CANNABIDIOL IN THE AUTISM SPECTRUM: CLINICAL EVIDENCE AND ETHICAL LIMITS OF THERAPEUTIC USE

Abstract

Introduction: Cannabidiol (CBD) has been discussed as a potential intervention in the management of symptoms associated with autism spectrum disorder (ASD), motivating clinical investigations that have evaluated everything from behavioral changes to the impact on neurological comorbidities. Recent literature has explored plausible neurophysiological mechanisms, including modulation of the endocannabinoid system, anti-inflammatory action, and effect on neuronal excitation, and has reported heterogeneous results stemming from varied study designs, small samples, and non-standardized outcome measures. Objective: To synthesize clinical evidence on the therapeutic use of cannabidiol in autism spectrum disorder and to analyze the ethical limitations associated with its application in vulnerable populations. Methodology: The review followed the PRISMA checklist for data searches, selection, extraction, and synthesis, consulting the PubMed, SciELO, and Web of Science databases and considering scientific articles published in the last ten years. Five descriptors were used: "cannabidiol," "autism spectrum disorder," "cannabinoids," "adverse effects," and "therapeutics." Controlled or observational clinical studies with behavioral and safety outcomes, systematic reviews, and book chapters were included; anecdotal reports without clinical data, preclinical studies without clinical translation, and publications outside the stipulated period were excluded. Results: Preliminary evidence of a reduction in symptoms such as agitation and episodes of aggression was found in some studies; however, variability in doses, formulations, and evaluation criteria compromised firm interpretations. Mild to moderate adverse effects and gaps in long-term follow-up were frequently reported. Conclusion: Clinical evidence pointed to potential benefits of CBD in subgroups of ASD, but was insufficient for generalized recommendations; methodological and ethical issues required robust, standardized studies with prolonged monitoring before its incorporation into clinical practice.