Abstract
Anecdotal evidence of successful cannabis treatment in autism spectrum disorder (ASD) are accumulating but clinical studies are lacking. This retrospective study assessed tolerability and efficacy of cannabidiol-rich cannabis, in 60 children with ASD and severe behavioral problems (age = 11.8 ± 3.5, range 5.0–17.5; 77% low functioning; 83% boys). Efficacy was assessed using the Caregiver Global Impression of Change scale. Adverse events included sleep disturbances (14%) irritability (9%) and loss of appetite (9%). One girl who used higher tetrahydrocannabinol had a transient serious psychotic event which required treatment with an antipsychotic. Following the cannabis treatment, behavioral outbreaks were much improved or very much improved in 61% of patients. This preliminary study supports feasibility of CBD-based cannabis trials in children with ASD.
References
Adler, B. A., Wink, L. K., Early, M., Shaffer, R., Minshawi, N., McDougle, C. J., et al. (2015). Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: A chart review study. Autism, 19(1), 102–106. https://doi.org/10.1177/1362361314524641.
Ballaban-Gil, K., & Tuchman, R. (2000). Epilepsy and epileptiform EEG: Association with autism and language disorders. Mental Retardation and Developmental Disabilities Research Reviews, 6(4), 300–308, https://doi.org/10.1002/1098-2779(2000)6:4%3C300::aid-mrdd9%3E3.0.co;2-r.
Campos, A. C., Fogaca, M. V., Scarante, F. F., Joca, S. R. L., Sales, A. J., Gomes, F. V., et al. (2017). Plastic and neuroprotective mechanisms involved in the therapeutic effects of cannabidiol in psychiatric disorders. Frontiers in Pharmacology, 8, 269. https://doi.org/10.3389/fphar.2017.00269.
Chakrabarti, B., & Baron-Cohen, S. (2011). Variation in the human cannabinoid receptor CNR1 gene modulates gaze duration for happy faces. Molecular Autism, 2(1), 10. https://doi.org/10.1186/2040-2392-2-10.
Devinsky, O., Cross, J. H., Laux, L., Marsh, E., Miller, I., Nabbout, R., et al. (2017). Trial of Cannabidiol for drug-resistant seizures in the dravet syndrome. The New England Journal of Medicine, 376(21), 2011–2020. https://doi.org/10.1056/NEJMoa1611618.
Devinsky, O., Patel, A. D., Cross, J. H., Villanueva, V., Wirrell, E. C., Privitera, M., et al. (2018). Effect of Cannabidiol on drop seizures in the lennox-gastaut syndrome. The New England Journal of Medicine, 378(20), 1888–1897. https://doi.org/10.1056/NEJMoa1714631.
Gururajan, A., Taylor, D. A., & Malone, D. T. (2012). Cannabidiol and clozapine reverse MK-801-induced deficits in social interaction and hyperactivity in Sprague-Dawley rats. The Journal of Psychopharmacology, 26(10), 1317–1332. https://doi.org/10.1177/0269881112441865.
Hofer, J., Hoffmann, F., & Bachmann, C. (2017). Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review. Autism, 21(4), 387–402. https://doi.org/10.1177/1362361316646559.
Kaplan, J. S., Stella, N., Catterall, W. A., & Westenbroek, R. E. (2017). Cannabidiol attenuates seizures and social deficits in a mouse model of Dravet syndrome. Proceedings of the National Academy of Sciences of the United States of America, 114(42), 11229–11234. https://doi.org/10.1073/pnas.1711351114.
Karhson, D. S., Krasinska, K. M., Dallaire, J. A., Libove, R. A., Phillips, J. M., Chien, A. S., et al. (2018). Plasma anandamide concentrations are lower in children with autism spectrum disorder. Molecular Autism, 9, 18. https://doi.org/10.1186/s13229-018-0203-y.
King, B. H., Dukes, K., Donnelly, C. L., Sikich, L., McCracken, J. T., Scahill, L., et al. (2013). Baseline factors predicting placebo response to treatment in children and adolescents with autism spectrum disorders: A multisite randomized clinical trial. JAMA Pediatrics, 167(11), 1045–1052. https://doi.org/10.1001/jamapediatrics.2013.2698.
Lee, B. H., Smith, T., & Paciorkowski, A. R. (2015). Autism spectrum disorder and epilepsy: Disorders with a shared biology. Epilepsy & Behavior, 47, 191–201. https://doi.org/10.1016/j.yebeh.2015.03.017.
Maskey, M., Warnell, F., Parr, J. R., Le Couteur, A., & McConachie, H. (2013). Emotional and behavioural problems in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(4), 851–859. https://doi.org/10.1007/s10803-012-1622-9.
Rosenberg, E. C., Patra, P. H., & Whalley, B. J. (2017). Therapeutic effects of cannabinoids in animal models of seizures, epilepsy, epileptogenesis, and epilepsy-related neuroprotection. Epilepsy & Behavior, 70(Pt B), 319–327. https://doi.org/10.1016/j.yebeh.2016.11.006.
Thiele, E. A., Marsh, E. D., French, J. A., Mazurkiewicz-Beldzinska, M., Benbadis, S. R., Joshi, C., et al. (2018). Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): A randomised, double-blind, placebo-controlled phase 3 trial. Lancet, 391(10125), 1085–1096. https://doi.org/10.1016/s0140-6736(18)30136-3.
Zamberletti, E., Gabaglio, M., & Parolaro, D. (2017). The endocannabinoid system and autism spectrum disorders: Insights from animal models. International Journal of Molecular Sciences. https://doi.org/10.3390/ijms18091916.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Author information
Authors and Affiliations
Contributions
AA: Study conception and design; acquisition, analysis and interpretation of data; drafted manuscript; critically revised manuscript and gave final approval. CH and LA: Study conception; interpretation of data; critically revised manuscript and gave final approval. WN: Study design; acquisition of data; critically revised manuscript and gave final approval. EH: Study design; acquisition, analysis and interpretation of data; drafted manuscript; critically revised manuscript and gave final approval.
Corresponding author
Ethics declarations
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Aran, A., Cassuto, H., Lubotzky, A. et al. Brief Report: Cannabidiol-Rich Cannabis in Children with Autism Spectrum Disorder and Severe Behavioral Problems—A Retrospective Feasibility Study. J Autism Dev Disord 49, 1284–1288 (2019). https://doi.org/10.1007/s10803-018-3808-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-018-3808-2