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Current state of evidence of cannabis utilization for treatment of autism spectrum disorders

机译:利用大麻治疗自闭症谱系障碍的最新证据

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摘要

The core symptoms and co-morbidities associated with autism spectrum disorders (ASD) affect daily living and quality of life. Existing pharmacological interventions are only able to attenuate some related symptoms but are unable to address the underlying etiologies associated with ASD. Anecdotal evidence, which claims benefit from the use of cannabis to treat symptoms among this population, has been gaining popularity as families seek solutions.This paper analyzed recent peer-reviewed literature to identify the current state of evidence regarding cannabis use for the ASD population. Systematic reviews, reports, and experimental studies were assessed to understand the current extent and nature of the evidence on the risks and benefits of cannabis use for ASD. At this time, three large-scale clinical trials are currently at varying stages of progress and publication of results. Only five small studies were identified that have specifically examined cannabis use in ASD. Given the sparse state of evidence directly assessed in this population, studies which examined effects of cannabis on shared pathological symptoms of ASD such as hyperactivity, sleep disorders, self-injury, anxiety, behavioral problems, and communication were also reviewed.Studies revealed mixed and inconclusive findings of cannabis effects for all conditions, except epilepsy. Adverse outcomes were also reported, which included severe psychosis, increased agitation, somnolence, decreased appetite, and irritability. In addition, a wide range of cannabis compositions and dosage were identified within the studies, which impact generalizability.There is currently insufficient evidence for cannabis use in ASD, which creates an urgent need for additional large-scale controlled studies to increase understanding of risks and benefits and also to examine the impact of “entourage effects.” This will support discussions of treatment options between health care providers and ASD patients and their families. Evidence may lead to a desired new line of treatment or prevent adverse outcomes from unsubstantiated use amongst families aiming for symptom reduction.
机译:与自闭症谱系障碍(ASD)相关的核心症状和合并症会影响日常生活和生活质量。现有的药理学干预措施只能减轻一些相关症状,但不能解决与ASD相关的潜在病因。随着家庭寻求解决方案,轶事证据声称使用大麻来治疗该人群的症状已得到人们的欢迎。本文分析了最近的同行评审文献,以确定有关ASD人群使用大麻的最新证据。对系统的审查,报告和实验研究进行了评估,以了解使用ASD的大麻的风险和益处的证据的当前程度和性质。目前,三项大规模的临床试验目前处于进展和结果公布的不同阶段。只有五项小型研究被确定专门检查了ASD中的大麻使用情况。鉴于直接在该人群中评估的稀疏证据状态,还审查了研究大麻对ASD共有病理症状(如活动过度,睡眠障碍,自伤,焦虑,行为问题和沟通)的影响的研究。除癫痫病外,所有情况下对大麻影响的结论性研究均无定论。还报告了不利的预后,包括严重的精神病,躁动,嗜睡,食欲下降和易怒。此外,研究中确定了范围广泛的大麻成分和剂量,这影响了普遍性。目前尚无足够的证据证明ASD中使用大麻,因此迫切需要进行其他大规模的对照研究,以加深对风险和好处,并检查“陪伴效应”的影响。这将支持医疗保健提供者与ASD患者及其家人之间关于治疗方案的讨论。证据可能会导致期望的新治疗方法,或防止旨在减轻症状的家庭中未经证实的使用而产生不良后果。

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