Studies revealed that CBD is a possible alternative to conventional autism treatments, like medications, as it may help reduce common ASD symptoms. Using lower doses of CBD and trace THC seems to be promising in managing behavioral problems associated with autism. In addition, this treatment could be effective in managing the core symptoms and cognitive functions. No significant side effects were seen at the low doses of CBD-enriched cannabis w …
CBD for Autism – August 2022
ASD includes a wide range of mental conditions and has no cure. Communication disabilities, repetitive characteristic behaviors, and social dysfunctions are among the common symptoms of autism (3) .
ASD shares particular symptoms of attention-deficit hyperactivity disorder (ADHD) (4) . However, ASD is a distinct disorder
Research indicated that CBD may relieve ASD symptoms effectively (5) .
Cannabis products such as CBD oils, capsules, and gummies may thus enhance the wellness of people with ASD and serve as possible prescription drug alternatives.
What Is CBD?
CBD is among the chemical compounds known as cannabinoids contained in the cannabis plant. However, it differs from the psychoactive compound tetrahydrocannabinol (THC), which produces mind-altering effects (6) .
Researchers have conducted various studies to examine CBD’s effects on symptoms like chronic pain (7) . CBD’s efficacy may be gauged through various means , such as questionnaires.
A 2016 study conducted by the Shaare Zedek Medical Center examined the efficacy of cannabidiol in children and adolescents with ASD-related behavioral problems (8) .
The study’s subjects did not improve with traditional autism treatments.
The researchers reported that over half the autistic patients experienced significant behavioral improvements.
Furthermore, anxiety issues were reduced by 39%, communication issues decreased by 47%, and disruptive behaviors improved by 29% (9) .
The parents also reported decreased stress levels in managing their children, based on their Autism Parenting Stress Index (APSI) (10) .
The study’s preliminary findings indicated that CBD hemp oil may effectively manage behavioral problems in autistic children.
Meanwhile, in another study, ASD patients administered oral drops of CBD oil, under license from the Israeli Ministry of Health (11) ,
The study’s results after 66 days indicated that participants showed improvement in self-injury symptoms (67.6%), hyperactivity (68.4%), sleep quality (71.4%), and anxiety symptoms (47.1%) (12) .
The researchers also observed that CBD produced mild adverse effects, such as a change in appetite and sleepiness.
Clinical Trials Examining CBD for Autism
Medical researchers, such as those from the University of California San Diego School of Medicine, continue conducting clinical trials on various issues. The research includes whether CBD may reduce the behavioral symptoms of severe ASD (13) .
The primary objective of such clinical trials is to investigate the potential therapeutic benefits provided by CBD for helping manage severe ASD.
In 2018 , the U.S. Food and Drug Administration (FDA) notably approved the prescription solution Epidiolex to treat rare types of epilepsy, including Lennox-Gastaut syndrome and Dravet syndrome (14 ) .
Researchers are studying the effects of CBD on autism symptoms as they include possibly severe behavior problems that may limit a child’s capabilities to learn and socialize (15) .
How CBD Works to Help People With Autism
The endocannabinoid system (ECS) is a network mainly responsible for regulating a wide range of bodily functions . It is believed to have a critical role in managing autism (16) .
The ECS’ effects are primarily expressed through cannabinoid receptors known as CB1 and CB2 receptors (17) .
An ECS study in 2015 showed that endocannabinoid signaling has a crucial role in several human health conditions and diseases within the central nervous system (CNS) (18) .
The researchers reported that the ECS plays a key role in brain development and social reward responsiveness, both critical in the treatment of autism (19) .
In another study with ASD patients, researchers noted that oral CBD use decreased the comorbidities connected to the medical condition (20) .
The most significant improvement s were seen in issues such as rage attacks, self-injury, sleep disorders, hyperactivity, and anxiety.
A 2017 observation study review examined the effects of CBD on ASD animal models (21) . Similar studies have used subjects such as a mouse model.
This study suggested that introducing alterations related to anandamide signaling and the ECS ’ CB1 receptor may respectively improve social skills and cognitive effects in animal models.
Anandamide is an endocannabinoid that helps with inflammation and neuron signaling.
CBD may improve anandamide signaling by plants, inhibiting the enzyme that causes it to degrade, according to a 2012 research report (22) .
