I’m Eric Hollander, and I am a professor of psychiatry investigating the compounds contained in cannabis for their potential to help autistic individuals improve their disruptive and compulsive behaviors, social communication and quality of life. ...

I have employed full spectrum tincture and I found a higher dosage to be necessary for a number of patients. Can you comment on this? Do you find full spectrum superior in selective patients compared to mono therapeutic CBD?

some of the existing data involves single cannabinoid compounds rather full spectrum cannabinoids, and the results may vary based on the dosage, blend, route of administration, etc

data with epidiolex in rare forms of epilepsy is with a single compound CBD;

data with CBDV is using a single compound that does not contain THC

there is some data with full spectrum 20:1 ratio CBD:THC

it is unclear whether or not THC is necessary or helpful, and whether or not an entourage effect is helpful or associated with additional side effects

there is a need for additional studies to determine benefits and risks for a range of different compounds, combination of compounds, dosing, optimal age ranges, particular behavioral symptoms, etc

Given that cannabis is also linked to exacerbating psychoses, what are the implications for people with this susceptibility and autism?

There is a real risk that individuals who are prone to psychosis can have an exacerbation of psychosis with THC.

Therefore, CBD or CBDV that do not contain THC would be a safer alternative

in addition, THC stimulates the CB1 and CB2 receptors, and could have adverse effects on the developing nervous system, so additional studies of risks vs benefits in young people are needed

I have also read that therapy can be augmented by the addition of other natural agents such as GABA or even cacao. This is based on Endo cannabinoid receptors. Any thoughts?

gabaergic mechanisms are involved in cortical inhibition and GABA enhancing approaches may also decrease epileptiform activity and decrease irritability and repetitive behaviors.

we are studying whether CBDV which impacts excitation/ihibition balance may improve irritability and disruptive behaviors, improve repetitive and compulsive behaviors and improve social communication

many individuals who take cannabinoids are also taking other natural supplements or complementary medicines.

best to be aware of potential drug-drug interactions, and to discuss with your health care team

sometimes these can have complementary effects on different symptom domains - cognition, sleep, anxiety, etc

CBDV is a plant or phytocannabinoid that has potential therapeutic effects.

The endogenous or endocannabinoid system is also implicated in ASD and related disorders; is influenced by stress, infection, excercise, and has an effect on mood, anxiety, behavior, appetite, wond healing, etc.

so another approach might be to modify the endocannabinoid system to get therapeutic effects

How does THC differently affect people on the spectrum compared to neurotipicals? Is there a higher psychosis-proneness in neurodiverse populations?

there may be a higher incidence of psychosis in ASD vs the general population

My Nephew has down syndrome and exhibits similar symptoms of someone on the spectrum (compulsive behavior, social communication, etc..). Would your study be relevant to people with down syndrome?

if data is promiising in ASD, then there may be relevance for other neurodevelopmental disorders

Might autism with ODD be looked at at some point?

I’ll keep an eye on your research.

thanks

some individuals with ASD do have oppositional behavior, and understanding what the individual is trying to communicate by the behavior and using behavioral techniques may be helpful.

this may or not be accompanied by irritability or disruptive behaviors

the irritability and disruptive behavior that can accompany autism in some individuals include aggression, self injury, temper tantrums.

What is the reason you mostly focus on children/young adults? (If the reason is that the symptoms lessen with age, could medication interfere with that process somehow?)

one reason is to reduce heterogeneity, and to focus on children with high irritability

What are the potential mechanisms by which CBDV might impact irritability in your trials?

CBDV may exert it's therapuetic effects by altering the excitation/inhibition balance (decreasing cortical excitation and increasing cortical inhibition), and also by dampening down the immune-inflammatory activation in autism spectrum disorders (ASD)

CBDV does not stimulate the CB1 receptors in the central nervous system or the CB2 receptors in the immune and GI systems, but may work via a different set of receptors, and may also block the above receptors

My friend's autistic teen is already very food focussed, he's always looking for the next snack.

Wouldn't weed exacerbate this behavior to a pathological extent?

THC can increase appetite and hunger, but CBD and CBDV may decrease appetite

What is the end goal for this in terms of application and everyday usage?

For most people who are not clinically minded, they might see this kind of research as a quasi offshoot of medical marijuana and it’s suspect benefits. I’m very pro pot, but I worry that some people will see this as a way to simply justify marijuana in all its forms. Is your end goal a pill that must be prescribed? Over the counter medication? Something you need a medical marijuana card for?

I feel that cannabis research will benefit the further away from “stoners” it gets, and this seems pretty far from the bong shop so I’m hopeful it’ll pay off in fantastic ways.

the end goal might be to have FDA approved pharmaceutical preparations with adequate safety and efficacy data and good manufacturing processes

my daughter (autism linked to Bainbridge Ropers Syndrome) is a prolific head banger, often till she bleeds from her forehead. Is this the type of behavioral symptoms that might be helped in the future due to your research?

yes, head banging is a symptom of irritability and disruptive behaviors

How has the broader body of research on CBDV grown since you and your team began working on it? How has that affected your approach?

there is evidence of anticonvulsant effects and some suggestion of enhancing social communication with CBDV in other studies.

Our studies are focussing on irritability, compulsivity and social communication in children and adolescents with ASD

If people are interested in participating in a research study of CBDV in childhood/adolescent ASD, they can e mail [email protected]

CBDV has also been studied in animal models of autism and found to improve cognition, repetitive behaviors, and seizures in animals

What can you tell me about tolerance, addiction, and withdrawal effects related to CBD? I know it is a partial serotonin agonist, so it seems to good to be true that it wouldn't have any risks or side effects

does not seem to be tolerance, withdrawal or addiction with CBD or CBDV

What are the benefits of CBDV over CBG?

Is CBDV showing any positive results for verbal and/or non-verbal communication?

Are there any studies you need participants for?

one preliminary study showed some improved verbal and communication endpoints

Why is there such an aversion in cannabis research to investigating multiple cannabis candidates at once? Or at least their relationship to each other?

Most studies that I read are using purified compounds like d9-THC, CBD, or in this case CBDV. I don’t doubt the potential for a single compound to have efficacy for certain targets, but it’s removing the context of the biosynthesis of these cannabanoids. Cannabis evolved to produce a complex collection of cannabinoids - why would we not take that into account when investigating isolated compounds?

I get that using whole-flower cannabis introduces a variety of logistical hurdles in research. But why is it that we then only use a single purified compound when we could be characterizing relationships between a handful of the 100s of identified cannabinoids on desired outcomes?

in some studies, individual compounds had similar efficacy to blended compounds, but you are right, further study and comparison with blended compounds is needed

Hey there!

I'm a person with a lot of AS/NLD symptoms, and cannabis definitely helped make me more "normal."

Is there any way someone like me can assist your research?

participating in clinical trials would be helpful to expand the knowledge base