EFEITO DOS CANABINOIDES NO COMPORTAMENTO SOCIAL DE CRIANÇAS E ADOLESCENTES COM TRANSTORNO DO ESPECTRO DO AUTISMO: REVISÃO SISTEMÁTICA
DOI:
https://doi.org/10.36557/2674-8169.2025v7n3p500-517Keywords:
Canabidiol, comportamento, Transtorno do Espectro Autista, SegurançaAbstract
Objective: To evaluate the effect and safety of cannabinoids on the social behavior of children and adolescents with Autism Spectrum Disorder (ASD). Methods: The study was conducted through a systematic review following the Prisma 2020 guidelines. The selection of articles was based on the PICOS criteria, including children and adolescents diagnosed with ASD as the target population. The intervention consisted of cannabinoid use at any dose and route of administration, with a comparison between the group that received cannabinoids and a control group that received a placebo. The outcomes assessed included the efficacy of cannabinoids in managing ASD symptoms, as well as safety and the occurrence of adverse effects. Randomized controlled trials (RCTs), crossover RCTs, quasi-randomized clinical trials were considered and cohort-type observational studies. Results: The initial screening resulted in the selection of 116 articles based on the title and abstract, while 97 were excluded at this stage. In the selection phase, two independent reviewers performed a full reading of the selected articles, resulting in the inclusion of 06 articles. The studies demonstrated improvement in social behavior with few adverse events. Conclusions: Cannabinoids are a promising therapeutic alternative for children and adolescents with ASD, providing improvements in social behaviors, psychomotor agitation, and anxiety, and being a relatively safe option.
Downloads
References
Nikolov R, Jonker J, Scahill L. Autismo: tratamentos psicofarmacológicos e áreas de interesse para desenvolvimentos futuros. Brazilian Journal of Psychiatry [Internet], 2006 [acesso em 2024 jun 26]; 28: s39-s46. Disponível em: https://doi.org/10.1590/S1516-44462006000500006
American Psychiatric Association. Manual diagnóstico e estatístico de transtornos mentais: DSM-5-TR. 5. ed. rev. Porto Alegre: Artmed; 2023.
Maenner MJ. Prevalência e características do transtorno do espectro do autismo entre crianças de 8 anos — Rede de monitoramento de deficiências de desenvolvimento e autismo, 11 locais, Estados Unidos, 2020. MMWR Surveillance Summaries, Atlanta, 2023; 72(2):1–14.
Almeida ML, Neves AS. A popularização diagnóstica do autismo: uma falsa epidemia? Psicologia: Ciência e Profissão [Internet], 2020 [acesso em 2024 jun 26]; 40. Disponível em: ttps://doi.org/10.1590/1982-3703003180896
Tomazellia J, Grianelli VR, Fernandes CS. Incidência de transtorno global do desenvolvimento em crianças: características e análise a partir dos CAPSi. Psicologia USP[Internet], 2023 [acesso em 2024 out 26]; 34: e210002. Disponível em: https://doi.org/10.1590/0103-6564e210002
Ministério da Educação (Br). Diretoria de Estatísticas Educacionais. Censo escolar 2023.
Matei R. Uma perspectiva multiprofissional acerca da participação dos pais na detecção precoce do diagnóstico e no prognóstico de crianças com TEA. Psicologia-Tubarão[Internet], 2020 [acesso em 2024 out 26]. Disponível em: https://repositorio.animaeducacao.com.br/items/698a0b2b-9812-4edc-8226-bb39f493e3f6
Barros-Neto SG; Brunoni D; Cysneiros RM. Abordagem psicofarmacológica no transtorno do espectro autista: uma revisão narrativa. Cadernos de Pós-Graduação em Distúrbios do Desenvolvimento [Internet], 2019 [acesso em 2024 ago 19]; 19(2): 38-6. Disponível em: https://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1519-03072019000200004
Pretzsch CM, Voinescu B, Mendez MA, Wichers R, Ajram,L, Ivin G, et al. The effect of cannabidiol (CBD) on low-frequency activity and functional connectivity in the brain of adults with and without autism spectrum disorder (ASD). J Psychopharmacol. [Internet], 2019 [acesso em 2024 ago 19];33(9):1141-8. Disponível em: https://pubmed.ncbi.nlm.nih.gov/31237191/
Schnapp A, Harel M, Cayam-Rand D, Cassuto H, Polyansky L, Aran A. A Placebo-Controlled Trial of Cannabinoid Treatment for Disruptive Behavior in Children and Adolescents with Autism Spectrum Disorder: Effects on Sleep Parameters as Measured by the CSHQ. Biomedicines. [Internet], 2022 [acesso em 2024 jun 26] 13;10(7):1685. Disponível em: doi: 10.3390/biomedicines10071685.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372. doi: 10.1136/bmj.n71
Higgins JPT, Savović J, Page MJ, Elbers RG, Sterne JAC. A revised tool for assessing risk of bias in randomized trials (RoB 2). In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane; 2020. Available from: www.training.cochrane.org/handbook
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355.
Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Schünemann HJ, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-6.
Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1-12.
Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomized and non-randomized studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377-84.
Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute; 2014. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
Aran A, Harel M, Cassuto H, Polyansky L, Schnapp A, Wattad N, Shmueli D, Golan D, Castellanos FX. Cannabinoid treatment for autism: a proof-of-concept randomized trial. Mol Autism. [Internet], 2021 [acesso em 2024 jun 28] Feb 3;12(1):6. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33536055/
Hacohen M, Stolar OE, Berkovitch M, Elkana O, Kohn E, Hazan A, Heyman E, Sobol Y, Waissengreen D, Gal E, Dinstein I. Children and adolescents with ASD treated with CBD-rich cannabis exhibit significant improvements particularly in social symptoms: an open label study. Transl Psychiatry. [Internet], 2022 [acesso em 2024 jun 28] 9;12(1):375. Disponível em: https://pubmed.ncbi.nlm.nih.gov/36085294/
Kuester G, Vergara K, Ahumada A, et al. Oral cannabis extracts as a promising treatment for the core symptoms of autism spectrum disorder: Preliminary experience in Chilean patients. J Neurol Sci [Internet], 2017 [acesso em 2024 jul 13] ; 381:932–933. Disponível em: https://www.jns-journal.com/article/S0022-510X(17)33120-9/abstract
Silva Junior EA da, Medeiros WMB, Santos JPM dos, Sousa JMM de, Costa FB da, Pontes KM, et al.. Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: randomized, double-blind, and placebo-controlled clinical trial. Trends Psychiatry Psychother [Internet]. 2024;46:e20210396. Available from: https://doi.org/10.47626/2237-6089-2021-039
Aran A, Cassuto H, Lubotzky A, Wattad N, Hazan E. Brief Report: Cannabidiol-Rich Cannabis in Children with Autism Spectrum Disorder and Severe Behavioral Problems-A Retrospective Feasibility Study. J Autism Dev Disord. [Internet], 2019 [acesso em 2024 out 06];49(3):1284-1288. doi: 10.1007/s10803-018-3808-2.Disponível em: https://doi.org/10.1007/s10803-018-3808-2. Acesso em: 06 out. 2024.
Barchel D, Stolar O, De-Haan T, Ziv-Baran T, Saban N, Fuchs DO, Koren G, Berkovitch M. Oral Cannabidiol Use in Children With Autism Spectrum Disorder to Treat Related Symptoms and Co-morbidities. Front Pharmacol. 2019 [acesso em 2024 out 06]9;9:1521. Disponível em: 10.3389/fphar.2018.01521.
Poleg S, Golubchik P, Offen D, Weizman A. Cannabidiol as a suggested candidate for treatment of autism spectrum disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2019 Mar 8;89:90-96. Disponível em: doi: 10.1016/j.pnpbp.2018.08.030.
Agarwal R, Burke SL, Maddux M. Estado atual da evidência da utilização de cannabis para o tratamento de transtornos do espectro do autismo. BMC Psychiatry, [Internet]. 2019 Jan. 15 [cited 2024 Oct. 31]; 19(1).
Engler GP, da Silva GAF, Torres TM, Priscilla D, Lopez AGP, da Silva M da CS, Morais MJ de D, Leitão FNC. O uso de Cannabis no tratamento do Transtorno do Espectro do Autismo – revisão sistemática. Braz. J. Hea. Rev. [Internet]. 2024 Jan. 15 [cited 2024 Oct. 31];7(1):1301-15. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/66334
Bar-Lev Schleider L, Mechoulam R, Saban N, Meiri G, Novack V. Real life Experience of Medical Cannabis Treatment in Autism: Analysis of Safety and Efficacy. Sci Rep. 2019 [acesso em 2024 out 06];9(1):200. Disponível em: doi: 10.1038/s41598-018-37570-y.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ana Gabriela Prazeres Oliveira, Leila Márcia Fróes da Silva , Julita Maria Freitas Coelho
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.