These studies and clinical data show that CBD may help relieve ASD symptoms and improve autistic children’s quality of life based on how the cannabinoid interacts with the ECS.
However, these are inconclusive medical studies and clinical data. Additional research is required to validate CBD’s effects on autism and the condition’s symptoms.
Usage of CBD for Autism
These are some key considerations when using CBD to help manage autism symptoms.
CBD and Medical Marijuana
CBD and medicinal cannabis originate from hemp plants and marijuana plants, respectively. CBD is one of the numerous substances in the Cannabis sativa plant that may contain medicinal properties (23) .
The production of CBD oil involves an extraction process, such as CO 2 extraction. Then, it is blended with a carrier oil, such as fractionated coconut oil.
CBD oil is legal in the United States if produced from industrial hemp (24) . Such hemp sources contain under 0.3% of the psychoactive element of the cannabis plant known as THC.
Medical cannabis contains cannabinoids like CBD, although it also contains more THC and is harvested differently (25) . Cannabis treatments through marijuana , which has high amounts of THC, are illegal under U.S. federal laws.
However, numerous states have recently passed laws that made medical marijuana use legal for individuals with a prescription from a doctor.
Benefits of CBD for Autism and Epilepsy
Past research indicate d that autism may connect definitively with the neurological condition epilepsy, which is characterized by recurring seizures.
Research shows that autistic children over 10 are 2.35 times more likely to have epilepsy compared to younger children (26) .
In neurology, such seizures may result from brain development, causing cells and neurons to act abnormally (27) .
CBD oil’s anticonvulsant properties may help individuals with seizures and epilepsy (28) .
Using CBD to Treat Autism-Related Aggression
Based on anecdotal evidence, parents are often concerned about aggressive behavior, physical violence, and fits of rage among their autistic children. Sedation is crucial in such scenarios.
CBD oil serves as an option for parents who seek alternatives to prescription medicines to address their autistic children’s strong emotion s (29) .
More research is required on issues such as cognitive excitation and inhibition to provide scientists with a clearer understanding of how CBD interacts with the brain functionality of a child with autism.
CBD Dosage for Autism
No standard dosages exist for the quantity of cannabis oil that should be administered to an autistic person.
A particular study on CBD labeling revealed no consistent doses among wide-ranging CBD concentrations of CBD products offered online (30) .
A better methodology than the trial and error approach may be to start at a low dosage. Parents can gradually increase their child’s CBD dosage to achieve the desired effects while the substance remains well tolerated.
Another approach is to apply CBD products dependent on a child’s bodyweight and the severity of their autism symptoms.
It is highly suggested to consult a pediatrician or other doctor to recommend the CBD oil dosage ideal for autism.
Prescription Requirement for CBD Oil
A child does not require a prescription to take CBD oil for autism. Rather, a physician can help determine the best CBD oil for meeting an autistic child’s needs.
Health food stores are one location for finding CBD oils for those residing in states without legalized medical marijuana.
Several CBD oil products for autism are available on the market. Thus, it is critical to research a particular brand and read reviews to determine the best CBD product for one’s child.
Administering CBD to Autistic Children: Saf ety , Risks, and Side Effects
Before providing CBD to children with autism spectrum disorder, here are some critical matters to consider:
Preliminary evidence suggest ed that CBD has potential as a treatment option for people with ASD. An example is a comprehensive study performed at Shaare Zedek Medical Center in Jerusalem, Israel, led by Adi Aran, MD (31) .
Aran’s team examined the efficacy, tolerability, and safety of cannabidiol for children with autism-caused behavioral problems.
The study included 60 autistic children who experienced no improvement of their development disorder through traditional ASD treatments (32 ) . The children between the ages of 5 to 17 received oral CBD for their autism.
The study’s preliminary findings suggest ed that hemp oil may effectively manage behavioral problems among children with ASD.
Risks and Side Effects
Past studies indicate d that CBD is a safe chemical compound for children. It may, however, cause side effects, including drowsiness, nausea, vomiting, and diarrhea (33 ) .
In contrast, the common ASD drug r isperidone may produce side effects in rare instances , including drowsiness, weight gain, involuntary movements, and hormonal changes (34) .
Parents must determine whether CBD’s health benefits outweigh the possible side effects. It is always critical to consult a doctor’s advice if one has any questions regarding a child’s medical condition.
