Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil.
Psychopharmacology (Berl). 2022 Sep;239(9):2713-2734. doi: 10.1007/s00213-022-06196-4. Epub 2022 Jul 29.
Autism spectrum disorder (ASD) is defined as a group of neurodevelopmental disorders whose symptoms include impaired communication and social interaction, restricted and repetitive patterns of behavior, and varying levels of intellectual disability. ASD is observed in early childhood and is one of the most severe chronic childhood disorders in prevalence, morbidity, and impact on society. It is usually accompanied by attention deficit hyperactivity disorder, anxiety, depression, sleep disorders, and epilepsy. The treatment of ASD has low efficacy, possibly because it has a heterogeneous nature, and its neurobiological basis is not clearly understood. Drugs such as risperidone and aripiprazole are the only two drugs available that are recognized by the Food and Drug Administration, primarily for treating the behavioral symptoms of this disorder. These drugs have limited efficacy and a high potential for inducing undesirable effects, compromising treatment adherence. Therefore, there is great interest in exploring the endocannabinoid system, which modulates the activity of other neurotransmitters, has actions in social behavior and seems to be altered in patients with ASD. Thus, cannabidiol (CBD) emerges as a possible strategy for treating ASD symptoms since it has relevant pharmacological actions on the endocannabinoid system and shows promising results in studies related to disorders in the central nervous system.
Review the preclinical and clinical data supporting CBD's potential as a treatment for the symptoms and comorbidities associated with ASD, as well as discuss and provide information with the purpose of not trivializing the use of this drug.
自闭症谱系障碍（ASD）被定义为一组神经发育障碍，其症状包括沟通和社交互动受损、行为受限和重复、以及不同程度的智力残疾。ASD 在儿童早期被观察到，是最严重的慢性儿童疾病之一，在患病率、发病率和对社会的影响方面都很严重。它通常伴有注意力缺陷多动障碍、焦虑、抑郁、睡眠障碍和癫痫。ASD 的治疗效果不佳，可能是因为它具有异质性，其神经生物学基础尚不清楚。利培酮和阿立哌唑等药物是仅有的两种被食品和药物管理局认可的药物，主要用于治疗这种疾病的行为症状。这些药物疗效有限，有引起不良影响的高风险，影响治疗的依从性。因此，人们对探索内源性大麻素系统很感兴趣，该系统调节其他神经递质的活性，在社交行为中起作用，并且似乎在 ASD 患者中发生改变。因此，大麻二酚（CBD）作为治疗 ASD 症状的一种可能策略出现，因为它对内源性大麻素系统具有相关的药理学作用，并且在与中枢神经系统障碍相关的研究中显示出有前景的结果。
综述支持 CBD 作为治疗 ASD 相关症状和共病药物的潜力的临床前和临床数据，并进行讨论和提供信息，目的不是轻视该药物的使用。
