The anecdotal reports of successful cannabinoid therapies seem to be supported by the fact that phytocannabinoids from cannabis, and other natural sources, display similar pharmacological characteristics to that of endocannabinoids that are dysregulated in ASD.^[31] The potential therapeutic value of supplementing the endocannabinoid system with phytocannabinoids has been suggested in the treatment of a number of diseases with suspected underlying endocannabinoid deficiencies.^[34] Documentation of the safety and clinical efficacy of phytocannabinoids in a variety of treatments continues to grow.^[16] In regards to the treatment of ASD, some similar characteristics are worth highlighting, including:

• Promotion of Neurogenesis^{[19, 2, 5]}
• Neuroprotection^{[15, 23, 35]}
• Powerful Antioxidants^{[3, 31, 15]}
• Neuromodulation^{[8, 23, 31, 43]}
• Anti-inflammatory^{[31, 18]}

Based on preclinical research ECS deficiencies appear to be associated with ASD, and it’s implicated as a potential target for treatment. Phytocannabinoids target the ECS and display similar pharmacological characteristics to endocannabinoids that are dysregulated. It’s been suggested that therapies for conditions with corresponding ECS deficiencies may include supplementation with phytocannabinoids. This seems to potentially support the anecdotal reports of successful cannabinoid therapies in ASD.

Treating Symptoms Associated with ASD

There is a considerable body of supportive preclinical data in regards to targeting the ECS with phytocannabinoids in the treatment of a number of symptoms and diseases associated with ASD. For sake of brevity some of these will be highlighted and cited:

• G.I. Disorders^{[4, 10, 42]}
• Repetitive Behaviors^{[6, 9, 14]}
• Seizures^{[20, 32, 40]}
• Sleep Dysfunction^{[28, 41]}
• Self Injurious Behavior and Tantrums^{[27, 29, 30]}
• Tuberous Sclerosis^{[21, 38, 44]}
• Cerebral Ischemia^{[37, 7, 26, 12]}
• Depression/Anxiety^{[17, 1, 36]}
• Cachexia^{[11, 24]}

Again, anecdotal reports of success appear to be supported by an abundance of preclinical research that indicates a potential role for phytocannabinoids in the treatment of symptoms and diseases associated with ASD.

Botanical Extracts > Dronabinol

Due to the relatively common off-label use of Dronabinol (a man-made/synthetic form of THC), for ASD therapy, it seems relevant to point out the substantial data, including clinical studies, suggesting that the combined administration of CBD along with THC (and possibly other cannabinoids/terpenes present in cannabis) exhibit additive and synergistic effects. This is known as the entourage effect and results in greater clinical efficacies when compared to either cannabinoid alone.^{[25, 18, 34]}

The second most prominent cannabinoid in cannabis is cannabidiol (CBD).^[13] CBD has been shown to inhibit intoxication, sedation, and tachycardia associated with delta-9-tetrahydrocannabinol (THC).^[34] It’s been shown to increase the clinical efficacy of THC, while adding therapeutic value in its own right.^[34]

A large portion of the research conducted thus far with ASD and cannabinoids has been with Dronabinol (a synthetic form of THC) alone. Dronabinol has indicated potential for treatment in a single adolescent case study of autism.^[22] Does that mean THC along with CBD might offer increased clinical efficacy similar to the way they have been demonstrated to with other conditions?^[34] Based on the results of previous research and anecdotal reports this might be the case.

The added benefit of additional cannabinoids (and the added benefit of specifically tailoring ratios) is an important component that sets botanical extracts from cannabis apart from THC or CBD alone. This is why having access to a variety of cannabis chemotypes will always have more potential for therapeutic value than a select cannabinoid, ratio, or cannabis chemotype.

Discussion

Based on their ability to target the ECS, and their shared characteristics with dysfunctional endocannabinoid levels, preclinical evidence supports the potential therapeutic value of phytocannabinoids in ASD therapy.

Highlighting individual pharmacological characteristics of CBD, THC, and other phytocannabinoids is beyond the scope of this paper. However, based on the ECS deficiencies associated with ASD, and the ability of phytocannabinoids to target and modulate aspects of the deficiencies, anecdotal reports seem to be supported by the best available scientific data. It appears that phytocannabinoids have the potential for therapeutic value in some severe cases of ASD.

This brings us to the topic of the final installment to this ASD series, the practical use of botanical extracts and when it might be appropriate to explore potential cannabis-based therapies for ASD symptom treatment.