Autism Spectrum Disorder
Study register · detail Kohortenstudie · Autism Spectrum Disorder · 2025

Purified cannabidiol leads to improvement of severe treatment-resistant behavioral symptoms in children with autism spectrum disorder.

Clear benefit GRADE Very low 4 citations
Samplen = 20 Pat.
Duration11 months follow-up
EndpointParent-reported symptom…
Blindingoffen
DesignKohortenstudie
Cannabinoidcbd
Max. dose700.0 mg
Key finding

90% of patients showed improvement in at least one symptom after CBD treatment; 83,5% of all reported symptoms improved; approximately 30% improvement in irritability, social withdrawal and hyperactivity.

Summary

Prospective before-after study n=20 children with severe treatment-refractory autism, purified CBD as add-on (median 363,5 mg, range 100–700 mg), median 11 months follow-up. 90 % (18/20) showed improvement in ≥1 symptom; 83,5 % of all reported symptoms improved. Secondary outcomes: ~30 % improvement in irritability, social withdrawal, hyperactivity; repetitive behavior improved in 50 %. 65 % mild to moderate transient side effects (increased irritability, decreased appetite). 40 % reduction/discontinuation of concomitant medication.

P
PopulationChildren with severe autism spectrum disorder (ASD) and treatment-resistant behavioral abnormalities as well as intellectual disability, n=20
I
InterventionPurified cannabidiol (CBD) as add-on medication, median total dose 363,5 mg (range 100–700 mg)
O
Outcome90 % of patients (18/20) showed improvement in at least one parent-reported symptom; irritability, social withdrawal and hyperactivity improved by approx. 30 %; repetitive behaviors improved in 50 % of patients
Confidence in the evidence
Very low

The lowest GRADE level, the effect estimate remains uncertain.

Downgraded for
Imprecision
Quality profile
Sample size
Blinding Open-label
Effect size Clear benefit
Citations / year
Authors
Fortini PS, Toibaro JJ, Caraballo RH
DOI 10.1016/j.pbb.2025.173971
Design: Kohortenstudie
Share
Abstract
Objective: The aim of our study was to evaluate the efficacy and safety of purified cannabidiol as an add-on medication in pediatric patients with autism spectrum disorder (ASD) associated with treatment resistant repetitive behaviors, behavior disorders, and intellectual disability and unresponsive to conventional medications and behavioral interventions. Material And Methods: A prospective, observational, before-and-after study was conducted including 20 patients with severe ASD who initiated treatment with purified CBD. Patients were evaluated using different scales at baseline and at three-month intervals during followup. Results: The median total CBD dose was 363.5 mg (range, 100-700), and the median follow-up was 11 months (range, 6-12). As to the primary outcome evaluating symptoms reported by parents, improvement in at least one was observed after CBD initiation in 18 patients (90 %) and no improvement in two (10 %) (1 worsening, 1 no response). In the responders, 83.5 % (n = 76) of all reported symptoms improved. Regarding the secondary outcomes based on the assessment with different scales, improvement of around 30 % was found in irritability, social withdrawal, hyperactivity. Restricted and repetitive behavior improved in nine (50 %), while no changes were seen in seven (38.8 %). Sleep patterns were found to be slightly improved. Adverse effects were reported in 13 patients (65 %), mainly consisting of increased irritability and decreased appetite, but were mild or moderate and transient in all. In 40 % of the children, concomitant medication could be reduced or partially discontinued. Conclusion: Our results suggest that treatment with purified CBD is effective and safe and could benefit patients with severe ASD by improving some of the core symptoms, including repetitive behaviors and social interaction, as well as associated comorbidities. The families considered the quality of life to have improved.

The impediment to action advances action. — Marcus Aurelius