Use of Cannabinoids in the management of behavioral symptoms of autism spectrum disorder Review
DOI:
https://doi.org/10.55892/jrg.v9i20.3291Keywords:
Autism Spectrum Disorder, Cannabidiol, Cannabinoids, Medical cannabis, Behavioral symptomsAbstract
Autism Spectrum Disorder (ASD) is characterized by persistent impairments in communication, social interaction, and behavior, frequently associated with behavioral symptoms such as irritability, aggression, hyperactivity, anxiety, and sleep disturbances. Given the limitations of conventional pharmacological therapies, cannabinoids, particularly cannabidiol (CBD), have emerged as a potential therapeutic alternative for managing these symptoms. This study aimed to analyze the scientific evidence regarding the use of cannabinoids in the management of behavioral symptoms associated with ASD. This is an integrative literature review based on the methodological framework proposed by Whittemore and Knafl, conducted using the PubMed/MEDLINE, Scopus, ScienceDirect, and Web of Science databases. Studies published between 2017 and 2025 were included, resulting in a final sample of 13 articles, including systematic reviews, randomized clinical trials, observational studies, and experimental research. The findings demonstrated that CBD-rich formulations showed potential benefits in reducing symptoms such as irritability, aggression, hyperactivity, anxiety, and sleep disturbances, particularly in individuals with severe and treatment-resistant conditions. Neurobiological studies also identified alterations in the endocannabinoid system in individuals with ASD, supporting the therapeutic plausibility of cannabinoids. However, the current evidence still presents important methodological limitations, including small sample sizes, heterogeneity of study designs, lack of therapeutic standardization, variability in cannabinoid formulations, and placebo effects in randomized clinical trials. It is concluded that cannabinoids represent a promising therapeutic alternative for managing behavioral symptoms in ASD; however, further methodologically robust studies are required to establish their long-term efficacy, safety, and clinical applicability.
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References
ARAN, A.; CASSUTO, H.; LUBOTZKY, A.; WATTAD, N.; HAZAN, E. Brief report: cannabidiol-rich cannabis in children with autism spectrum disorder and severe behavioral problems: a retrospective feasibility study. Journal of Autism and Developmental Disorders, New York, v. 49, n. 3, p. 1284-1288, 2019. DOI: 10.1007/s10803-018-3808-2.
ARAN, A.; HAREL, M.; CASSUTO, H.; POLYANSKY, L.; SCHNAPP, A.; WATTAD, N. et al. Cannabinoid treatment for autism: a proof-of-concept randomized trial. Molecular Autism, London, v. 12, n. 1, p. 6, 2021. DOI: 10.1186/s13229-021-00420-2.
BARCHEL, D.; STOLAR, O.; DE-HAAN, T.; ZIV-BARAN, T.; SABAN, N.; FUCHS, D. O. et al. Oral cannabidiol use in children with autism spectrum disorder to treat related symptoms and co-morbidities. Frontiers in Pharmacology, Lausanne, v. 9, p. 1521, 2019. DOI: 10.3389/fphar.2018.01521.
BAR-LEV SCHLEIDER, L.; MECHOULAM, R.; SABAN, N.; MEIRI, G.; NOVACK, V. Real life experience of medical cannabis treatment in autism: analysis of safety and efficacy. Scientific Reports, London, v. 9, p. 200, 2019. DOI: 10.1038/s41598-018-37570-y.
FLEURY-TEIXEIRA, P.; CAIXETA, F. V.; RAMIRES DA SILVA, L. C.; BRASIL-NETO, J. P.; MALCHER-LOPES, R. Effects of CBD-enriched Cannabis sativa extract on autism spectrum disorder symptoms: an observational study of 18 participants undergoing compassionate use. Frontiers in Neurology, Lausanne, v. 10, p. 1145, 2019. DOI: 10.3389/fneur.2019.01145.
FUSAR-POLI, L.; CAVONE, V.; TINACCI, S.; CONCAS, I.; PETRALIA, A.; SIGNORELLI, M. S. et al. Cannabinoids for people with ASD: a systematic review of published and ongoing studies. Brain Sciences, Basel, v. 10, n. 9, p. 572, 2020. DOI: 10.3390/brainsci10090572.
KARHSON, D. S.; KRASINSKA, K. M.; DALLAIRE, J. A.; LIBOVE, R. A.; PHILLIPS, J. M.; CHIEN, A. S. et al. Plasma anandamide concentrations are lower in children with autism spectrum disorder. Molecular Autism, London, v. 9, p. 18, 2018. DOI: 10.1186/s13229-018-0203-y.
PEREIRA, D. A.; CHEIDDE, L.; MEGIOLARO, M. D. R.; CAMARGO, A. E. F.; WEBA, E. T. P.; SOARES, V. G. et al. Efficacy and safety of cannabinoids for autism spectrum disorder: an updated systematic review. Cureus, Palo Alto, v. 17, n. 3, p. e80725, 2025. DOI: 10.7759/cureus.80725.
PRETZSCH, C. M.; FREYBERG, J.; VOINESCU, B.; LYTHGOE, D.; HORDER, J.; MENDEZ, M. A. et al. Effects of cannabidiol on brain excitation and inhibition systems: a randomised placebo-controlled single dose trial during magnetic resonance spectroscopy in adults with and without autism spectrum disorder. Neuropsychopharmacology, London, v. 44, n. 8, p. 1398-1405, 2019. DOI: 10.1038/s41386-019-0333-8.
SILVA JUNIOR, E. A.; MEDEIROS, W. M. B.; TORRO, N.; SOUZA, J. M. M.; ALMEIDA, I. B. C. M.; COSTA, F. B. et al. Cannabis and cannabinoid use in autism spectrum disorder: a systematic review. Trends in Psychiatry and Psychotherapy, Porto Alegre, v. 44, p. e20200149, 2022. DOI: 10.47626/2237-6089-2020-0149.
SILVA JUNIOR, E. A.; MEDEIROS, W. M. B.; SANTOS, J. P. M.; SOUSA, J. M. M.; COSTA, F. B.; PONTES, K. M. et al. Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: randomized, double-blind, and placebo-controlled clinical trial. Trends in Psychiatry and Psychotherapy, Porto Alegre, v. 46, p. e20210396, 2024. DOI: 10.47626/2237-6089-2021-0396.
TRAUNER, D.; UMLAUF, A.; GRELOTTI, D. J.; FITZGERALD, R.; HANNAWI, A.; MARCOTTE, T. D. et al. Cannabidiol (CBD) treatment for severe problem behaviors in autistic boys: a randomized clinical trial. Journal of Autism and Developmental Disorders, New York, 2025. DOI: 10.1007/s10803-025-06884-y.
WHITTEMORE, R.; KNAFL, K. The integrative review: updated methodology. Journal of Advanced Nursing, Oxford, v. 52, n. 5, p. 546-553, 2005. DOI: 10.1111/j.1365-2648.2005.03621.x.
WONG, S. S.; WILENS, T. E. Medical cannabinoids in children and adolescents: a systematic review. Pediatrics, Springfield, v. 140, n. 5, p. e20171818, 2017. DOI: 10.1542/peds.2017-1818.
