CBD & Autism:
Can it help? September 2021

Recent studies of CBD-rich cannabis extracts in autistic children show promising findings. While it’s not a cure, CBD may improve some symptoms of this difficult-to-treat condition.

Gleb Oleinik September 19, 2018 Affiliate Disclosure Some links are specifically formatted for which we may receive a commission on resulting sales or clicks from affiliate partners (“Affiliate Links”).

Evidence Based
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Strength of
Evidence

CBD may significantly improve some symptoms of autism.
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Effect
Magnitude

CBD may improve some symptoms of autism and related issues such as anxiety and sleeping problems. However, it has to come in the form of a whole-plant cannabis extract.
Results Consistency icon

Results
Consistency

CBD may improve some symptoms of autism and related issues such as anxiety and sleeping problems. However, it has to come in the form of a whole-plant cannabis extract.

Cannabidiol (CBD) is a popular option for dealing with pain, insomnia, and other common health problems. This non-intoxicating cannabinoid may also hold some benefits for autism spectrum disorder.

Recent human studies of CBD-rich cannabis extracts found significant improvements in symptoms of autism and related issues, such as anxiety and sleep disturbances.

Read on to learn more about using CBD for autism, how it works, the research evidence, side effects, dosage, and more.

Autism Overview

Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects communication and behavior. It causes difficulties in socializing and communicating alongside restricted interests and repetitive behaviors.

Autism spectrum disorder typically begins at an early age and continues into adulthood, causing difficulties at school, work, and other social situations.

It includes several conditions that were considered separate in the past, such as autism and Asperger’s syndrome. Since it’s a spectrum disorder, the severity can vary from person to person.

That means some children with ASD have low intelligence and significant difficulties with learning, whereas others might have normal or high intelligence but still have trouble with communicating and socializing.

ASD is estimated to affect about 0.76% of people worldwide and 1 in 59 children in the United States. ¹ Boys are about three times as likely as girls to be diagnosed with ASD.

Although there’s no single cause of autism, researchers believe the interplay of genetic and environmental factors affecting the developing brain plays a major role.

For example, studies have found structural differences in some parts of the brain of children with ASD. Researchers are also continuing to identify genes associated with ASD.

Meanwhile, environmental risk factors include advanced parental age, prenatal exposure to air pollution or pesticides, and maternal immune infections or disorders.

Autism Subtypes

Before it was reclassified into a spectrum disorder in 2013, autism was divided into four related conditions: ²

  1. Asperger’s Syndrome: A milder, high-functioning form of autism. People with Asperger’s have normal to high intelligence and can handle adult life. However, they still struggle socially and may have limited interests.
  2. Pervasive developmental disorder not otherwise specified (PDD-NOS): A term for autism that’s more serious than Asperger’s but not as severe as autistic disorder.
  3. Autistic disorder: This disorder has the same types of symptoms as other forms of autism but is more severe.
  4. Childhood disintegrative disorder: The rarest and most severe type of autism, this disorder causes children to have severe and sudden reversals in language, social, and motor skills.

 

Autism Symptoms & Pathology

The symptoms of autism spectrum disorder include, but aren’t limited to:

  • Limited social interaction with peers
  • Poor eye contact and lack of facial expressions
  • Delayed speech and difficulty communicating
  • Repetitive movements or phrases
  • Difficulty reading body language
  • Clumsiness
  • Following specific routines and having obsessive interests
  • Sensory sensitivity
  • Intensely focusing on an object or activity

 

Some children with ASD may have intellectual disability and difficulty learning, whereas others can have normal or high intelligence. ASD is also associated with a higher risk of seizures, gastrointestinal issues, and anxiety disorders.

Can CBD Help With Autism?

CBD may help ease the symptoms of autism spectrum disorder.

It mainly works by interacting with the body’s endocannabinoid system (ECS), which regulates vital physiological and cognitive processes, including learning, mood, sleep, and inflammation. ³

This system is made up of endocannabinoids naturally made by our bodies, the cannabinoid receptors they activate, and enzymes that build and break them down. A growing volume of research suggests that ECS dysfunction is involved in autism.

For example, one 2018 study found that children with ASD had lower levels of the endocannabinoid anandamide than their healthy counterparts. ⁴

Similarly, a 2019 study reported lower levels of three endocannabinoid molecules — anandamide, OEA, and PEA — in ASD children. ⁵

Another 2021 study found that autistic children and mice had reduced levels of endocannabinoids, and higher levels of endocannabinoid-degrading enzymes and cannabinoid receptors.

The researchers concluded that “Current evidence strongly implicates alterations in the eCB system in human patients with ASD and in animal models.” ⁶

Indeed, the ECS regulates major processes involved in ASD, including brain development and the function of neurons and other brain cells. ⁷ It also influences other issues commonly seen in ASD, such as seizures, anxiety, and sleep disturbances.

That’s why targeting the ECS with cannabinoid-based treatments is a growing area of research.

CBD in particular has a lot of promise because it’s been shown to increase the levels of anandamide, one of the two major endocannabinoids, and lacks the intoxicating effects of THC. ⁸

CBD has also been shown to have anxiolytic (anxiety-reducing), antidepressant, antipsychotic, and other beneficial cognitive effects by acting on serotonin receptors and other systems. ⁹

As a result, it may help with anxiety, seizures, and other issues that commonly occur alongside autism spectrum disorder.

