Bilge Serap, Ekici Barış
Department of Pediatric Neurology, Çukurova Medical School, 01790, Balcalı, Turkey.
Department of Pediatric Neurology, Pediatric Neurology Clinics, Istanbul, Turkey.
J Cannabis Res. 2021 Dec 16;3(1):53. doi: 10.1186/s42238-021-00108-7.
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.
In this study, we aim to share our 2-year experience with CBD-enriched cannabis treatment in autism and review the latest studies.
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%.
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.
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.
自闭症谱系障碍是一种神经发育障碍，其特征为沟通、社交互动、兴趣受限及重复行为方面存在缺陷。尽管诊断出的病例越来越多，但尚无药物被批准用于治疗与自闭症相关的核心症状或认知及行为问题。因此，迫切需要开发一种有效且安全的治疗方法。
在本研究中，我们旨在分享我们在自闭症患者中使用富含大麻二酚（CBD）的大麻治疗的两年经验，并回顾最新研究。
该研究纳入了33名（27名男性，6名女性）在2018年1月至2020年8月期间接受随访的自闭症谱系障碍患儿。平均年龄为7.7±5.5岁。大麻二酚（CBD）的平均日剂量为0.7毫克/千克/天（0.3 - 2毫克/千克/天）。治疗的中位持续时间为6.5个月（3 - 28个月）。本研究中使用的制剂含有全谱CBD和含量低于3%的痕量元素四氢大麻酚（THC）。
基于临床访谈对治疗前后的结果进行评估。在每次随访时，要求家长评估富含CBD的大麻治疗的有效性。根据家长报告，6名（19.35%）患者的日常生活活动无变化。治疗的主要改善情况如下：10名患者（32.2%）报告行为问题减少，7名患者（22.5%）报告表达性语言增加，4名患者（12.9%）报告认知改善，3名患者（9.6%）报告社交互动增加，1名患者（3.2%）报告刻板行为减少。家长报告称，坚持使用富含CBD的大麻治疗两年以上的患者认知有所改善。仅1名表现出轻度自闭症谱系障碍症状的患者能够停用抗精神病药物。其他药物的使用和剂量没有变化。此外，本研究还对关于自闭症谱系障碍中CBD治疗的文献进行了广泛综述。根据最近的研究，CBD的平均剂量为3.8±2.6毫克/千克/天。所用制剂中CBD与THC的比例为20:1。在20% - 70%的患者中报告的行为问题改善最为显著。
使用较低剂量的CBD和痕量THC在管理与自闭症相关的行为问题方面似乎很有前景。此外，这种治疗在管理核心症状和认知功能方面可能有效。与其他研究相比，低剂量富含CBD的大麻未见明显副作用。
