A study in "Frontiers in Psychiatry" has found personalized cannabis treatments may improve symptoms and quality of life for patients with autism spectrum disorders, with most participants reporting positive effects from a regimen of CBD and THC oils tailored to their needs. The study's promising results now need larger-scale trials to conclusively determine the effectiveness of cannabis for ASD.
A personalized cannabis usage program may help alleviate symptoms in patients with autism spectrum disorders, according to an August study published by the medical journal “Frontiers in Psychiatry”. Researchers from Brazil analyzed 20 patients with autism who followed a personalized program using either full-spectrum CBD oil, THC oil, or a combination of both. Despite the study’s small size, the majority of patients with autism noted a significant improvement in their individual symptoms and better quality of life for themselves and their families.
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Autism spectrum disorder (ASD) does not have a single or defined cause, but includes a spectrum of symptoms and behaviors that affect development, motor functions, and communication to varying degrees. Typically characterized by difficulties in social relationships, sensory issues, and repetitive behaviors, ASD may also be associated with a high level of co-occurring conditions, including intellectual disabilities, mood disorders, and seizure states.
Although these symptoms and potentially related conditions vary from person to person with ASD, they can make life challenging for individuals with autism and their families. Unfortunately, there are few therapies available that can meet these needs. Some patients report positive experiences with developmental and psychological approaches, such as occupational therapy and cognitive-behavioral therapy, but there are currently no medications directly targeted to patients with ASD.
Some researchers and advocates, based on smaller, earlier studies, have long suggested that cannabis could be a potential therapy for ASD symptoms, partly because a 2019 study found that patients with autism might have lower levels of endocannabinoids. This could suggest a disorder in the endocannabinoid system, a biological cell signaling system that regulates various body functions, which cannabis and its various compounds can stimulate. The endocannabinoid system is responsible for maintaining homeostasis in the body and regulates appetite, pain sensation, emotions, sleep, and the brain’s reward center, among other things.
The results of previous studies have shown that cannabis can reduce the severity of autism symptoms, but methodologies and beneficial outcomes have varied significantly between studies. Both the symptoms of ASD and the chemical composition of cannabis treatments can also vary drastically.
This lack of clarity and consistency prompted the authors of the recent “Frontiers in Psychiatry” study to investigate whether cannabis treatment, specifically tailored to each individual case, could prove more effective.
Researchers from “Frontiers in Psychiatry” in Brazil, who were monitored by an ethical committee at the University of Brasilia, took on the challenge by designing a study for 20 individuals, where each patient received a specific dose of cannabis extract. Patients ranged in age from 4 to 38 years, and the majority were male.
Beginning with a small dose of full-spectrum CBD-rich extract, researchers adjusted each patient’s program in response to their symptoms; most did not consume THC extract during treatment. As the study and treatment progressed, some patients reported improved outcomes after adding full-spectrum THC extract, ultimately finding the most optimal THC to CBD ratios for each participant. The CBD:THC ratios in the administered extracts ranged from 49:1 to 3:1. Once researchers identified the ideal dosage and CBD to THC ratio for each patient, they continued this program for at least 3 months, and in some cases, over 6 months.
After 3 months of personalized cannabis treatment and monitoring, caregivers filled out a detailed survey about the impact cannabis had on each patient’s life, as well as on their families’ lives. The survey included diverse areas relevant to ASD and associated symptoms.
The survey results indicated that the majority of caregivers felt that cannabis treatment generally improved all analyzed symptom categories.
Overall, the quality of life for patients with autism improved in 95% of cases, and the lives of their families reportedly improved in 83% of cases. However, details varied between individuals.
Many caregivers reported improvements in co-occurring conditions and symptoms, such as seizures (84%), emotional outbursts (76%), discomfort in noisy or crowded places (72%), aggression towards others (67%), eating inedible things (63%), excessive craving (62%), and issuing screams and random sounds (54%).
Cannabis also seemed to consistently improve communication-related abilities – 85% of caregivers reported that their charge with autism was more open to direct verbal communication. Additionally, 75% reported an improvement in eye contact and attention during conversation; verbal communication improved in 50% of patients.
Cannabis is often associated with making neurotypical adults distracted and calm. However, intellectual and cognitive performance—sometimes impaired in patients with ASD due to co-occurring intellectual disorders—improved in 57% of cases in this study. The authors highlighted this finding because no other medication directly improved this particular co-occurring condition.
Nevertheless, some patients experienced no change or a worsening of specific symptoms, such as difficulties in making eye contact, paying attention to verbal communication, outbursts of anger, and aggression towards themselves or others. Like any drug, marijuana is not a cure-all, and two out of twenty patients experienced an overall worsening of symptoms, however, 19 out of 20 patients with autism reported an overall improvement in quality of life.
While the results are promising, this study has several limitations, including a small number of participants, lack of a control group, and an open survey that may encourage “wishful thinking” in self-reporting results by patients’ families.
As a result, further research on a larger group of patients is needed to confirm that these results can be applied to a broader spectrum of patients with ASD. Since patients and caregivers knew they were receiving cannabis products, it is also possible that the placebo effect could have influenced some outcomes.
Nonetheless, the study suggests that larger clinical trials with a double-blind (placebo) trial are needed to give us more insight into how marijuana affects patients with autism. Additionally, it sheds light on how different patients may respond better to different dosages and ratios of CBD to THC—and how to approach this challenge clinically. This knowledge could change the way future research on autism and marijuana is conducted and provide more accurate results about its potential benefits.
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(Featured image by Caleb Woods via Unsplash)
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