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Cannabidiol: Hope for autistic people?

Dennis N. McGillOctober 23, 2021

Hemp-derived substance has been touted as a possible treatment for ASD

One issue that has come to the fore recently is the possible benefits of hemp and its main non-intoxicating component, cannabidiol (CBD), for people with Autism Spectrum Disorder (ASD). Preliminary studies point to a possible use of CBD to help with a variety of symptoms, from sleep problems to hyperactivity and anger. But first, you need to better understand what cannabidiol is and what science already knows for sure about its use as a medicine.

The plant called Hemp sativa (C. sativa), has more than 100 substances in its composition. The initial scientific interest in the herb was focused on THC, which is the psychoactive element in hemp – the one that makes people feel hallucinations, anxiety, and paranoia. These effects of THC are the main argument used for the prohibition of legalized hemp cultivation, which has always hindered neurobiological research with the plant.

For this reason, for a long time, the approved clinical uses of hemp were limited to a small number of specific conditions, such as treatment for pain in multiple sclerosis and appetite stimulation for AIDS and chemotherapy patients.

Cannabidiol shows potential to treat anxiety, psychosis, and epilepsy

But recently, researchers have turned their attention to cannabidiol (CBD), which is one of the elements of hemp without lysergic effects. The results were encouraging. CBD is the second most abundant substance in hemp – behind only THC – and there is increasing evidence of its potential for treating symptoms of neuropsychiatric disorders, such as addiction, anxiety and psychosis, mobility disorders, and epilepsy.

In the case of studies with cannabidiol in people with autism, the evidence is very positive. A study conducted in October 2019 looked at the effects of hemp sativa extract enriched with pure cannabidiol (CBD) on symptoms of ASD. Fifteen autistic patients adhered to treatment, with 10 being non-epileptic and 5 epileptic. By the ninth month of treatment, most patients in both groups showed some level of improvement in symptoms. The most significant improvements were reported for seizures, ADHD, sleep disturbances, and communication and social interaction deficits.

Other research, from September 2019, looked at how the use of cannabidiol might change a person’s brain activity. To do this, 17 people with ASD and 17 without ASD consumed CBD and underwent an MRI scan. The scans showed that CBD significantly increased activity in some specific brain locations in the participants with ASD, but caused no relevant changes in the people without ASD. These data indicate that CBD has the ability to alter brain activity in regions implicated in TEA.

Scientists have yet to understand the effects of long-term CBD use

A May 2019 publication compared effects of cannabidiol on the brain’s excitation and inhibition systems. To do this, 17 patients with ASD and 17 without ASD underwent magnetic resonance spectroscopy (MRS). In all brain regions studied, cannabidiol increased inhibition in typical people, while autistic people showed less inhibition. This suggests that the inhibition and arousal systems (also called the glutamate-GABA system) of autistics respond in a particular way.

A fourth study, from January 2019, focused on autistic children. The hypothesis tested was the oral use of cannabidiol as an aid in the treatment of ASD symptoms and comorbidities. In all, 53 children between the ages of 4 and 22 received cannabidiol for an average of 66 days. Self-injury and anger attacks improved in 67.6% and worsened in 8.8%. Hyperactivity symptoms improved in 68.4%, did not change in 28.9%, and worsened in 2.6%. Symptoms of sleep problems improved in 71.4% and worsened in 4.7%. Anxiety improved in 47.1% and worsened in 23.5%.

What do these researches reveal to us about cannabidiol and ASD? That the picture is the same as with CBD studies for other conditions: there is encouraging evidence, but scientists still need to go a longer way before a safe remedy is developed.

Most research still covers small groups of people, which does not allow understanding how the substance behaves in different organisms. The possible adverse effects and consequences of long-term use also need to be clarified, as well as exactly how the parts of the brain altered by CBD affect autistic behaviors.

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