Autismo/Síndrome de Asperger

Autism & Asperger Syndrome (AS) and Medical Cannabis

Definition

Autism is thought to exist on a spectrum to some extent, although all types of autism, whether “low” or “high” functioning, seem to have one particular symptom in common: extreme sensitivity to external stimuli. Some find ways to manage this, whilst others sadly do not. Whilst some delineate between the conditions “Autism” and “Asperger Syndrome”, many have incorporated the once-separate (often considered a sub-type) “Asperger’s” or “Asperger Syndrome” into “Autism”.

Potential Efficacy / Quality of Evidence (Low, Average, High) of Medical Marijuana for Autism & Asperger’s Syndrome

Average

Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help

• THC may help increase anandamide production.
• CBD may help manage autism as well, in particular managing mood.
• A combination of CBD, THC, CBDA and THCA may be helpful.
• CBD:THC 20:1; CBD:THC 1:1

Medical Cannabis Pros

• Cannabis is an anxiolytic, easing the stress of overstimulation as well as social interaction and preventing the likelihood of repetitive or self-injurious behavior.
• Could cannabis help synesthesia be more pleasurable/tolerable?
• Could help reduce or replace the need for antidepressants, antipsychotics and stimulants, many of which are not best taken together in the first instance.
• Cannabis may help regulate synapse signalling problems in autistics, in particular anandamide signalling.
• Blocking CB1 receptors can relieve seizures, memory issues, anxiety and other problems associated with Fragile X Syndrome.
• There is some suggestion that those with autism have an awry default mode network (DMN). The default mode network (DMN) is a network of interacting brain regions that is active when a person is not focused on the outside world, measurable with the fMRI technique. Could cannabinoids help reset the DMN to some extent? You can read more about the default mode network and its relationship to conditions like PTSD, depression and addiction here.
• High doses of CBD may help prevent overstimulation and have sedating effects.
• THC and THCA may help prevent overstimulation and seizures.
• Reduce the need to rely on the anti-psychotic, risperidone which can treat aggressive behavior but can have severe side-effects.

Medical Cannabis Cons

• Large amounts of THC may increase anxiety in some.
• May also induce “over-stimulation” of the senses.
• The right cannabinoid-terpenoid profile must be used, or cannabinoids may prove ineffective. Often, a mixture of both THC and CBD is ideal.
• Too little CBD may be overstimulating, as CBD can indirectly antagonize CB1 receptors in low doses. Higher doses of CBD may be needed.
• Little evidence of cannabis’ efficacy for high-functioning autism, although there may still be some benefits.

More About the Condition

Autism can cause sensory processing difficulties as it alters how nerve cells and synapses connect and organize. There is some evidence to suggest that those with autism are more likely to experience synesthesia, suggesting that there is definitely both an extreme sensitivity to light, taste, touch and sound and a “crossing” or “joining” of the senses to some degree. However, autism is also characterized by impaired social interaction and communication, as well as restricted and repetitive behavior. Extreme anxiety and an inability to easily understand others is also a symptom of autism.

Cannabis may help for autism in several regards. One, cannabis could help regulate synapse signalling in those with autism. There are mutations of the protein neuroligin-3 found in those with autism, which can interfere with endocannabinoid signalling in the brain.

Two, CBD could possibly help modulate the immune system, which is found to be dysregulated in those with autism. Those with autism also seem shifts in their gut microbiota, and are prone to IBS. Again, cannabis could help treat these symptoms.

Three, those with autism are often prescribed a mixture of antidepressants, antipsychotics (e.g. risperidone, aripiprazole) and stimulants. These all have a significant number of side-effects when compared to cannabinoid-based medications, and could be reduced or replaced.

Four, cannabinoids may help improve the mood and reduce anxiety. So there are several ways in which cannabis can help with autism – more research is needed to see how and in what way, precisely.

Quotes from Experts

“There has been a dramatic increase in the number of children diagnosed with autism spectrum disorders (ASD) worldwide. Recently anecdotal evidence of possible therapeutic effects of cannabis products has emerged. The aim of this study is to characterize the epidemiology of ASD patients receiving medical cannabis treatment and to describe its safety and efficacy. We analysed the data prospectively collected as part of the treatment program of 188 ASD patients treated with medical cannabis between 2015 and 2017. The treatment in majority of the patients was based on cannabis oil containing 30% CBD and 1.5% THC. Symptoms inventory, patient global assessment and side effects at 6 months were primary outcomes of interest and were assessed by structured questionnaires. After six months of treatment 82.4% of patients (155) were in active treatment and 60.0% (93) have been assessed; 28 patients (30.1%) reported a significant improvement, 50 (53.7%) moderate, 6 (6.4%) slight and 8 (8.6%) had no change in their condition. Twenty-three patients (25.2%) experienced at least one side effect; the most common was restlessness (6.6%). Cannabis in ASD patients appears to be well tolerated, safe and effective option to relieve symptoms associated with ASD.” Source: Bar-Lev Schleider, Lihi et al. ‘Real life Experience of Medical Cannabis Treatment in Autism: Analysis of Safety and Efficacy‘ Scientific reports vol. 9,1 200. 17 Jan. 2019, doi:10.1038/s41598-018-37570-y

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