Uso de canabidiol em crianças e adolescentes com transtorno do espectro autista
uma revisão de escopo
DOI:
https://doi.org/10.23925/2176-2724.2025v37i4e72186Palavras-chave:
Transtorno do espectro autista, Crianças, Canabidiol, Eficácia, SegurançaResumo
Introdução: O transtorno do espectro autista (TEA) é um transtorno do neurodesenvolvimento que afeta a comunicação social e provoca comportamentos repetitivos. O tratamento envolve abordagens terapêuticas e medicamentosas, sendo o canabidiol (CBD) uma alternativa promissora para reduzir sintomas disruptivos e melhorar a interação social. Objetivo: Analisar os efeitos do canabidiol no tratamento de sintomas comportamentais em crianças e adolescentes com TEA, considerando sua eficácia, segurança e interações medicamentosas. Métodos: Esta revisão analisou quatro estudos com 350 participantes, sugerindo redução de sintomas comportamentais. Além disso, houve relatos de melhora na comunicação e efeitos adversos leves. Resultados: Os estudos incluídos nesta revisão de escopo sugerem que o CBD pode apresentar potenciais efeitos benéficos no TEA, mas não houve consenso sobre a superioridade do extrato de planta inteira em relação aos compostos isolados de CBD. Os efeitos variam conforme formulação e gravidade, com avaliações divergentes. A segurança do uso prolongado não está bem estabelecida, e há preocupações sobre interações medicamentosas e riscos metabólicos e cardiovasculares. Conclusão: Esta revisão de escopo mapeou as evidências científicas disponíveis sobre o uso de canabidiol em crianças e adolescentes com Transtorno do Espectro Autista. Os achados indicam que o canabidiol apresenta potencial terapêutico para sintomas comportamentais do TEA, porém, a heterogeneidade dos estudos e a ausência de pesquisas de longo prazo limitam conclusões definitivas sobre sua eficácia e segurança. São necessárias mais pesquisas para preencher as lacunas de conhecimento e fornecer subsídios para a prática clínica.
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Referências
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th edition, text revised. Washington (DC): American Psychiatric Association; 2022.
2. Fombonne E, MacFarlane H, Salem AC. Epidemiological surveys of ASD: advances and remaining challenges. Journal of Autism and Developmental Disorders. 2021 Apr 17; 51.
3. Santomauro DF, Erskine HE, Mantilla AM, Miller PA, Shadid J, Hagins H, et al. The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021. The Lancet Psychiatry [Internet]. 2024 Dec 1;12(2). Available from: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00363-8/fulltext
4. Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, et al. Global Prevalence of autism: a Systematic Review Update. Autism Research [Internet]. 2022;15(5): 778–90. Available from: https://pubmed.ncbi.nlm.nih.gov/35238171/
5. Bolbocean C, Andújar FN, McCormack M, Suter B, Holder JL. Health-Related Quality of Life in Pediatric Patients with Syndromic Autism and their Caregivers. Journal of Autism and Developmental Disorders. 2021 May 3; 52(3): 1334–45.
6. Nelson MA, Shaffer RC, Schmitt LM, Coffman MC, Horn PS, Reisinger DL, et al. Health Related Quality of Life in Autistic Youth and Their Families. Journal of Autism and Developmental Disorders. 2023 Aug 29;
7. Kogan MD, Strickland BB, Blumberg SJ, Singh GK, Perrin JM, van Dyck PC. A National Profile of the Health Care Experiences and Family Impact of Autism Spectrum Disorder Among Children in the United States, 2005-2006. PEDIATRICS. 2008 Dec 1; 122(6): e1149–58.
8. de Pablo GS, Jordá CP, Vaquerizo-Serrano J, Moreno C, Cabras A, Arango C, et al. Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response. Journal of the American Academy of Child & Adolescent Psychiatry [Internet]. 2022 Apr 22; 62(2). Available from: https://www.sciencedirect.com/science/article/pii/S0890856722001988#:~:text=Some%20pharmacological%20interventions%20(particularly%20risperidone
9. Hirota T, King BH. Autism Spectrum Disorder: A Review. Jama. 2023 Jan 10; 329(2): 157–68.
10. Choi H, Kim JH, Yang HS, Kim JY, Cortese S, Smith L, et al. Pharmacological and non-pharmacological interventions for irritability in autism spectrum disorder: a systematic review and meta-analysis with the GRADE assessment. Molecular autism. 2024 Jan 23;15(1).
11. Mazza JA de S, Ferreira LS, Martins-Vieira A de F, Beserra DDL, Rodrigues VA, Malcher-Lopes R, et al. Clinical and Family Implications of Cannabidiol (CBD)-Dominant Full-Spectrum Phytocannabinoid Extract in Children and Adolescents with Moderate to Severe Non-Syndromic Autism Spectrum Disorder (ASD): An Observational Study on Neurobehavioral Management. Pharmaceuticals [Internet]. 2024 May 27; 17(6): 686–6. Available from: https://www.mdpi.com/1424-8247/17/6/686
12. FDA. FDA Regulation of Cannabis and Cannabis-Derived Products: Q&A [Internet]. U.S. Food and Drug Administration. 2019. Available from: https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd
13. Agência Nacional de Vigilância Sanitária. Resolução da Diretoria Colegiada – RDC nº 327, de 9 de dezembro de 2019. Ministério da Saúde do Brasil; 2019.
