MD Undergraduate Program, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Paediatrics, BC Children's Hospital/University of British Columbia, Vancouver, British Columbia, Canada.
Child Care Health Dev. 2022 Jan;48(1):33-44. doi: 10.1111/cch.12909. Epub 2021 Aug 31.
Autism spectrum disorder (ASD) is a neurodevelopmental condition estimated to affect 1 in 66 children in Canada and 1 in 270 individuals worldwide. As effective therapies for the management of ASD core and associated symptoms are limited, parents are increasingly turning to clinicians for advice regarding the use of medicinal cannabis to manage behavioural disturbances.
The objective of this scoping review was to identify and map symptoms, outcomes and adverse events related to medicinal cannabis treatment for ASD-related behaviours.
Ovid MEDLINE, Embase, CINAHL, PsycInfo, Web of Science Core Collection, Google Scholar and grey literature sources were searched up to 5 January 2020 for studies. Included studies met the following criteria: (1) investigate the use of medicinal cannabis, (2) at least 50% participants had ASD, (3) at least 50% of the study population was 0-18 years old and (4) any study design (published or unpublished).
We identified eight completed and five ongoing studies meeting the inclusion criteria. All studies reported substantial behaviour and symptom improvement on medicinal cannabis, with 61% to 93% of subjects showing benefit. In the three studies reporting on concomitant psychotropic medication usage and with cannabis use, up to 80% of participants observed a reduction in concurrent medication use. Adverse events related to cannabis use were reported in up to 27% of participants related, and two participants had psychotic events.
Early reports regarding medicinal cannabis in paediatric ASD symptom management are presented as positive; the evidence, however, is limited to very few retrospective cohort and observational studies. Evidence of safety and efficacy from prospective clinical trials is needed.
自闭症谱系障碍（ASD）是一种神经发育障碍，据估计，在加拿大每 66 名儿童中就有 1 名受到影响，在全球范围内，每 270 人中就有 1 名受到影响。由于针对 ASD 核心症状和相关症状的有效治疗方法有限，因此越来越多的父母向临床医生寻求有关使用药用大麻来管理行为障碍的建议。
本次范围综述的目的是确定和绘制与治疗 ASD 相关行为的药用大麻治疗相关症状、结果和不良事件。
检索了 Ovid MEDLINE、Embase、CINAHL、PsycInfo、Web of Science 核心合集、Google Scholar 和灰色文献来源，以获取截至 2020 年 1 月 5 日的研究。纳入的研究符合以下标准：（1）调查药用大麻的使用情况，（2）至少 50%的参与者患有 ASD，（3）至少 50%的研究人群年龄在 0-18 岁之间，以及（4）任何研究设计（已发表或未发表）。
我们确定了 8 项已完成的研究和 5 项正在进行的研究符合纳入标准。所有研究均报告了药用大麻在行为和症状方面的显著改善，61%至 93%的患者受益。在三项报告同时使用精神药物和大麻的研究中，多达 80%的参与者观察到同时使用药物的减少。高达 27%的参与者报告了与大麻使用相关的不良事件，有两名参与者出现了精神病事件。
早期关于儿科 ASD 症状管理中药用大麻的报告结果为阳性；然而，证据仅限于极少数回顾性队列和观察性研究。需要来自前瞻性临床试验的安全性和疗效证据。
