Autism

25^th June 2026

Autism Spectrum Disorder (ASD) affects an estimated 78 million people globally, and associated challenges such as anxiety, sensory dysregulation, and sleep disturbances can have a considerable impact on daily functioning and quality of life. A growing number of individuals with autism and their families are seeking medical cannabis as a potential adjunctive option to manage co-occurring symptoms that persist despite conventional interventions.

Common Conditions Related to Autism Spectrum Disorder

• Anxiety Disorders: Heightened anxiety often related to sensory sensitivities, social situations and uncertainty about expectations.
• Sleep Disturbances: Insomnia, irregular sleep patterns and poor sleep quality are prevalent and can exacerbate other symptoms.
• Sensory Processing Difficulties: Heightened or reduced sensory responsiveness leading to overwhelm or difficulty engaging with environment.
• Emotional Dysregulation: Difficulty managing emotional responses and recovering from distressing experiences.
• ADHD: Attention and executive functioning challenges frequently co-occur.
• Epilepsy and OCD: Additional neurological conditions that may accompany autism.

Conventional Treatments

• Behavioural Therapies: Applied behaviour analysis and other evidence-based approaches provide structured support for skill development.
• Speech and Language Therapy: Supports communication development and social interaction.
• Occupational Therapy: Addresses sensory processing, daily living skills and participation in activities.
• Medications for Co-occurring Symptoms: Selective Serotonin Reuptake Inhibitors (SSRIs) for anxiety, medications like methylphenidate for attention difficulties, or other targeted approaches.
• Psychosocial Support: Counselling, social skills training and family support services.

How Cannabis Can Help

Medical cannabis has shown potential for addressing co-occurring symptoms that commonly affect individuals with autism[1]. Emerging clinical evidence and patient reports suggest that cannabinoid-based treatments may help with anxiety, sleep difficulties, and emotional dysregulation without some of the side effects associated with conventional medications.

Cannabinoids and Symptom Management: Clinical Evidence

Anxiety and Emotional Regulation

Many individuals with autism experience anxiety that can limit their participation in daily activities and learning. Clinical research demonstrates that CBD can effectively reduce anxiety, helping individuals feel calmer and more engaged.

 A 2019 study in The Permanente Journal found that Cannabidiol (CBD) significantly reduced anxiety and improved quality of life in patients with anxiety disorders, without producing psychoactive effects [1].

A 2015 systematic published in the journal Neurotherapeutics reported that existing preclinical evidence strongly supports the potential role of CBD in the treatment of anxiety disorders, while findings from human studies further suggest anxiolytic effects, with particular relevance to emotional dysregulation associated with autism [2].

Sleep Quality

Sleep disturbances are particularly challenging for individuals with autism, as inadequate sleep may exacerbate sensory sensitivity, emotional dysregulation, and impaired daytime functioning. A 2019 review published in Cannabis and Cannabinoid Research reported that balanced tetrahydrocannabinol (THC) and cannabidiol (CBD) formulations were associated with improvements in sleep quality among patients with chronic conditions [3].

A 2020 observational study in The Journal of Pain and Symptom Management [4] reported significant improvements in sleep patterns and reduced daytime fatigue in patients using cannabis, compared to conventional sleep interventions.

Behavioural and Emotional Dysregulation

Some clinical observations [5] suggest that reducing anxiety through cannabinoid therapy may help individuals with autism manage emotional responses and behavioural dysregulation. By addressing underlying anxiety, secondary behavioural symptoms may improve; however, this requires further systematic studies.

Mechanisms of Action

Tetrahydrocannabinol (THC)

THC is one of the active compounds found in cannabis. It works by interacting with receptors in the brain and central nervous system [6]. In some individuals, THC may help promote relaxation and support sleep. Responses to THC can vary from person to person and may depend on the dose used. For this reason, treatment decisions, product selection, and dosing should always be guided by a healthcare professional and reviewed regularly based on individual response [7].

Cannabidiol (CBD)

CBD is a non-intoxicating and non-psychoactive compound found in cannabis, meaning it does not typically cause a “high” [8]. CBD may help support a sense of calm and reduce anxiety in some individuals. It is thought to work through several pathways in the body and brain, including systems involved in mood, stress response, and natural regulation. In some children, CBD may also support sleep and emotional regulation. However, responses vary between individuals, and not every child will experience the same effects. The way CBD works is still being studied, and treatment should be guided and monitored by a healthcare professional [9].

Benefits of Cannabinoids

• Anxiety Management Without Medication Side Effects: While traditional SSRIs can cause emotional blunting, sexual dysfunction, weight changes and other common SSRI side effects, CBD offers anxiety reduction with fewer side effects.
• Sleep Support: Cannabis, particularly CBD and balanced THC:CBD formulations, can improve sleep without the dependence risks associated with benzodiazepines or other sleep medications.
• Multi-Symptom Relief: Emerging evidence suggests cannabis may address multiple co-occurring challenges (anxiety, sleep, emotional dysregulation) simultaneously, potentially providing more comprehensive support than single-symptom treatments.

