.

What is Autism Spectrum Disorder (ASD)?

ASD encompasses a number of neurological developmental disorders that usually manifest early in life and often coincide with general cognitive deficits (1). Its symptoms include difficulties in communication and social interaction, repetitive behaviors and, in some cases, intellectual disability (2).

ASD is approximately four times more common in males than in females, and may be accompanied by anxiety, depression, insomnia, epilepsy, bowel dysfunction and attention deficit hyperactivity disorder (ADHD).

Relationship between Autism and the Environment: Autism and Pollution

Recent studies suggest that both genetic and environmental factors may contribute to ASD. (4) However, it remains unclear to what extent environmental factors have influenced the recent increase in ASD cases. The contradictory data in the literature on the role of environmental factors can be attributed to methodological problems, such as the selection of contaminants for analysis and their quantification.

European studies have reported no association between maternal exposure to air pollution and ASD in children (5,6). In contrast, several studies conducted in the United States and other countries have found a relationship.

In addition, it is crucial to determine whether there is a critical time window of exposure that is particularly associated with the onset of ASD in children. Numerous studies have investigated the correlation between autism and various air pollutants, focusing on substances such as ozone (ground-level ozone), lead, particulate matter (PM), carbon monoxide (CO), nitrogen dioxide (NO2) and sulfur dioxide (SO2).

Treatments for Autism

There are several treatment modalities for autism, often in combination. These include: (11)

• Behavioral and developmental interventions
• Educational interventions
• Socio-relational interventions
• Pharmacological interventions
• Psychological interventions
• Complementary and alternative therapies (e.g., special diets, art therapy, mindfulness).

Pharmacological treatment

Pharmacological treatments do not cure ASD; they are intended to control specific symptoms. Some medications target hyperactivity, self-injurious behaviors or attention-related problems, while others treat comorbid conditions such as anxiety, depression, epilepsy and gastrointestinal problems, which pose a particular challenge in the treatment of ASD (11).

Potential of CBD in the Treatment of ASD

In recent years, CBD has gained attention as a potential treatment for ASD, and many physicians in various countries have incorporated it into their therapeutic strategies. However, its use should be carefully considered and monitored by health professionals.

Mechanism of action

CBD is believed to be potentially useful in the treatment of ASD due to its interaction with the endocannabinoid system and its influence on various neurotransmitter systems such as GABA, serotonin and dopamine. (12)

CBD exhibits neuroprotective properties, which may be relevant in autism, where there may be alterations in brain development and function. In addition, some research suggests that neuroinflammation may play a role in the pathophysiology of ASD. CBD also has anti-inflammatory properties and can modulate the immune response, which may help reduce inflammation in the brain and alleviate associated symptoms.

Potential Benefits of CBD in Autism

CBD can help alleviate symptoms of anxiety and stress often experienced by people with ASD and can also help control problem behaviors associated with autism, such as aggression, agitation and irritability. Its calming effects can reduce disruptive behaviors and improve overall mood stability.

In addition, many people with ASD suffer from sleep disorders and CBD has been shown to improve sleep quality.

Although seizures are not a core symptom of autism, they occur at a higher rate in individuals with ASD compared to the general population. CBD has been approved as a treatment for certain types of epilepsy, and its anticonvulsant properties may benefit people with autism who suffer from seizures as a comorbid condition. At this point it is also worth mentioning that CBD has interactions with certain drugs for epilepsy, such as Topiramate, Rufinamide, Zonisamide and Eslicarbazepine. Therefore, the importance of prescription and supervision by a specialist physician is emphasized.

Side effects of CBD

In terms of side effects, compared to traditional pharmacological interventions, CBD is generally well tolerated and has a favorable side effect profile. This makes it a potentially attractive option for people with ASD who may be sensitive to the side effects of conventional medications. However, it should be remembered that CBD is not a currently approved medication for ASD, but is still in the research phase. Therefore, consult with your medical specialist about possible treatments for autism.

On the other hand, it is not advisable to use cannabis products containing THC, such as marijuana or homemade cannabis preparations. In case of autism, it is preferable to use pure CBD and avoid any trace of THC, especially in children. THC is psychoactive and can produce psychosis and unwanted adverse effects. The use of THC products should be cautiously supervised by a medical specialist, especially in minors.

Clinical Experience: CBD and Autism

Dr. Mauro Cardoso Lins is a Brazilian physician with extensive experience in the treatment of patients with ASD and ADHD, especially children and adolescents. Interviewed by Cannabiscientia, Dr. Lins tells us that his clinical experience with CBD to treat mild to moderate and severe cases of autism is, so far, exciting.

According to their experience and the data collected, CBD is effective in improving aspects of behavior, especially in initial and mild-moderate cases, but also in more severe cases.

Improvements observed include:

• Decreased aggressiveness (probably the most important result),
• Increased attention span,
• Increased communication and sociability,
• Improved task performance.

CBD product used, dosage, routes of administration and duration of use of CBD

This section presents the information provided by Dr. Lins in his interview for Cannabiscientia. This information shows his clinical experience and is NOT PRESCRIPTIVE.

CBD is not an approved medication for autism and is under investigation. Advice and supervision by a medical specialist are essential in the treatment of autism. Consult your medical specialist before using CBD.

