Cannabidiol (CBD) is a phytocannabinoid which is a compound that binds to specific receptors in cells that alter the activity of neurotransmitters.
CBD is extracted from Cannabis sativa (hemp plant) and diluted with a carrier oil to produce CBD oil.
Overview of Autism
Autism denotes a developmental disorder which is marked by difficulties in social interactions and communication, particularly due to restrictive and repetitive behaviour.
The initial symptoms are manifested within the first three years of the child’s life. The most prominent signs can often be seen as the child reaches different developmental milestones.
Autism affects information processing in the brain by changing the synaptic organization and hence, there is no absolute cure.
Benefits of CBD in Autism
The major benefits of CBD in managing the symptoms of autism are linked with its nature as anti-inflammatory and anxiolytic. It helps in improving social interactions in autistic children and raise the overall quality of life. It also aids in reducing the frequency and intensity of the epileptic seizures that develop in individuals with high-functioning autism.
CBD holds great potential in diminishing the chance of developing comorbid problems like anxiety disorders and phobias, particularly by stimulating neurotransmitter activity. It also helps in reducing ritualistic behaviours which are characteristic of autism and improving cognitive control.
1. CBD Improves Social Interaction
One of the major features of autism is a characteristic difficulty in social interactions.
Social impairment also acts as a precursor for anxiety in children with autism spectrum disorders (ASDs).
There have been many comprehensive intervention strategies that have shown promise in treating behavioural and cognitive problems, however, none have been effective in improving social interactions.
The complications experienced by young children with autism revolve around two fundamental problems which include their capacity to engage cooperatively with others (joint attention/joint engagement), as well as the measure and value of their interactive skills which might enable them to maintain relations with peers.
Younger children suffering from autism are recognized by their seeming lack of awareness of others around them which is often referred to as joint attention.
They may be so fixated on playing that it might be difficult for another person to join in or share with them (joint engagement).
School-going children with high-functioning autism often encounter significant social challenges, particularly in interacting with other children.
In the case of older children, major social difficulties involve the development of skills that require perception, knowledge, as well as an understanding of others, and the development of peer relationships such as friendships.
Several intervention strategies have been developed to improve the quality of social lives yet this field still requires a decisive therapeutic measure.
Using medication like CBD to soothe and relax the children to improve social interactions has become popular in the recent years.
A 2018 experimental study published in the journal, Epilepsy Currents, revealed that CBD helped in improving social deficits in the mouse model and it was seen that the treated mice exhibited a greater interest in interacting with other mice as compared to the placebo group.
It was reasoned that the improved social interaction was due to the marked reduction in anxiety, repetitive behaviours, and seizure frequency.
CBD can be used to improve social interactions as it reduces anxiety and abnormal repetitive behavioural patterns.
2. CBD Oil Helps in Epilepsy
Epilepsy denotes a brain disorder that is marked by a long-lasting predisposition to produce seizures and by the collectively detrimental neurobiological, cognitive, psychological, and social impact of this condition.
Epileptic seizures are quite common in people suffering from autism spectrum disorders (ASDs) and therefore, epilepsy has been acknowledged as an extra clinical complication that must be dealt with in the treatment of ASDs.
The comorbidity rate typically fluctuates depending upon the age of the patient and the type of disorder.
Several studies have shown that ASDs and epilepsy often occur simultaneously which indicates the presence of common neurobiological mechanisms shared by these conditions.
Recently, an abundance of genetic mutations was discovered in both the disorders that probably lead to the development of abnormalities in synapse formation which, in turn, affected the balance between neuronal excitation and inhibition.
Intellectual disability (ID) has been found to be a major risk factor for the development of epilepsy in autistic patients. 8% of the autistic children develop epilepsy if there is no ID, but a whopping 20% of such children will develop epilepsy if they also suffer from ID.
Furthermore, age is also a major risk factor for the onset of epilepsy in autistic children.
Seizures negatively affect brain development via several mechanisms and usually lead to additional problems, such as mood disorders, behavioural abnormalities, as well as sleep disruption.
Researchers also hypothesize that chronic inflammation of the nerve tissue may trigger epileptic seizures.
In order to reduce the intensity and duration of seizures, cannabinoids have become popular as novel lines of therapy.
