It has been hypothesized that since the endocannabinoid system controls emotional and behavioral responses, as well as social interaction, a disruption in this system may be a contributing factor in the development of autism. A number of recent scientific reports have investigated this hypothesis.
A case study published from Austria in 2010 documented the use of dronabinol (synthetic THC) in a six-year-old boy diagnosed with autism. He received dronabinol therapy for six months with no change in other therapies or initiation of any other new treatments. An examiner and his parents rated his behaviors on a scale. He had significant decreased hyperactivity, lethargy and irritability. Stereotypic behavior and speech also improved. There were no reported adverse side effects. The dosing for this child was synthetic THC (no CBD), initially starting with 0.62mg one time per day in the morning and at the end of six months, he was taking 1.2mg in the morning, 0.62mg in the afternoon and 1.86mg at night for a total daily dose of 3.68mg to achieve the reported improvements.6
Most of the families that come to my office seeking cannabis treatment for their loved one with autism have tried multiple medications and interventions without success. Some of these patients respond to CBD-rich cannabis, some to THC-rich cannabis, and some to combination CBD+THC; more recently, I have seen a number of autism patients have unexpected significant improvements with THCA. I recommend starting with low dose sublingual drops as accurate dosing and titration is easiest with this method in the pediatric population (although some children may swallow the liquid if they cannot cooperate with holding the liquid under the tongue). Accurately tested edible products may work well. However, it is important that the parent or caregiver start with very low doses as THC-rich edible products can cause uncomfortable psychoactivity if the dose is too high.
In children I recommend starting with CBD-rich or THCA-rich oil, and adding in THC as needed to obtain the desired effects. Many of these patients appear to have a high tolerance to the psychoactivity of THC. This may be due to an endocannabinoid deficiency/dysfunction or to less sensitivity in general, as children have immature cannabinoid receptors.
Since it is unclear which patient may have higher tolerance, I recommend caution in using THC and always recommend starting with low milligram doses and titrating up as needed. The same approach holds true for adults with autism. Chemovars high in myrcene and/or linalool, both of which have calming effects, can be very helpful for these patients.
Although many patients with autism achieve good results with cannabis treatment, it can be frustrating to find the right preparation that gives the desired results. I encourage patients and their caregivers to experiment with different doses, different CBD:THC ratios, different chemovars and different delivery methods as each person responds uniquely.
Maccarrone, Mauro, et al. “Abnormal mGlu 5 receptor/endocannabinoid coupling in mice lacking FMRP and BC1 RNA.” Neuropsychopharmacology 35.7 (2010): 1500-1509.
Jung, Kwang-Mook, et al. “Uncoupling of the endocannabinoid signaling complex in a mouse model of fragile X syndrome.” Nature communications 3 (2012): 1080.
Schultz, Stephen T. “Can autism be triggered by acetaminophen activation of the endocannabinoid system?.” Acta neurobiologiae experimentalis 70.2 (2009): 227-231.
Kerr, D. M., et al. “Alterations in the endocannabinoid system in the rat valproic acid model of autism.” Behavioural brain research 249 (2013): 124-132.
Siniscalco, Dario, et al. “Cannabinoid receptor type 2, but not type 1, is up-regulated in peripheral blood mononuclear cells of children affected by autistic disorders.” Journal of autism and developmental disorders 43.11 (2013): 2686-2695.
Kurz, René, and Kurt Blaas. “Use of dronabinol (delta-9-THC) in autism: A prospective single-case-study with an early infantile autistic child.” Cannabinoids 5 (2010): 4-6