Severe and moderate autism spectrum disorder: serial cases treated with combined usage of Cannabidiol and Tetrahydrocannabinol, in a university hospital

Background: 15 patients diagnosed with autism spectrum disorder (ASD) from a neurodevelopment outpatient clinic in combined use of Cannabidiol (CBD) and Tetrahydrocannabinol (THC), in 100 mg/ml CBD concentration and 3 mg/ml of THC, with initial dosage of 1 mg/kg/day and maximum of 5 mg/kg/day for a six-month period. The patients were all non-syndromic, without epilepsy, and with ASD level 2 or 3, with or without associated intellectual deficiency.

Objective: The parameters analyzed prior and after treatment were aggressiveness, social cognition, learning capabilities, language, sleep, appetite, and collateral effects, through clinical evaluation, neuropsychological testing, and questionnaire answered by the parents.

Methods: Level 2 and 3 ASD patients present a higher degree of compromise in their social cognition and communication, with more disruptive behaviors (self-injury, Hetero-Aggressiveness) and higher inflexibility of repetitive and/or restrictive interests. Out of the 15 patients selected, 13 were male and 2 were female; 12 were ASD Level 2 and 3 were Level 3. The average age was 11,1 years old.

Results: Among the evaluated patients, 12 (80%) showcased improvement in their social cognition, with higher frequency of eye contact; 10 (66%) had less aggressiveness, both Hetero-Aggressiveness and self-injury; 10 (66%) presented a higher degree of interest in communication and language usage, both receptive and expressive; 7 (46%) demonstrated better learning capabilities. Regarding the appetite: 7 showcased enhanced food selectivity behavior, though 4 (53%) of them got better; out of the 6 that previously had overeating disorders, 4 (66%) demonstrated some improvement in regulating their appetite. All the 3 patients that previously had sleeping disorders showed improvement. Regarding collateral effects, one patient initially had nausea and vomiting, which later stopped; another patient had an increase in their overeating disorder habits.

Conclusions: This work brings to light therapeutic possibilities in the management of more severe ASD cases, since it is common that, in spite of commonly requiring the use of several drugs, many patients remain with a high number of maladaptive behaviors. Even with the reduced sample size, this research contributes by demonstrating the treatment used presented an improvement in social-related symptoms, such as eye contact and communication interest, which is the main concern of this disorder, and that other therapeutic options did not tackle as efficiently.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
18 September 2023