Effects of CBD-Enriched Cannabis sativa Extract on Autism Spectrum Disorder Symptoms: An Observational Study of 18 Participants Undergoing Compassionate Use

Abstract

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. After 6–9 months of treatment, most patients, including epileptic and non-epileptic, showed some level of improvement in more than one of the eight symptom categories evaluated: Attention Deficit/Hyperactivity Disorder; Behavioral Disorders; Motor Deficits; Autonomy Deficits; Communication and Social Interaction Deficits; Cognitive Deficits; Sleep Disorders and Seizures, with very infrequent and mild adverse effects. The strongest improvements were reported for Seizures, Attention Deficit/Hyperactivity Disorder, Sleep Disorders, and Communication and Social Interaction Deficits. This was especially true for the 10 non-epileptic patients, nine of which presented improvement equal to or above 30% in at least one of the eight categories, six presented improvement of 30% or more in at least two categories and four presented improvement equal to or above 30% in at least four symptom categories. Ten out of the 15 patients were using other medicines, and nine of these were able to keep the improvements even after reducing or withdrawing other medications. The results reported here are very promising and indicate that CBD-enriched CE may ameliorate multiple ASD symptoms even in non-epileptic patients, with substantial increase in life quality for both ASD patients and caretakers.

Endocannabinoid Signaling Contributes to Experience-Induced Increase of Synaptic Release Sites From Parvalbumin Interneurons in Mouse Visual Cortex

“…Unlike other signaling mechanisms that promote PV-IN output, like BDNF for example, cortical CB1 receptors can be readily accessed by small molecules capable of crossing the blood-brain barrier. In this context, it will be of interest to determine whether the beneficial effects of cannabidiol in models of Alzheimer's disease (Aso et al, 2018) and autism spectrum disorder (Fleury-Teixeira et al, 2019) are partly due to an increase in PV-IN release sites.…”

Medical Cannabis in Children

“…[40][41][42][43] Short-term adverse events of pure CBD or CBDrich whole-plant extracts include somnolence, weight loss, and increased liver transaminases. 35,36,[44][45][46][47]…”

“…112 Four uncontrolled case-series, including 60, 188, 53, and 18 children with ASD and severe behavioral problems, reported high tolerability and efficacy of artisanal CBD-rich cannabis strains. [44][45][46][47] In the largest cohort, data collection was partial, and there was also an unknown overlap between the first three January 2020  Volume 11  Issue 1  e0003 cohorts. Most participants were followed for at least 6 months, and the retention rate was about 80%.…”

Little is known about cannabidiol for improving severe behavioral symptoms of autistic spectrum disorder

“…[2][3][4][5][6][7][8][9][10][11] The remaining nine articles consisted of a viewpoint, ethics statement, letter, two studies done on adult populations, and four studies done using cannabis-based products for the treatment of autism related symptoms in children. [12][13][14][15][16][17][18][19][20] The 2019 Schleider et al article was about a prospective study looking at the safety and efficacy of medical cannabis treatment in children with ASD. 17 A CBD:THC solution of 30% to 1.5% was used in 188 children with ASD who had comorbid behavioral symptoms.…”

“…Fleury-Teixeira et al conducted an observational study that looked at the effect on behavioral symptoms in 18 children with ASD after using a cannabis sativa extract (CBD:THC ratio of 75:1) . 18 The authors measured treatment effect via a monthly questionnaire assessing behavioral improvements. This study design is not ideal and the population size is a concern, even though it matches our clinical scenario.…”