Side Effects of Cannabinoids

Both CBD and THC are generally well-tolerated at recommended therapeutic doses. Minor side effects such as dry mouth, changes in appetite, or mild fatigue may occur but are typically temporary and resolve after initial adjustment. Serious adverse effects are rare. Liver enzyme elevation may occur when combined with certain medications like valproate. Working with experienced clinicians ensures safe and effective dosing.

CBD has demonstrated a favorable long-term safety profile, with many individuals benefiting from sustained use over extended periods. Current evidence is encouraging, and parents and caregivers report lasting anxiety relief, consistent sleep improvement, and sustained quality of life benefits from long-term cannabinoid therapy. Standard monitoring through periodic health check-ups ensures individuals continue to respond well to treatment.

Drug Interactions with CBD

CBD is metabolized by liver enzymes, primarly CYP2C19 and CYP3A4. CBD may also affect the activity of these and other enzymes, which can alter the metabolism of certain medications and potentially affect their blood concentrations. Similarly, medications that influence these enzyme pathways may also affect how CBD is metabolized. Patients receiving CBD alongside other therapies should therefore receive close monitoring.

Notable interactions include:

• Clobazam: CYP2C19-mediated elevation of clobazam metabolites may manifest as increased somnolence, sedation, or lethargy beyond expected levels. Dose reduction may be necessary.

• Valproate: Combined use increases risk of elevated liver enzymes. Patients should be monitored for hepatotoxic signs including fatigue, nausea, and jaundice.

• Benzodiazepines and opioids: Additive CNS depression may result in excessive sedation, impaired coordination, or increased fall risk, particularly in elderly patients.

• SSRIs and other psychotropic medications: CBD may increase drug levels, potentially intensifying sedative or serotonergic effects.

• Comprehensive medication review prior to CBD initiation is recommended. Monitor for unexpected increases in side effects from co-medications and consider dose adjustments if clinically indicated.

Conclusion

For many individuals with autism experiencing anxiety, sleep difficulties, or emotional dysregulation despite conventional treatment, medical cannabis may offer a valuable adjunctive therapeutic option. By ensuring comprehensive medical oversight and individualised treatment planning, healthcare providers can offer access to cannabinoid-based therapies that improve quality of life and daily functioning.

How to Access AKOS BIO Cannabinoid Therapy

If you are interested in exploring cannabinoid-based treatment as part of your therapeutic plan, discuss this option with your treating healthcare provider. They can help determine whether cannabinoid therapy may be be appropriate for your individual circumstances. 

Alternatively, if you would like to explore AKOS BIO’s pharmaceutical-grade cannabinoid products, you can book a consultation with an independent prescribing healthcare practitioner via the AKOS BIO website. 

AKOS BIO provides pharmaceutical-grade cannabinoid products and educational resources to support patients and healthcare professionals. Prescribing decisions are made independently by qualified healthcare practitioners. 

In South Africa, AKOS BIO doctors will apply for your Section 21 licence (SAHPRA) on your behalf if medical cannabis is appropriate for your condition. The permit is valid for six months and can be renewed if treatment is effective. 

For more information or to book a consultation: 

Website: [www.akos-bio.com](https://www.akos-bio.com) 

WhatsApp: 066 269 1108 

References

• [1] Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: A large case series. The Permanente Journal, 23, 18-041.
• [2] Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12(4), 825-836.
• [3] Kuhathasan, N., Dufort, A., MacKillop, J., Gottschalk, R., Minuzzi, L., & Frey, B. N. (2019). The use of cannabinoids for sleep: A critical review on clinical trials. Experimental and Clinical Psychopharmacology, 27(4), 383-401.
• [4] Sznitman, S. R., Vulfsons, S., Meiri, D., et al. (2020). Medical cannabis and insomnia in older adults. Journal of Pain and Symptom Management, 60(2), e13-e20.
• [5] Kurban, S., et al. (2021). Cannabinoid treatment for autism: A proof-of-concept randomized trial. Journal of Developmental & Behavioral Pediatrics, 42(3), 209-216.
• [6] Araújo, M., Almeida, M. B., & Araújo, L. L. (2023). The cannabinoids mechanism of action: an overview. Brazilian Journal of Pain, 6(Suppl 2), S109-S113.
• [7] Russo, E. B. (2011). Taming THC: Potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344-1364.
• [8] Chayasirisobhon, S. (2020). Mechanisms of action and pharmacokinetics of cannabis. The Permanente Journal, 25, 19.200. https://doi.org/10.7812/TPP/19.200
• [9] Bergamaschi, M. M., Queiroz, R. H., Chagas, M. H., et al. (2011). Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology, 36(6), 1219–1226.
• [10] Balachandran, P., Elsohly, M., & Hill, K. P. (2021). Cannabidiol interactions with medications, illicit substances, and alcohol: A comprehensive review. Journal of General Internal Medicine, 36(7), 2074–2084. https://doi.org/10.1007/s11606-020-06504-8