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.
Israeli study gives encouragement, and guidance, to cannabis-for-autism efforts
Scientists say their work may cause a pivot in research, as it suggests THC is the more promising cannabinoid than CBD
Nathan Jeffay is The Times of Israel’s health and science correspondent
Israeli scientists are reporting they have made autistic mice more sociable and less obsessive by giving them cannabis products.
The study could change the direction of efforts to use cannabis to treat the disorder, the researchers say, as it suggests that the wrong compound from the plant is currently the subject of the most focus.
Autistic patients who are informally self-prescribing, and trials currently underway, mostly use cannabidiol (CBD), the cannabis compound famous for mostly avoiding the high.
An Israeli study in 2019 reported positive results for autistic patients treated with cannabis products that were mostly CBD.
The latest study to examine CBD is taking place at the Center for Medicinal Cannabis Research of UC-San Diego. On Sunday CNN ran an interview with a mother who said she is “getting my boy back” thanks to CBD.
However, after studying large numbers of autistic mice, Tel Aviv University researchers concluded that another compound, tetrahydrocannabinol (THC), which does cause highs, may be far more effective.
“Studies that are underway mostly don’t focus enough on the details of what it is in the cannabis that may be helping people,” researcher Shani Poleg told The Times of Israel. “In our study, we looked at the details, and came up with surprising and interesting findings.
“THC was more effective. The main difference was that THC treatment also improved social behavior, not only repetitive compulsive behavior.” CBD mostly helped the mice in the study just to deal with repetitive compulsive behavior.
She said that while THC causes highs, the research suggested that the amount of the compound needed to deliver results are small. “Our study shows that when treating autism with medicinal cannabis oil there is no need for high contents of either CBD or THC,” she said.
“We observed significant improvement in behavioral tests following treatments with cannabis oil containing small amounts of THC and observed no long-term effects in cognitive or emotional tests conducted a month and a half after the treatment began.”
Discussing why cannabis products may have benefits she said: “According to the prevailing theory, autism involves over-arousal of the brain, which causes compulsive behavior. In the lab, in addition to the behavioral results, we saw a significant decrease in the concentration of the arousing neurotransmitter glutamate in the spinal fluid, which can explain the reduction in behavioral symptoms.”
Poleg stressed that the research, supervised by Prof. Daniel Offen and recently peer-reviewed and published in the journal Translational Psychology, is preliminary and shouldn’t be considered treatment advice.
She also noted that the mutation that caused autism in her mice, Shank3, is only responsible for a small minority of human autism cases. “But we hope that this may have the effect of both encouraging further exploration of medical cannabis use for autism, and lead to a better type of cannabis being used,” she said.
If so, we have a request.
Every day, our journalists aim to keep you abreast of the most important developments that merit your attention. Millions of people rely on ToI for fast, fair and free coverage of Israel and the Jewish world.
We care about Israel – and we know you do too. So today, we have an ask: show your appreciation for our work by joining The Times of Israel Community, an exclusive group for readers like you who appreciate and financially support our work.
We’re really pleased that you’ve read X Times of Israel articles in the past month.
That’s why we started the Times of Israel ten years ago – to provide discerning readers like you with must-read coverage of Israel and the Jewish world.
So now we have a request. Unlike other news outlets, we haven’t put up a paywall. But as the journalism we do is costly, we invite readers for whom The Times of Israel has become important to help support our work by joining The Times of Israel Community.
For as little as $6 a month you can help support our quality journalism while enjoying The Times of Israel AD-FREE, as well as accessing exclusive content available only to Times of Israel Community members.
David Horovitz, Founding Editor of The Times of Israel
Medical cannabis oil shows promise as an effective treatment for autism
TEL AVIV, Israel — Medical cannabis oil could become a new treatment for patients with autism, according to a new study. Researchers at Tel Aviv University say it successfully improved behavioral and biochemical symptoms among animals with the condition.
Autism is a neurodevelopmental disease which generally leads to social deficiencies and compulsive behavior. Estimates show that one in 44 children in the United States have the condition and previous studies point to that number skyrocketing over the last two decades. These cases can range from mild to severe, with the cause of autism being either genetic or environmental.
Study authors say about one percent of all autism cases are due to a mutation in the Shank3 gene. Instead of examining humans, the team decided to first study animals with this mutation — seeing how they react to receiving medicinal cannabis oil.
“We saw that cannabis oil has a favorable effect on compulsive and anxious behaviors in model animals,” says study author Shani Poleg in a university release. “According to the prevailing theory, autism involves over arousal of the brain which causes compulsive behavior. In the lab, in addition to the behavioral results, we saw a significant decrease in the concentration of the arousing neurotransmitter glutamate in the spinal fluid – which can explain the reduction in behavioral symptoms.”
THC is the key
Researchers add that what makes cannabis oil so effective at easing the symptoms of autism is THC — the main psychoactive ingredient in marijuana. THC (or Tetrahydrocannabinol) is what gives recreational users the well-known “high” feeling.
“Clinical trials testing cannabis treatments for autism usually involve strains containing very large amounts of CBD – due to this substance’s anti-inflammatory properties, and because it does not produce a sense of euphoria,” Poleg explains. “Moreover, the strains used for treating autism usually contain very little THC, due to apprehension regarding both the euphoria and possible long-term effects.”
‘CBD alone has no impact’
“In the second stage of our study we inquired which active substance in cannabis causes the behavioral improvement, and were surprised to discover that treatment with cannabis oil that contains THC but does not contain CBD produces equal or even better effects – both behavioral and biochemical. Moreover, our results suggest that CBD alone has no impact on the behavior of model animals,” the study author continues.
CBD, the non-psychoactive ingredient in cannabis, is an increasingly popular product due to its reported health benefits. Previous studies point to it being an effective pain reliever and even a cancer-fighter.
“Since cannabis is not defined as a medication, trials have already been conducted in children and adolescents with autism – without any preliminary studies addressing issues like the effect of cannabis on biochemical processes in the brain, spinal fluid or blood, and who can benefit from which type of cannabis oil. There is a great deal of misinformation on the subject of medicinal cannabis and autism, and Shani Peleg’s doctoral project represents pioneering basic research with regard to treating autism with cannabis oil,” adds Prof. Daniel Offen.
“This is an initial study,” concludes Poleg. “But we hope that through our basic research we will be able to improve clinical treatments. Our study shows that when treating autism with medicinal cannabis oil there is no need for high contents of either CBD or THC. We observed significant improvement in behavioral tests following treatments with cannabis oil containing small amounts of THC and observed no long-term effects in cognitive or emotional tests conducted a month and a half after the treatment began.”