CANNABIS IN THE TREATMENT OF AUTISM

WHAT IS AUTISM?

Definition of Autism

Autism is a complex, multidimensional developmental disorder that affects the normal development of the brain, particularly in the areas of social and communication skills. Autism Spectrum Disorder (ASD) is a condition that impacts an individual’s behavior, communication, and interaction with others. The autism spectrum ranges widely, from mild symptoms to more severe issues that significantly affect daily life. People living with autism often struggle to understand social situations and communication cues, making it difficult for them to form and maintain relationships.

Symptoms of Autism

Behavioral Challenges

Autism symptoms vary widely, but generally include the following behavioral challenges:

Difficulty in social interactions: People with autism often have trouble understanding social situations and interacting with others.

Communication difficulties: Autistic children and adults often struggle with verbal and nonverbal communication, such as maintaining eye contact or comprehending speech.

Behavioral stereotypes: Repetitive movements, like hand-flapping or rocking, are common among those with autism spectrum disorder.

Sensory sensitivity: People with autism are often hypersensitive to certain sounds, lights, or touches.

Cognitive challenges: Symptoms of autism can include learning difficulties and a lack of problem-solving skills.

Autism symptoms typically appear in early childhood, and in most cases, affected individuals require some level of support and treatment. Early diagnosis and appropriate interventions can significantly improve the quality of life and developmental outlook for children living with autism.

Causes of Autism

Most research indicates genetic causes for the development of autism, though this is debated by some. According to a 2010 study published in Autism Research, the likelihood of a woman over 40 giving birth to a child with autism is 50% higher than that of a mother aged 25-29. The rate of autism is also significantly higher among second-born children when the interval between the two births is less than three years.

Researchers at Semmelweis University studying autism suggest that antidepressants and certain chemicals, such as bisphenol-A, that enter the mother's body may cause autism. Bisphenol-A (BPA) is a synthetic compound widely used in plastic manufacturing. It is commonly found in food storage containers, such as water bottles and baby food jars, and also serves as an inner coating in food packaging, like the lining of cans. (Manufacturers are increasingly developing and offering BPA-free products in response to public health concerns. Make sure to only use BPA-free plastic products!)
Source: https://hu.wikipedia.org/wiki/Autizmus

Pharmacological Treatment of Autism

There is no medication that cures autism. As a last resort, medications are used to treat accompanying symptoms such as depression, anxiety, or possible outbursts of anger. For many, medication in combination with various developmental therapies is the only available treatment option. Complementary therapies might include animal-assisted therapy, music sessions, or puppet therapy.


GABA AND GLUTAMATE

ASD is characterized by a disruption in the excitatory and inhibitory balance of GABAergic* and glutamatergic signaling across different brain structures.

The GABA (gamma-aminobutyric acid) neurotransmitter is a chemical in the brain involved in communication between nerve cells. In the central nervous system, GABA acts as an inhibitory neurotransmitter, reducing the activity of nerve cells and neuronal excitability. By binding to GABA receptors, it can decrease central nervous system activity and help reduce anxiety, producing a calming effect.

The glutamate neurotransmitter plays a crucial role in communication between nerve cells in the brain. Glutamate is the brain's most abundant and important excitatory neurotransmitter. "Excitatory" means it has a stimulating or enhancing effect on the body. Excitatory neurotransmitters increase nerve cell activity and neural excitability.

Glutamate is produced and released by nerve cells and affects target cells via the synaptic cleft. When glutamate binds to receptors on the target cell membrane, it transmits a signal and increases the target cell's activity. This excitatory neurotransmitter is involved in many important brain processes, including neural plasticity, learning, and memory.

It is important to note that excessive glutamate levels or overstimulation of glutamate receptors can have harmful effects on the nervous system. This can lead to excessive excitability and the destruction of nerve cells, resulting in neurodegenerative diseases such as Alzheimer’s or Parkinson’s disease. Overactivation of glutamate receptors may also contribute to conditions like migraines or epilepsy.

Glutamate is naturally present in certain foods, such as meats, cheeses, and soy sauce.

Overall, glutamate plays a pivotal role in communication between brain nerve cells, signal transmission, and the proper functioning of the central nervous system.

What Role Does Cannabis Play in Autism Treatment?

Doctors hypothesize that the endocannabinoid system is involved in modulating the imbalanced GABA and glutamate transmission. The endocannabinoid system is one of the body's primary biological regulators, influencing numerous vital processes. Compounds found in cannabis with therapeutic properties, such as CBD, have a significant impact on the functioning of our endocannabinoid system, thereby regulating both GABA and glutamate.



Recently, an Israeli research team examined the effectiveness of cannabinoids in patients with ASD. The study aimed to describe the epidemiology of ASD patients undergoing medical cannabis treatment and to assess the safety and effectiveness of the treatment. Between 2015 and 2017, data were collected on 188 ASD patients treated with medical cannabis. The treatment was based on a cannabis oil containing 30% CBD and 1.5% THC. Most patients consumed CBD Oil three times a day, averaging a total dose of 61.5–79.5 mg CBD and 3.0–4.0 mg THC.

After six months, 155 patients remained in treatment, of whom 93 were evaluated. Out of these 93, 28 patients (30.1%) reported significant improvement, 50 (53.7%) moderate improvement, 6 (6.4%) mild improvement, and 8 (8.6%) showed no change. Twenty-three patients (25.2%) experienced at least one side effect; the most common was restlessness (6.6%). According to the study, cannabis appears to be well tolerated, safe, and effective in alleviating symptoms related to ASD, especially seizures, tics, depression, restlessness, and anger outbursts. Overall, more than 80% of parents reported significant or moderate improvement in their children's general condition.