A 2017 review by the University of Pavia has established that CBD oil has shown great potential in reducing the frequency of convulsions and seizures as it modulates the endocannabinoid system (ECS) and has an anti-inflammatory effect.
As CBD oil helps in reducing the frequency and intensity of seizures, it helps in providing relief to people with autism.
3. CBD Exerts an Anxiolytic Effect
Clinically significant anxiety is quite commonly observed in individuals with autism spectrum disorders (ASDs).
The development of such comorbid anxiety has been associated with an increase in psychosocial, familial, behavioural, and academic impairments.
Several studies have been conducted to diminish anxiety in autistic individuals and hence, this remains a key research area.
Approximately 80% of the children with autism tend to experience some form of clinically significant anxiety, particularly with elevated rates of social phobia (30%), generalized anxiety disorder (35%), obsessive-compulsive disorder ( 37%) as well as separation anxiety disorder (38%).
Higher chances of anxiety are linked with enhanced severity of ASD symptoms and related deficits, such as those in psychosocial functioning.
For instance, individuals with autism and comorbid anxiety stand at an elevated risk of displaying behaviour problems, reclusion from social activities, problems maintaining peer dynamics, disruptions in family functioning, and even personal problems like sleep disturbances.
Young adults with ASDs often exhibit ritualistic behaviours which have some external resemblance to unusual behaviours displayed by youths suffering from anxiety disorders, such as compulsions.
These rituals may be undertaken to establish some form of control over the surroundings and, thereby, reduce anxiety. They could also be performed for internal reasons.
Many clinical trials have been conducted to determine the efficacies of therapies that are designed to overcome comorbid anxiety in people suffering from ASDs.
Cognitive-behavioural therapy or CBT has been shown to be most effective in developing youths and young adults. Medications to reduce anxiety are less common but CBD has become popular in this regard.
A 2014 review by the Federal University of Rio de Janeiro evaluated several animal studies and concluded that CBD exerts an anti-anxiety effect.
It was established that the anxiolytic effect of CBD stems from its ability to stimulate 5-HT1A serotonergic transmission.
CBD is useful in treating comorbid anxiety disorders by stimulating neurotransmitter activity and hence, has a positive effect on individuals suffering from ASDs.
4. CBD Reduces Cognitive Deficits
Cognitive control denotes the ability to malleably assign mental resources so as to guide thoughts and undertake actions as per the situation.
Individuals with autism suffer from specific behavioural restrictions, which definitely corresponds with some form of cognitive deficits.
They are often unable to perform simple cognitive functions such as information processing and decision-making.
There are several speculative theories regarding impaired cognitive control in autism spectrum disorders (ASD) but one of the most significant theories has to be the executive function hypothesis.
This theory propositions that the shortages in planning, attention spans, inhibitory control, as well as working memory are fundamental to the disorder.
Cognitive control requires the processing of relevant information over competing data to complete the task at hand. While control is not required for automatic behaviours, it must be employed to complete engaging and difficult tasks.
Autism causes an impairment of such control, making it difficult for the individual to execute many daily activities on their own.
Extensive research has been conducted on the development of cognitive control in normally developing children and young adults, along with those with ASDs.
It was observed that in normal development, more complex facets of such control continue to develop well into adolescence whereas, in case of ASDs, the results were mixed and recorded both deficiency and progression with time.
A model based on cognitive control deficits also helps in explaining the manifestation of several key symptoms of autism such as ritualistic and repetitive behaviours.
Researchers have hypothesized that it is because of poor cognitive functioning that autistic individuals have the tendency to repeat certain responses even when it does not serve the task at hand.
CBD, as a phytocannabinoid, has come to the forefront as an alternative line of treatment in case of neurological conditions.
A 2017 experimental study by the University of Wollongong demonstrated the cognitive benefits conferred by CBD.
It was found that the administration of CBD helped in improving working memory which helped in executing activities.
CBD usage helps in improving working memory and cognitive control and can, therefore, be used to reduce cognitive impairments in individuals with autism.
5. CBD Reduces Restrictive and Repetitive Behaviours
Individuals suffering from autism-spectrum disorders tend to display several forms of repetitive or restricted behaviour.
