Progress in neuro-psychopharmacology & biological psychiatry · 2026
Cannabinoid-based interventions for behavioral outcomes in children and adolescents with autism spectrum disorder: A systematic review of safety and effectiveness.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Vasconcelos Quezia Damaris Jones Severino, de Freitas Renê Felipe, Freitas Madna Costa, de Andrade Isadora Porto, Brandão Carla Barbosa, Nascimento Cidianna Emanuelly, Neves Kelly Rose, Magalhães Paulo Sávio, Filho Valter Barbosa, Oliveira Giovanna Lima, de Moura Matheus Alisson Melo, Aragão Gislei Frota
Аннотация
BACKGROUND: Autism spectrum disorder (ASD) lacks effective options for core symptoms. Cannabinoids, especially cannabidiol (CBD) and combined CBD:Δ9-tetrahydrocannabinol (THC) formulations, are of interest, but clinical evidence is heterogeneous.
PURPOSE: To evaluate the effectiveness and safety of cannabinoid-based interventions for behavioral outcomes in children and adolescents with ASD.
METHODS: Six databases (Scopus, Web of Science, Embase, Cochrane Library, PubMed, PsycINFO) were searched from February 2024 to June 2025. Risk of bias was assessed using RoB 2 (randomized controlled trials [RCTs]) and the Newcastle-Ottawa Scale (non-RCTs); certainty was evaluated with GRADE.
RESULTS: Twelve studies (4 RCTs, 8 non-RCTs) were included; six ongoing trials were identified. Most interventions used full-spectrum extracts with high CBD:THC ratios (often 20:1), with titration up to ∼10 mg/kg/day; doses varied across studies. Responder rates for global improvement vs placebo (49% vs 21%) and greater improvement in social communication. No between-group differences were observed for sleep or overall symptom severity, and repetitive behaviors showed a non-significant trend toward improvement. Non-RCTs studies suggested benefits but had high risk of bias and very low certainty. Adverse events were mostly mild and non-serious (e.g., somnolence, appetite changes, sleep problems, irritability); no treatment-related serious adverse events were reported.
CONCLUSIONS: Evidence remains limited. A whole-plant 20:1 extract improved global clinical impression and social communication in one RCT, whereas other standardized outcomes were null. Current data support only cautious, adjunctive use under medical supervision. Larger, well-designed RCTs using validated outcomes are needed to clarify efficacy, optimal formulations, and long-term safety. PROSPERO registration: CRD42024508518.
PURPOSE: To evaluate the effectiveness and safety of cannabinoid-based interventions for behavioral outcomes in children and adolescents with ASD.
METHODS: Six databases (Scopus, Web of Science, Embase, Cochrane Library, PubMed, PsycINFO) were searched from February 2024 to June 2025. Risk of bias was assessed using RoB 2 (randomized controlled trials [RCTs]) and the Newcastle-Ottawa Scale (non-RCTs); certainty was evaluated with GRADE.
RESULTS: Twelve studies (4 RCTs, 8 non-RCTs) were included; six ongoing trials were identified. Most interventions used full-spectrum extracts with high CBD:THC ratios (often 20:1), with titration up to ∼10 mg/kg/day; doses varied across studies. Responder rates for global improvement vs placebo (49% vs 21%) and greater improvement in social communication. No between-group differences were observed for sleep or overall symptom severity, and repetitive behaviors showed a non-significant trend toward improvement. Non-RCTs studies suggested benefits but had high risk of bias and very low certainty. Adverse events were mostly mild and non-serious (e.g., somnolence, appetite changes, sleep problems, irritability); no treatment-related serious adverse events were reported.
CONCLUSIONS: Evidence remains limited. A whole-plant 20:1 extract improved global clinical impression and social communication in one RCT, whereas other standardized outcomes were null. Current data support only cautious, adjunctive use under medical supervision. Larger, well-designed RCTs using validated outcomes are needed to clarify efficacy, optimal formulations, and long-term safety. PROSPERO registration: CRD42024508518.