What Does the Research Say?

Research on the use of CBD for autism is steadily growing.

Israeli researchers published the most noteworthy study in 2021, which compared the effects of CBD-enriched cannabis oil (with a 20:1 ratio of CBD to THC) and pure CBD/THC oil to placebo.

A total of 150 children with ASD were assigned to one of the three treatments for 12 weeks before taking a 4-week break and changing groups for another 12 weeks.

Pure cannabinoids had no significant effect. However, 49% of the children taking whole-plant extract saw improvements in disruptive behavior versus 21% for placebo. The whole-plant extract also improved scores on the SRS scale of ASD severity by 14.9 points versus only 3.6 for placebo. ¹⁰

In a similar 2018 study, 60 children with ASD took CBD-enriched cannabis oil (with a CBD/THC ratio ranging from 20:1 to 6:1) daily for 7-13 months.

Seven children withdrew due to side effects and low efficacy. However, 61% of those who completed the study saw significant improvements in behavioral outbreaks. ¹¹ Many also reduced or stopped their use of other medications.

Meanwhile, a 2019 study looked at the effects of CBD oil with a 20:1 ratio of CBD to THC in 53 ASD children and adults (aged 4-22). They took the oil for anywhere from 30 to 588 days.

Self-injury and rage attacks improved in 67.6%, hyperactivity symptoms in 68.4%, sleep in 71.4%, and anxiety in 47.1%, although a small number of children had the opposite, negative effect. ¹²

Another 2019 study looked at the effects of CBD-enriched cannabis extract with a 75:1 ratio of CBD and THC in 18 children with autism. They took capsules daily for 6-9 months.

Three children discontinued the treatment after a month due to side effects and one didn’t see any changes.

However, the remaining 14 children saw improvements in more than one of eight symptom categories: attention-deficit hyperactivity disorder (ADHD), behavioral disorders, motor deficits, autonomy deficits, communication and social interaction deficits, cognitive deficits, sleep disorders, and seizures. ¹³

There were particularly big improvements in symptoms of seizures, ADHD, sleep disorders, and communication and social interaction deficits.

The researchers concluded that “…CBD-enriched CE yields positive effects in multiple autistic symptoms, without causing the typical side effects found in medicated ASD patients.”

Overall, the findings are promising and suggest that whole-plant, CBD-rich cannabis preparations may help with many symptoms of autism and related issues. However, further placebo-controlled studies are required.

Using CBD for Autism

According to the research, whole-plant, CBD-rich cannabis extracts work best for autism.

This provides further evidence for the entourage effect: the fact that cannabis works best when all of the cannabinoids, terpenes, and other phytochemicals are used together instead of isolated THC and CBD.

As such, full-spectrum CBD products are the ideal choice for autism since they contain the same active compounds and a similar, high ratio of CBD to THC. ¹⁴

In particular, we recommend using full-spectrum CBD oil because the most rigorous studies also used whole-plant, sublingual (under-the-tongue) cannabis oil.

Although full-spectrum CBD capsules can also help, they will have weaker effects because CBD and other cannabinoids have low oral bioavailability. ¹⁵

How Much CBD Should I Take for Autism?

The right dosage of CBD for autism will be different for everyone. It varies depending on body weight, genetics, symptom severity, product type, and other factors.

It’s best to start with a low dose and slowly raise it over time. ¹⁶ You could begin with 10-15 mg of full-spectrum CBD and wait for about two hours to see the effects.

If it’s not enough, gradually increase the dosage over time, making sure to stop for at least two hours to assess how you or your child feel. Use this conservative approach to find the right CBD amount for your desired effects.

Older children have seen improvements at 25mg of CBD twice a day. Some adults have even taken as much as 90mg of CBD split over three times a day.

Are There Any Side Effects?

Studies of CBD-rich cannabis extracts reported mostly mild side effects, such as sleepiness, decreased appetite, sleep disturbances, irritability, euphoria, and anxiety.

However, it should be noted that these effects are not just from CBD but also other cannabinoids and terpenes present in whole-plant extracts.

For example, the mild euphoria and anxiety reported by one study were likely due to the small amounts of THC, the main intoxicating component of cannabis.

Aside from that, research has shown that pure CBD is a relatively safe substance with few and minor side effects. ¹⁷

Conclusion

Clinical studies of CBD-rich cannabis extracts in children with autism spectrum disorder are promising.

Although further research is needed, CBD may help improve many of the symptoms of autism and might also help with related issues such as seizures, anxiety, and sleeping problems.

In most cases, the researchers used whole-plant cannabis oil rich in CBD and low in THC. That’s why it’s recommended to use full-spectrum CBD oil, which is the closest equivalent. You can start with a low dose and slowly increase it over time.

CBD is a safe compound and the extracts used in research resulted in mostly minor side effects.


Gleb Oleinik

Gleb Oleinik is a freelance CBD & cannabis writer from Vancouver, Canada. He’s read thousands of studies about cannabinoids and other beneficial natural compounds, helping him translate complex science into plain language. He’s also written third-party lab test reports of CBD products and knows the industry inside and out. When he’s not writing, Gleb likes to spend his time in the gym and out in nature.