As autism is categorized as a neurodevelopmental disorder, these behaviours are simply the manifestations of neurological malfunctioning and changes in the synaptic organization.
One of the prime reasons behind impaired social interaction and severe anxiety associated with autism is this characteristic behavioural pattern. The Repetitive Behaviour Scale-Revised (RBS-R) divides them into several categories depending upon the most distinctive feature of the behaviours.
Stereotyped behaviours include constantly recurring body movements, postures, or even, utterances, such as hand flapping or body rolling.
Compulsive behaviours are time-consuming yet performed persistently to reduce obsessive thoughts and anxieties. The most common examples include repeated hand-washing and checking things.
Another key behavioural pattern observed in autistic individuals is sameness which denotes a conscious effort to resist any form of change, such as even moving furniture or objects.
In conjunction with sameness, they also display ritualistic behaviour wherein individuals strictly adhere to an unvarying pattern in performing daily activities.
Autistic individuals also show restricted interests which means that they show an abnormal amount of interest, rather a fixation, in a particular theme or activity.
For instance, they may be unflinchingly preoccupied with a particular game. If individuals sense a divergence from the sameness, they may resort to self-injury as a result of anxiety or fear.
While there is no overall cure for autism, individuals can improve the quality of their lives with behavioural therapies.
They may slowly adjust to a life wherein they can perform daily activities without resorting to any restricted or ritualistic behaviour.
Medication may also be used to relax them and aid in reducing anxiousness.
As already mentioned, CBD holds great potential in treating anxiety associated with autism. It has a calming effect and can be used along with behavioural therapies to moderate ritualistic behaviours without inciting an anxious response.
A 2017 review by the University of Campani established the role of dysregulation in the endocannabinoid system (ECS) in the pathophysiology of autism.
It was also shown that inflammation due to immune system malfunction went hand-in-hand with the EC dysregulation.
As a result, the anti-inflammatory CBD helps in restoring normal conditions which might significantly curb restricted behavioural patterns.
As CBD exerts an anxiolytic effect and modulates the ECS to reduce inflammation, it helps in reducing the symptoms of autism such as repetitive and restricted behaviour.
It is advisable to consult a medical practitioner before consuming medications containing THC.
The dosage depends on the mode of delivery as the CBD products can be orally ingested or inhaled by a vaporizer.
The dosage to treat the symptoms of autism depends upon the age and weight of the individual.
Children should be given 35-40mg per day split across three meals whereas adults should begin with a dose of 60-70mg split across three meals.
The dose can be increased as per the individual’s tolerance level and dosage efficacy.
Vaporizers containing CBD oil can be used to relieve seizures and anxiety attacks. 6-8mg should be inhaled.
The phytocannabinoid, CBD, has very few known side-effects.
Daily oral doses of up to 500mg can be had for as long as half a year as it does not cause any unwanted complications.
However, the majority of the CBD products have varying amounts of the psychotropic agent, tetrahydrocannabinol (THC), in them which is responsible for any side-effects.
While the quantity of THC is quite low to produce a substantial hallucinatory effect, some individuals may be sensitive and hence, it is advisable, to begin with, small doses.
CBD often interacts with a class of liver enzymes (cytochrome p450) which are responsible for metabolizing drugs and hence, might reduce the efficacies of such medications. High-THC containing products might cause dizziness, disorientation, nausea, vomiting, fatigue, impaired balance, unsteady gait, hallucinations, and paranoia.
They might also raise the heart rates for a short duration and this condition is known as tachycardia.
Cannabis products containing high amounts of THC should also not be accompanied by alcohol.
Pregnant and lactating women should consult a gynaecologist before consuming CBD products.
Caution should also be maintained while administering THC-containing products to children and adolescents as it might affect their CNS differently.
To summarise, it can be said that CBD confers several benefits to people suffering from autism spectrum disorders (ASDs).
It helps in improving social interactions and engaging the attention of autistic children in social situations which ultimately helps them to build and sustain peer relationships.
CBD also helps in reducing the frequency and intensity of convulsions and seizures.
Being anxiolytic and anti-inflammatory in nature, this phytocannabinoid reduces the risk of developing anxiety disorders in individuals with autism.
It also improves cognitive control and improves executive functioning in patients. Finally, it helps in reducing the restricted and repetitive behaviours.