Medical cannabis for autism compared to standard medications: what the evidence shows | Research

The takeaway

A review comparing cannabis to standard ASD medications found that commonly prescribed drugs have significant side effects that overlap with ASD symptoms, while CBD-rich cannabis showed promising tolerability and efficacy in early studies.

Parents of children with ASD, clinicians treating autism, and researchers designing cannabinoid clinical trials.

Zero FDA-approved drugs for core ASD symptoms; cannabis shows early promise

What the researchers found

Commonly prescribed ASD medications display varying efficacy, safety, and tolerability, with some causing side effects (aggression, anxiety, irritability, cognitive effects) that mirror the very symptoms they target. CBD-rich medical cannabis appeared effective and tolerable for both core ASD symptoms and comorbidities like irritability and sleep problems in observational studies, though no placebo-controlled trials existed at the time of review.

Why it matters

With no FDA-approved medications for core ASD symptoms and only two approved for associated irritability, families face difficult treatment decisions. Understanding how cannabis compares to existing options is directly relevant to clinical practice.

The numbers in context

Zero approved medications for core ASD symptoms. Two FDA-approved medications for ASD-related irritability. Zero published placebo-controlled cannabis trials for ASD at the time of review. Circulating endocannabinoids identified as a possible ASD biomarker.

How the study worked

Literature review comparing safety and efficacy profiles of medications commonly used in ASD with available evidence on medical cannabis, including biological plausibility through the endocannabinoid system.

What this study cannot tell us

No placebo-controlled cannabis trials for ASD existed at the time of review. Observational studies have inherent biases. Long-term safety of cannabis in ASD populations is unknown. Heterogeneity of ASD makes treatment comparisons difficult.

How to read the evidence

Review comparing established medication evidence with preliminary cannabis observational data; no head-to-head trials available.

When this study was published

Published in 2022.

The bigger picture

The gap between the limited approved treatments for ASD and the growing patient interest in cannabis underscores the urgent need for controlled clinical trials comparing these options directly.

Questions still open

Would CBD-rich cannabis outperform current medications in a head-to-head trial? Could endocannabinoid levels serve as a diagnostic or treatment-response biomarker for ASD?

Common questions

How does cannabis compare to standard autism medications?

The review found that standard ASD medications have variable efficacy and can cause side effects (like aggression and anxiety) that overlap with ASD symptoms, while early CBD-rich cannabis studies showed promising tolerability, though controlled trials are needed.

Are there approved medications for autism?

There are no FDA-approved medications for the core symptoms of ASD. Only two medications are approved for ASD-related irritability, and both come with significant side effect profiles.

Read the original research

Safety and Efficacy of Medical Cannabis in Autism Spectrum Disorder Compared with Commonly Used Medications.

Cannabis and cannabinoid research, 7(4), 451-463

View on PubMed ↗Publisher’s paper ↗

Citation

Holdman, Richard; Vigil, Daniel; Robinson, Kelsey; Shah, Puja; Contreras, Alexandra Elyse. (2022). Safety and Efficacy of Medical Cannabis in Autism Spectrum Disorder Compared with Commonly Used Medications.. Cannabis and cannabinoid research, 7(4), 451-463. https://doi.org/10.1089/can.2020.0154