Efficacy of cannabinoids in neurodevelopmental and neuropsychiatric disorders among children and adolescents: a systematic review

A better understanding of the endocannabinoid system and a relaxation in regulatory control of cannabis globally has increased interest in the medicinal use of cannabinoid-based products (CBP). We provide a systematic review of the rationale and current clinical trial evidence for CBP in the treatment of neuropsychiatric and neurodevelopmental disorders in children and adolescents. A systematic search of MEDLINE, Embase, PsycINFO, and the Cochrane Central Register of Trials was performed to identify articles published after 1980 about CBP for medical purposes in individuals aged 18 years or younger with selected neuropsychiatric or neurodevelopmental conditions. Risk of bias and quality of evidence was assessed for each article. Of 4466 articles screened, 18 were eligible for inclusion, addressing eight conditions (anxiety disorders (n = 1); autism spectrum disorder (n = 5); foetal alcohol spectrum disorder (n = 1); fragile X syndrome (n = 2); intellectual disability (n = 1); mood disorders (n = 2); post-traumatic stress disorder (n = 3); and Tourette syndrome (n = 3)). Only one randomised controlled trial (RCT) was identified. The remaining seventeen articles included one open-label trial, three uncontrolled before-and-after trials, two case series and 11 case reports, thus the risk of bias was high. Despite growing community and scientific interest, our systematic review identified limited and generally poor-quality evidence for the efficacy of CBP in neuropsychiatric and neurodevelopmental disorders in children and adolescents. Large rigorous RCTs are required to inform clinical care. In the meantime, clinicians must balance patient expectations with the limited evidence available.

The role of cannabinoids in neurodevelopmental disorders of children and adolescents

Neurodevelopmental disorders have a multifactorial etiology that results from the interaction between biological and environmental factors. The biological basis of many of these disorders is only partially understood, which makes therapeutic interventions, especially pharmacological ones, particularly difficult. The impact of medical cannabis on neurological and psychiatric disorders has been studied for a long time. This study aimed to review the currently available clinical and pre-clinical studies regarding the use of cannabinoids in pediatric neurodevelopmental disorders and to draw attention to the potential therapeutic role of cannabidiol in this field.

The therapeutic role of Cannabidiol in mental health: a systematic review

The therapeutic application of cannabidiol (CBD) is gaining interest due to expanding evidence for its use.
Objective: To summarize the clinical outcomes, study designs and limitations for the use of CBD and nabiximols (whole plant extract from Cannabis sativa L. that has been purified into 1:1 ratio of CBD and delta-9- tetrahydrocannabinol) in the treatment of psychiatric disorders.

Add-on cannabidiol significantly decreases seizures in 3 patients with SYNGAP1 developmental and epileptic encephalopathy

Authors: Mathieu Kuchenbuch, Gianluca D’Onofrio, Nicole Chemaly, Giulia Barcia, Théo Teng, Rima Nabbout Published in Epilepsia Open July 2020 Abstract Mutations in SYNGAP1 are associated with developmental delay, epilepsy, and…

Cannabidiol in conjunction with clobazam: analysis of four randomized‐controlled trials

Authors: Boudewijn Gunning, Maria Mazurkiewicz‐Beldzinska, Richard F.M. Chin, Hari Bhathal Charlotte Nortvedt, Eduardo Dunayevich, Daniel Checketts Published in Acta Neurologica Scandinavica September 2020 Abstract Objectives To assess the efficacy and…

A pediatric patient with autism spectrum disorder and epilepsy using cannabinoid extracts as complementary therapy: a case report

Authors: Juliana Andrea Ponton, Kim Smyth, Elias Soumbasis, Sergio Andres Llanos, Mark Lewis, Wilhelm August Meerholz & Robert Lawrence Tanguay Published in Journal of Medical Case Reports September 2020 Abstract…

Possible therapeutic applications of cannabis in the neuropsychopharmacology field.

Authors: Javier Fernández-Ruiz, Ismael Galve-Roperh, Onintza Sagredo, Manuel Guzmán
European Neuropsychopharmacology, 10 February 2020

Cannabis use induces a plethora of actions on the CNS via its active chemical ingredients, the so-called phytocannabinoids. These compounds have been frequently associated with the intoxicating properties of cannabis preparations. However, not all phytocannabinoids are psychot…

Plasma anandamide concentrations are lower in children with autism spectrum disorder.

Authors: Debra S. Karhson, Karolina M. Krasinska, Jamie Ahloy Dallaire, et al
Molecular Autism, 12 March 2018

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by restricted, stereotyped behaviors and impairments in social communication. Although the underlying biological mechanisms of ASD remain poorly understood, recent preclinical research ha…

Endocannabinoid Signaling in Autism.

Authors: Bhismadev Chakrabarti, Antonio Persico, Natalia Battista, Mauro Maccarrone
Neurotherapeutics, October 2015

Autism spectrum disorder (ASD) is a complex behavioral condition with onset during early childhood and a lifelong course in the vast majority of cases. To date, no behavioral, genetic, brain imaging, or electrophysiological test can specifically validate a clinical diagnosis o…

Cannabinoid receptor type 2, but not type 1, is up-regulated in peripheral blood mononuclear cells of children affected by autistic disorders.

Authors: Dario Siniscalco, Anna Sapone, Catia Giordano, Alessandra Cirillo, Laura de Magistris, et al
Journal of Autism and Developmental Disorders, November 2013

Autistic disorders (ADs) are heterogeneous neurodevelopmental disorders arised by the interaction of genes and environmental factors. Dysfunctions in social interaction and communication skills, repetitive and stereotypic verbal and non-verbal behaviours are common features of…

Would some cannabinoids ameliorate symptoms of autism?

Authors: Rami Bou Khalil
European Child & Adolescent Psychiatry, DATE

Dear Sir, There has been a massive growth of public awareness and research funding around autism spectrum disorders (ASD) over the past 10 years. This disorder is one of the groups of neurodevelopmental disorders known as pervasive developmental disorders characterized by thre…

Use of dronabinol (delta-9-THC) in autism: A prospective single-case-study with an early infantile autistic child.

Authors: René Kurz, Kurt Blaas
Cannabinoids, 21 November 2010

Objective: To evaluate the effectiveness of dronabinol (delta-9-THC) as supplementary therapy in a child with autistic disorder. Methods: A child who met the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) criteria for a diagnosis of autistic disorder and who to…