Selecting the Best CBD Oil for Autism
Pediatrics and psychiatry professionals and parents of autistic children ought to know how to select an ideal CBD oil for children with autism, related to factors such as the product’s quality.
When selecting a CBD product, key considerations include whether CBD is sourced from the hemp or marijuana plant, which affects the THC content.
For instance, hemp-based CBD oil contains high concentrations of cannabidiol and may additionally contain THC (35) .
Types of CBD
Consumers have three primary options when selecting CBD:
Products such as full-spectrum CBD oil contain the significant chemical compounds in hemp, including permissible amounts of THC, terpenes, and flavonoids (36) . Terpenes are aromatic compounds, while flavonoids are plant pigments.
Scientists believe this variety of CBD oil produces the entourage effect, or synergistic effect (37) .
Products such as broad-spectrum CBD oil contain the same substances as full-spectrum CBD, including terpenes, flavonoids, and other cannabinoids. However, these products typically do not have the psychoactive THC (38) .
Broad-spectrum CBD functions as a viable alternative to CBD products with THC, which some parents prefer their children to avoid.
These products are a form of pure CBD. CBD companies sometimes label these items as high-quality CBD concentrates or crystals and may have a purity as high as 99.99% CBD.
Consumers can also select different forms of CBD, including oral, topical, and vape.
CBD Product Ingredients
It is highly recommended to examine the ingredients of CBD products. This precaution may avoid the intake of ingredients that may trigger allergies or adverse events .
Some options to help prevent such reactions include purchasing CBD products produced from organic hemp plants and lacking genetically modified organisms (non-GMO).
Some CBD forms contain herbals, medium-chain triglyceride (MCT) carrier oils, and flavoring agents.
The most common carrier oils added to CBD products include hempseed oil. This plant-based oil is known to contain significant amounts of linoleic acid (LA) and other fatty acids (39) .
Safety and Reliability
Here are some considerations when selecting CBD products:
Independent lab testing : Options include third-party lab tests and certificates of analysis (C o A). Such documents indicate if a third-party laboratory has used, tested, and validated a CBD product.
Drug interactions : Consult with medical practitioners such as pediatricians and dermatologists to learn about any prescription drugs with which CBD may interact or interfere.
Past research : Review studies in journals like NeuroSci , pharmacology journals, and databases like PubMed. Some of the primary study methodologies used in CBD research include double-blind, feasibility, retrospective, or observational stu dies .
Examine factors such as the effects of the CBD in contrast with the control group’s placebo and whether the study established a baseline for subsequent research.
State-based restrictions : While the Farm Bill legalized CBD on the federal level, it is critical to learn of possible stipulations related to CBD use to prevent possible legal issues.
Customer reviews : Perusing multiple reviews can provide an overview of a particular CBD brand or product. Reviews from “verified” purchases tend to be more objective.
Product disclaimers : Read the se before taking any CBD product. This step is essential to help select the most suitable product for people with ASD.
CBD product labeling : Determine if any additives are included in the product. Some may produce adverse effects on ASD patients.
What Is Autism and How Is It Treated Conventionally?
Autism refers to a range of mental conditions characterized by difficulties in speech, repetitive behaviors, and social skills (40) .
ASD symptoms are present in children between 2 to 3 years old, although scientists may detect the disorder as early as 18 months (41) .
People with ASD may also exhibit symptoms, such as attention deficits, with a different range or severity than others. This characteristic explains why autism is a “spectrum” of disorders.
Consequently, some people with ASD need little help conducting activities daily , while others require assistance.
The most common behavioral symptoms of the developmental disability include communication disabilit ies , repetitive characteristic behaviors, and impairments in social interaction (42) .
Children with autism experience difficulty interacting with others socially and being aware of other people’s feelings (43) .
They also may be unable to observe and respond to other people’s nonverbal communication or may misinterpret nonverbal communication (44) .
Autistic people may also exhibit sleep problems or dietary issues.
During the last 20 years, autism spectrum disorder has risen among American children (45) .
A study by the American Academy of Pediatrics indicated that 1 in 40 children in the United States is affected by autism (46) .
One factor associated with the increased risk of autism is pregnant women’s use of antidepressants (47) .
In 1980, the DSM (Diagnostic and Statistical Manual of Mental Disorders) added autism. This classification change caused the rates of diagnosis to rise (48 ) .
