THC and CBD for autism

Recently, a study from Israel was published, according to which a cannabis extract with high amounts of CBD and low amounts of THC can alleviate symptoms of autism. It thus confirms experiences from medical practice that cannabis can be used to treat this congenital disorder. Autism is a disorder of perception and information processing. It is already noticeable in childhood.

 Recently, a 22 year old male presented to my practice suffering from Asperger's type autism. The disorder was associated with various secondary symptoms, including sleep disturbances, anxiety with panic attacks, depression, difficulty concentrating, external agitation, bruxism (teeth grinding), tension and pain in the temporomandibular joints, neck and shoulder muscles, and increased sweating. He had been in inpatient psychiatric treatment for one year during childhood without any relevant improvement of the symptoms. He later had good experiences with the use of cannabis for self-medication. The use of cannabis facilitates social interactions and reduces anxiety and panic attacks. It allows him to sleep better, be less depressed and more relaxed.

 People with autism may have alterations in the endocannabinoid system. This may help explain the therapeutic effectiveness of cannabis. For example, researchers at Stanford University in the U.S. have found that two specific mutations promote autism. Both mutations significantly impaired the signaling of the endocannabinoid system. Thus, in November 2013, they wrote in an article for the journal Neuron that "alterations in endocannabinoid signaling may contribute to the pathophysiology of autism." In 2018, they reported that in a comparison of 59 individuals with autism and 53 healthy children, differences in concentrations of the endocannabinoid anandamide precipitated. Children with low anandamide concentrations were more likely to suffer from autism. The authors wrote that "these findings represent the first empirical human data confirming preclinical rodent findings to support an association between plasma anandamide concentrations in children with autism spectrum disorders."

 There are some disorders that can be summarized as brain development disorders. In addition to autism, these include ADHD (attention deficit/hyperactivity disorder), Tourette syndrome, post-traumatic stress disorder, borderline personality disorder, and obsessive-compulsive disorder. It is not uncommon for these disorders to occur together, for example, Tourette syndrome and ADHD, autism and ADHD, or autism and obsessive-compulsive disorder. There is growing evidence that many patients suffering from these disorders may benefit from cannabis-based medications

 An Israeli study of patients treated with a cannabis extract was published in an autism research journal. Scientists at a medical center in Jerusalem had studied the effects of a cannabis extract on 60 autistic children between the ages of 5 and 18. They were given an oral cannabis extract containing CBD and THC in a ratio of 20 to 1. The dose was dosed up to a maximum CBD dose of 10 milligrams per kilogram of body weight and a maximum THC dose of 0.5 milligrams per kilogram of body weight. This corresponds to a daily dose of 500 mg CBD and 25 mg THC for a body weight of 50 kg. After cannabis treatment, behavioral outbursts were significantly or very significantly improved in 61 percent of patients. Anxiety and communication problems were significantly improved in 39 percent and very significantly improved in another 47 percent. Patients suffered less stress. Both CBD and THC were administered at doses that are therapeutic for other conditions. It is therefore unclear whether the effect is due to CBD, to THC, or to both cannabinoids.

Given the limited drug treatment options for autism, the disruption of the endocannabinoid system in affected children, and the initial positive clinical experience with a cannabis extract, a treatment trial is warranted and reasonable.