Current state of evidence of cannabis utilization for treatment of autism spectrum disorders
Current state of evidence of cannabis utilization for treatment of autism spectrum disorders
复制标题
DOI：
10.1186/s12888-019-2259-4
复制
发表时间：
2019-10-29
期刊：
影响因子：
4.4
通讯作者：
Maddux, Marlaina
中科院分区：
文献类型：
--
作者：
Agarwal, Rumi;Burke, Shanna L.;Maddux, Marlaina
自闭症谱系障碍(ASD)的核心症状和共病影响日常生活和生活质量。现有的药理学干预措施只能缓解一些相关症状，但无法解决与ASD相关的潜在病因。坊间证据声称在这一人群中使用大麻治疗症状是有益的，随着家庭寻求解决方案，这种证据越来越受欢迎。本文分析了最近的同行评议文献，以确定关于自闭症人群使用大麻的证据现状。对系统性综述、报告和实验研究进行了评估，以了解目前有关使用大麻对自闭症风险和益处的证据的范围和性质。目前，三项大规模临床试验目前正处于进展和结果公布的不同阶段。只有五项小规模研究专门研究了自闭症患者的大麻使用情况。鉴于在这一人群中直接评估的证据稀少，对大麻对自闭症共同病理症状如多动、睡眠障碍、自残、焦虑、行为问题和沟通的影响的研究也进行了综述。研究发现，大麻对除癫痫外的所有疾病的影响都是混合的和不确定的。不良结果也有报道，包括严重的精神病、激越、嗜睡、食欲下降和易怒。此外，研究中确定了广泛的大麻成分和剂量，这影响了普适性。目前没有足够的证据表明自闭症患者使用大麻，这就迫切需要更多的大规模对照研究，以增加对风险和益处的了解，并检查“环境效应”的影响。这将支持医疗保健提供者与自闭症患者及其家人之间讨论治疗方案。证据可能导致希望的新的治疗路线，或防止在旨在减轻症状的家庭中未经证实的使用造成不良后果。
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.