Conventional Autism Treatments
The variety of treatments that healthcare professionals prescribe for autistic children is significantly based on the individual’s needs.
ASD is a spectrum condition. Thus, each child’s treatment approach is unique and depends on the patient’s behavioral symptoms (49) . Such symptoms may range from mild to severe.
Doctors often prescribe antipsychotics, medications used to manage hallucinations and psychosis, to treat certain symptoms of autism (50) .
These medications may be prescribed to manage irritability and related behaviors, such as aggression and self-injury (51) .
Risperidone or Risperdal is the first prescription drug that the U.S. FDA approved to treat autism-related irritability (52) .
Furthermore, a pplied b ehavioral a nalysis (ABA) is the more frequently used ASD treatment. However, some medical experts and caregivers of ASD patients have questioned the drug’s effectiveness.
Ari Ne’eman started the Autistic Self Advocacy Network and is the former chairperson of the National Council on Disability (NCD) (53) .
Ne’eman is an autistic person and argues that ABA uses a predatory approach by eliciting the message that parents of autistic children should exclusively work with an ABA provider.
In addition, the common ASD medication r isperidone may cause various side effects, including drowsiness, weight gain, anxiety, restlessness, stomach pain, and nausea (54) .
According to experts, not all individuals respond to the medication as it fail ed to improve many core issues connected to autism (55) .
CBD offers an alternative option for families with ASD due to its purported health benefits (56) .
Legality of CBD
The U.S. Congress passed the Agricultural Improvement Act or Farm Bill in 2018. This legislation legalized industrial hemp on the federal level.
The FDA classifies hemp as a cannabis plant with less than 0.3% THC (57) . Meanwhile, if a cannabis plant contains over 0.3% THC , it is instead classified as marijuana.
THC is the psychoactive compound contained in marijuana and some cannabis extracts. Meanwhile, the lower THC levels of the hemp plant do not induce the same mind-altering effect as in marijuana.
Consumers may be confused regarding the legality of CBD fo r medical use as the compound can be derived from marijuana or hemp plants.
Parents of children with autism should research applicable state and local laws regarding the use of CBD .
It is estimated that 2.5% of American children are autistic, while the mental health issue’s prevalence has reportedly risen over the past two decades (58) .
An increasing number of parents and medical professionals are seeking alternatives to prescription medications and behavior-focused therapies (59) .
Studies revealed that cannabidiol is a possible alternative to conventional autism treatments , like medications and interventions, as it may help reduce common symptoms of ASD (60) .
A 2019 study led by Lihi Bar-Lev Schleider researched the use of CBD oil as autism treatment (61) . The researchers reported that CBD was generally well tolerated and may be effective in relieving ASD symptoms.
Consulting with a physician experienced in cannabis use is recommended before taking CBD products .
CBD-enriched cannabis for autism spectrum disorder: an experience of a single center in Turkey and reviews of the literature
Introduction: Autism spectrum disorder is a neurodevelopmental disorder characterized by deficits in communication, social interaction, restricted interest, and repetitive behaviors. Although more cases are being diagnosed, no drugs are approved to treat the core symptoms or cognitive and behavioral problems associated with autism. Therefore, there is an urgent need to develop an effective and safe treatment.
Objective: In this study, we aim to share our 2-year experience with CBD-enriched cannabis treatment in autism and review the latest studies.
Materials and methods: 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%.
Results: 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%). The parents reported improvement in cognition among patients who adhered to CBD-enriched cannabis treatment for over two years. The antipsychotic drug could be stopped only in one patient who showed mild ASD symptoms. No change could be made in other drug use and doses. Additionally, this study includes an extensive review of the literature regarding CBD treatment in autism spectrum disorder. According to recent studies, the average dose of CBD was 3.8±2.6 mg/kg/day. The ratio of CBD to THC in the used preparations was 20:1. The most significant improvements were seen in the behavioral problems reported in 20-70% of the patients.
Conclusion: Using lower doses of CBD and trace THC seems to be promising in managing behavioral problems associated with autism. In addition, this treatment could be effective in managing the core symptoms and cognitive functions. No significant side effects were seen at the low doses of CBD-enriched cannabis when compared to other studies.
Keywords: Autism spectrum disorder; Cannabidiol; Cannabis.