CBD product used

Dr. Lins uses pure isolated CBD oil and pharmaceutical grade broad spectrum CBD.

Dose

When determining the CBD dosage, Dr. Lins adheres to the principle of “start low and go slow“. In the case of children, the initial dose he uses ranges from 15 to 25 mg per day, administered 2 or 3 times daily, depending on the symptoms and age of the patient. The dose is then gradually increased until the desired therapeutic effect is achieved, with minimal side effects.

Duration

Periodic follow-up evaluations are performed every 2 to 3 months to assess progress and adjust the dose if necessary.

Routes of Administration

As for administration, Dr. Lins suggests the use of sublingual CBD, on an empty stomach whenever possible. Alternatively, CBD can be incorporated into food after a meal to mask its taste, depending on the patient’s level of aggressiveness and compliance.

What Controls are Recommended in CBD and Autism?

Dr. Lins recommends monitoring liver enzymes by blood tests at the beginning of treatment and periodically every 6 months. In addition, the evaluation of food allergies and gastrointestinal problems can provide valuable information for the treatment of certain cases.

Conclusions

ASD (Autism Spectrum Disorder) is a complex disorder with an unclear etiology, probably derived from a combination of genetic, environmental and psychological factors. Current treatments focus mainly on improving behavior, sociability and integration in affected children. Pharmacological interventions are often limited by side effects, and are typically focused on the management of comorbidities.

With the approval of medical cannabis, particularly CBD (cannabidiol) based products, in many countries, CBD has emerged as a promising treatment option in numerous cases, backed by the first-hand experiences of physicians such as Dr. Lins. Unfortunately, the lack of clinical studies in larger numbers of patients means that, to date, it is not possible to reach definitive conclusions to recommend CBD in cases of ASD.

Future prospects

Although anecdotal evidence and individual experiences are promising, strong scientific evidence is essential for widespread adoption and integration of CBD-based therapies into routine medical practice.

The Handbook of Principles of Clinical Cannabinology – from which this article is taken – is a resource in this task, as it provides a comprehensive overview of the therapeutic potential of cannabinoids. Whether you are a healthcare professional seeking knowledge about the therapeutic potential of cannabinoids, this handbook offers tools necessary for comprehensive patient care.

Note: This is an informative article based on the latest scientific research. It is not intended to prevent, diagnose or treat any disease. Its contents may complement, but should never replace, any diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines and are intended for external use. The authors and Cannactiva are not responsible for any misuse of this information. Please note that new scientific evidence may become available since the date of publication. Therefore, consult your doctor before using CBD or if you have any doubts about it.

References and further information

1. Zamberletti, E., Gabaglio, M., Parolaro, D., 2017. The endocannabinoid system and autism spectrum disorders: insights from animal models. Int. J. Mol. Sci. 18, 1916.
2. American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association press, Washington, DC
3. Jinan Zeidan, Eric Fombonne, Julie Scorah, et al. Global prevalence of autism: A systematic review update. Autism Res. 2022 May;15(5):778-790.
4. M.C. Flores-Pajot, M. Ofner, M.T. Do, E. Lavigne, P.J. Villeneuve. Childhood autism spectrum disorders and exposure to nitrogen dioxide, and particulate matter air pollution: a review and meta-analysis. Environ. Res., 151 (2016), pp. 763-776.
5. T Gong, C Dalman, S Wicks, et al. Perinatal exposure to traffic-related air pollution and autism spectrum disorders. Environ Health Perspect, 125:119-126
6. Guxens M, Ghassabian A, Gong T, Garcia-Esteban R, et al. Air pollution exposure during pregnancy and childhood autistic traits in four European population-based cohort studies: the ESCAPE Project. Environ Health Perspect 124:133-140;
7. HeeKyoung Chun, Cheryl Leung, Shi Wu Wen, Judy McDonald, Hwashin H Shin. Maternal exposure to air pollution and risk of autism in children: A systematic review and meta-analysis. Environmental Pollution. Volume 256, January 2020, 113307
8. Frédéric Dutheil, Aurélie Comptour, Roxane Morlon, et al. Autism spectrum disorder and air pollution: A systematic review and meta-analysis.Environ Pollut. 2021 Jun 1;278:116856.
9. F Gorini, F Muratori, MA Morales. The role of heavy metal pollution in neurobehavioral disorders: a focus on autism. Review Journal of Autism and Developmental Disorders volume 1, pages 354-372 (2014).
10. Adams, J. B., Audhya, T., McDonough-Means, S., Rubin, R. A., Quig, D., Geis, E., et al. (2012). Toxicological status of children with autism vs. neurotypical children and the association with autism severity. Biological Trace Element Research, 151(2), 171-180.
11. Melissa DeFilippis, Karen Dineen Wagner. Treatment of Autism Spectrum Disorder in Children and Adolescents. Psychopharmacol Bull. 2016 Aug 15; 46(2): 18-41.
12. Adi Aran, Dalit Cayam Rand. Cannabinoid treatment for the symptoms of autism spectrum disorder. Expert Opin Emerg Drugs. 2024 Jan 16:1-15.

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