14. Devinsky O, Jones NA, Cunningham MO, Jayaskera BAP, Devore S, Whalley BJ. Cannabinoid treatments in epilepsy and seizure disorders. Physiological Reviews [Internet]. 2023 Oct 26; Available from: https://pubmed.ncbi.nlm.nih.gov/37882730/
15. Williams CM, Stephens GJ. Development of cannabidiol as a treatment for severe childhood epilepsies. British Journal of Pharmacology [Internet]. 2020 Oct 27; 177(24): 5509–17. Available from: https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bph.15274
16. Murni W, Umar TP, Tandarto K, Simatupang A, Hasugian AR, Purwoko RY, et al. Efficacy and safety of medical cannabinoids in children with cerebral palsy: a systematic review. Einstein [Internet]. 2023 Jan 1; 21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691312/
17. Rodrigues D da S, Soares ASB, Bueno CDF. The use of cannabinoids in children with epilepsy: A systematic review. Epilepsy & Behavior [Internet]. 2023 Aug 1; 145: 109330. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1525505023002494#:~:text=In%20general%2C%20the%20use%20of
18. Jawed B, Esposito JE, Pulcini R, Zakir SK, Botteghi M, Gaudio F, et al. The Evolving Role of Cannabidiol-Rich Cannabis in People with Autism Spectrum Disorder: A Systematic Review. International Journal of Molecular Sciences [Internet]. 2024 Nov 20; 25(22): 12453–3. Available from: https://www.mdpi.com/1422-0067/25/22/12453
19. Siniscalco D, Sapone A, Giordano C, Cirillo A, de Magistris L, Rossi F, et al. Cannabinoid Receptor Type 2, but not Type 1, is Up-Regulated in Peripheral Blood Mononuclear Cells of Children Affected by Autistic Disorders. Journal of Autism and Developmental Disorders. 2013 Apr 13; 43(11): 2686–95.
20. Schiavi S, Manduca A, Carbone E, Buzzelli V, Rava A, Feo A, et al. Anandamide and 2-arachidonoylglycerol differentially modulate autistic-like traits in a genetic model of autism based on FMR1 deletion in rats. Neuropsychopharmacology [Internet]. 2023 May 1; 48(6): 897–907. Available from: https://www.nature.com/articles/s41386-022-01454-7
21. De Pol M, Kolla NJ. Endocannabinoid markers in autism spectrum disorder: A scoping review of human studies. Psychiatry Research. 2021 Dec; 306: 114256.
22. Aran A, Harel M, Cassuto H, Polyansky L, Schnapp A, Wattad N, et al. Cannabinoid treatment for autism: a proof-of-concept randomized trial. Molecular Autism. 2021 Feb 3;12(1).
23. Hacohen M, Stolar OE, Berkovitch M, Elkana O, Kohn E, Hazan A, et al. Children and adolescents with ASD treated with CBD-rich cannabis exhibit significant improvements particularly in social symptoms: an open label study. Translational Psychiatry [Internet]. 2022 Sep 9; 12(1): 375. Available from: https://pubmed.ncbi.nlm.nih.gov/36085294/
24. Silva EA da, Medeiros WMB, Santos JPMD, 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 controlled placebo clinical trial. Trends in Psychiatry and Psychotherapy [Internet]. 2022 May 26; 44. Available from: https://pubmed.ncbi.nlm.nih.gov/35617670/
25. Robinson T, Ali MU, Easterbrook B, Hall W, Jutras-Aswad D, Fischer B. Risk-thresholds for the association between frequency of cannabis use and the development of psychosis: a systematic review and meta-analysis. Psychological Medicine. 2022 Mar 24; 53(9): 1–11.
26. Colizzi M, Weltens N, McGuire P, Lythgoe D, Williams S, Van Oudenhove L, et al. Delta-9-tetrahydrocannabinol increases striatal glutamate levels in healthy individuals: implications for psychosis. Molecular Psychiatry. 2019 Feb 15; 25(12): 3231–40.
27. Gaston TE, Bebin EM, Cutter GR, Liu Y, Szaflarski JP. Interactions between cannabidiol and commonly used antiepileptic drugs. Epilepsia [Internet]. 2017 Aug 6; 58(9):1586–92. Available from: http://doi.wiley.com/10.1111/epi.13852
28. Balachandran P, Elsohly M, Hill KP. Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. Journal of General Internal Medicine. 2021 Jan 29; 36(7).
29. Bozzi Y, Provenzano G, Casarosa S. Neurobiological bases of autism-epilepsy comorbidity: a focus on excitation/inhibition imbalance. European Journal of Neuroscience. 2017 May 17; 47(6): 534–48.
30. Specchio N, Di Micco V, Trivisano M, Ferretti A, Curatolo P. The epilepsy–autism spectrum disorder phenotype in the era of molecular genetics and precision therapy. Epilepsia. 2021 Nov 6; 63(1): 6–21.
31. Fleury-Teixeira P, Caixeta FV, da Silva LCR, Brasil-Neto JP, Malcher-Lopes R. Effects of CBD-Enriched Cannabis sativa Extract on Autism Spectrum Disorder Symptoms: An Observational Study of 18 Participants Undergoing Compassionate Use. Frontiers in Neurology. 2019 Oct 31; 10.
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Copyright (c) 2025 Joao Victor Bomtempo de Castro, Marcelo Trindade Junior, Valeriana de Castro Guimarães, Deborah Branco Ferreira Perilo, Neuma Chaveiro

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