Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel.
Israel School of Medicine, Hebrew university of Jerusalem, Jerusalem, Israel.
Expert Opin Emerg Drugs. 2024 Mar;29(1):65-79. doi: 10.1080/14728214.2024.2306290. Epub 2024 Jan 23.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting approximately 3% of school-age children. The core symptoms are deficits in social communication and restricted and repetitive patterns of behavior. Associated problems in cognition, language, behavior, sleep and mood are prevalent. Currently, no established pharmacological treatment exists for core ASD symptoms. Risperidone and aripiprazole are used to manage associated irritability, but their effectiveness is limited and adverse events are common.
This mini-review summarizes existing scientific literature and ongoing clinical trials concerning cannabinoid treatment for ASD. Uncontrolled case series have documented improvements in both core ASD symptoms and related behavioral challenges in children treated with cannabis extracts rich in cannabidiol (CBD). Placebo-controlled studies involving CBD-rich cannabis extracts and/or pure CBD in children with ASD have demonstrated mixed efficacy results. A similar outcome was observed in a placebo-controlled study of pure CBD addressing social avoidance in Fragile X syndrome. Importantly, these studies have shown relatively high safety and tolerability.
While current clinical data suggest the potential of CBD and CBD-rich cannabis extract in managing core and behavioral deficits in ASD, it is prudent to await the results of ongoing placebo-controlled trials before considering CBD treatment for ASD.
自闭症谱系障碍(ASD)是一种影响大约 3%学龄儿童的神经发育障碍。其核心症状是社交沟通障碍和受限及重复的行为模式。认知、语言、行为、睡眠和情绪相关问题普遍存在。目前,针对 ASD 的核心症状尚无既定的药物治疗方法。利培酮和阿立哌唑用于治疗相关的易激惹,但疗效有限,且常见不良反应。
本迷你综述总结了有关大麻素治疗 ASD 的现有科学文献和正在进行的临床试验。非对照病例系列研究记录了富含大麻二酚(CBD)的大麻提取物治疗儿童 ASD 后,核心 ASD 症状和相关行为挑战均有改善。涉及 ASD 儿童的富含 CBD 的大麻提取物和/或纯 CBD 的安慰剂对照研究显示出混合的疗效结果。一项针对脆性 X 综合征社交回避的纯 CBD 安慰剂对照研究也观察到了类似的结果。重要的是,这些研究显示出相对较高的安全性和耐受性。
虽然目前的临床数据表明 CBD 和富含 CBD 的大麻提取物在治疗 ASD 的核心和行为缺陷方面具有潜力,但在考虑 CBD 治疗 ASD 之前,应等待正在进行的安慰剂对照试验的结果。