The complete abstract of the above study is available on the Nature website: https://www.nature.com/articles/s41598-018-37570-y

Bonni Goldstein is a physician and a leading expert in medical cannabis. For many years, she has been helping patients use cannabis-based therapies to treat diverse health issues, such as chronic pain, epilepsy, and autism. Through numerous publications and presentations, she has contributed to making knowledge about cannabinoids more widely accessible. Her goal is to provide effective, personalized treatment options for patients.

Recent research on the relationship between cannabis and autism has brought significant breakthroughs in medicine. Dr. Bonni Goldstein gave a detailed talk on a recently published study titled "Cannabis-Responsive Biomarkers: Pharmacometabolomic-Based Application to Evaluate the Effect of Medical Cannabis Treatment in Children with Autism Spectrum Disorder."

The study aimed to identify biomarkers that respond to cannabis treatment and examine how medical cannabis affects children with Autism Spectrum Disorder (ASD).

Let’s pause for a moment to understand the significance of biomarkers!

Biomarkers are chemicals in the body that reflect cell function and can indicate the presence or severity of various diseases. For example, white blood cell count is a biomarker.

In the case of a severe bacterial infection, white blood cell count rises, providing doctors with a clue and signaling that serious infection should be investigated. Conversely, a very low white blood cell count might indicate a pathological condition. Biomarkers have what is called a physiological or normal range. For white blood cells, this range is between 4,000 and 12,000 cells. The cells in your body contain many different biomarkers that can be measured and provide useful information for medical diagnosis.

In the study described by Goldstein, saliva samples from 15 children with autism were analyzed and compared with samples from neurotypical, or typically developing, children. Out of hundreds of biomarkers examined, 31 were identified as relevant to autism—that is, 31 distinctive markers typical for autism that were not present in typically developing children. During the study, 15 autistic children were treated with cannabis.

The results showed that cannabis treatment shifted the biomarkers toward the physiological range, suggesting that the treatment initiated a restorative or corrective process in the body, which is a major breakthrough!

Particularly interesting was the examination of the biomarker N-acetyl-aspartic acid (NAA), which is involved in neuroinflammation and myelin formation. Neuroinflammation—the inflammatory processes of the nervous system—is receiving increasing attention in ASD research. Numerous studies have found elevated levels of certain inflammatory markers, such as cytokines and microglial activation, in the brains of individuals with autism.

This suggests that neuroinflammation may play a role in the altered nervous system development underlying autism symptoms. While causation is not yet fully understood, inflammatory processes may affect synaptic function, neural connectivity, and neuroplasticity, which are critical for social and cognitive functions. The study showed that after cannabis treatment, NAA levels normalized in children regardless of whether initial levels were high or low.

Other biomarkers examined included spermine, which is associated with inflammation and pain, and dehydroepiandrosterone sulfate (DHEAS), which plays a role in hormonal balance and regulation of aggression. Both biomarkers showed positive responses to cannabis treatment, further supporting cannabis’s therapeutic potential in autism management.

It is important to note that this study had a limited number of participants, so further research is needed to confirm these findings. Nevertheless, these results are promising and may open new avenues for using cannabis-based therapies in Autism Spectrum Disorder treatment.

Dr. Goldstein emphasized that cannabis treatment requires a personalized approach, as patients respond differently. Finding the right dosage and cannabinoid ratio is crucial for both effectiveness and safety. This research may help us better understand how cannabis works for people with autism and how to optimize treatment protocols for the best results.

Overall, the study highlights the potential benefits of cannabis-based therapies for children with Autism Spectrum Disorder, particularly in improving behavioral challenges. Identifying and monitoring biomarkers provide an objective way to measure treatment effectiveness, an important step toward broader acceptance of medical cannabis.

Which cannabinoids have proven effective, and what are the right ratios for treating autism?

Among cannabinoids used in treating ASD, the most promising results have been achieved with combinations of cannabidiol (CBD) and tetrahydrocannabinol (THC). Due to their anti-inflammatory and neuroprotective effects, and their positive impact on cognitive functions, the use of CBG is also justified. However, these combinations are not universally applicable, as effectiveness and safety greatly depend on individual sensitivity and the severity of autism.

In highly anxious or aggressive children, cannabis products with minimal THC content may help but can also worsen the situation.

Treatment should always start with a low dose and gradually increase to find the optimal amount. The use of cannabis oils is recommended only under specialist medical supervision, especially in children.

Quality and Purity
Only cannabis oil that has been laboratory tested and verified for high quality should be used. Cannabinoid analysis of cannabis products precisely shows which active compounds (cannabinoids) are present and their concentrations. This information is essential for making a well-informed decision and choosing the product that best suits your needs.

In summary, cannabis therapy for autism is still in the research phase, but current results are promising, especially in reducing anxiety, irritability, and improving self-regulation.

CBD Oil is not a miracle cure! The foundations of maintaining good health are regular exercise, a balanced diet, and a stress-free lifestyle. CBD does not replace any of these! In Hungary and most EU countries, CBD is classified as a "novel food," since its widespread use before 1997 was not confirmed. Therefore, no health or treatment claims may be made about CBD-containing products. The above are summaries of scientific studies.

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