Use of cannabidiolic acid in the treatment of autism spectrum disorder and associated disorders
The present invention relates to the use of cannabidiolic acid (CBDA) in the treatment of autism spectrum disorder (ASD) and ASD-associated disorders, such as Fragile X syndrome (FXS); Rett syndrome (RS); or Angelman syndrome (AS). CBDA has been shown to be particularly effective in improving cognitive dysfunction in rodent models of ASD, FXS, RS and AS. The CBDA is preferably substantially pure. It may take the form of a highly purified extract of cannabis such that the CBDA is present at greater than 95% of the total extract (w/w) and the other components of the extract are characterised. Alternatively, the CBDA is synthetically produced.
1. A method of treating one or more symptoms or disease characteristics associated with autistic spectrum disorder (ASD) or ASD-associated disorders, as defined by DSM-IV, in a subject in need thereof, the method comprising administering cannabidiolic acid (CBDA) to the subject, wherein the one or more symptoms or disease characteristics are one or more of: (i) qualitative impairment in social interaction; (ii) qualitative impairment in communication; and (iii) restricted repetitive and stereotyped patterns of behaviour interest and activities, wherein the CBDA is present as a highly purified extract of cannabis such that the CBDA is present at greater than 95% of the total extract (w/w).
2. The method according to claim 1 , wherein the symptoms or disease characteristics of (i) qualitative impairment in social interaction include one or more of: (a) marked impairment in the use of multiple nonverbal behaviours; (b) failure to develop peer relationships appropriate to developmental level; (c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people; and (d) lack of social or emotional reciprocity.
3. The method according to claim 1 , wherein the symptoms or disease characteristics of (ii) qualitative impairment in communication include one or more of: (a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime); (b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others; (c) stereotyped and repetitive use of language or idiosyncratic language; and (d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.
4. The method according to claim 1 , wherein the symptoms or disease characteristics of (iii) restricted repetitive and stereotyped patterns of behaviour interest and activities include one or more of: (a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus; (b) apparently inflexible adherence to specific, non-functional routines or rituals; (c) stereotyped and repetitive motor mannerisms; and (d) persistent preoccupation with parts of objects.
5. The method according to claim 1 , wherein the symptoms or disease characteristics associated with of autistic spectrum disorder comprise two or more symptoms associated with (i) qualitative impairment in social interaction; one or more symptoms associated with (ii) qualitative impairment in communication, and one or more symptoms associated with (iii) restricted repetitive and stereotyped patterns of behaviour interest and activities.
6. A method of treating one or more symptoms or disease characteristics associated with autistic spectrum disorder (ASD) or ASD-associated disorders, as defined by DSM-V, in a subject in need thereof, the method comprising administering cannabidiolic acid (CBDA) to the subject, wherein the one or more symptoms or disease characteristics are one or more of: (a) persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and (b) restricted, repetitive patterns of behaviour, interests, or activities, wherein the CBDA is present as a highly purified extract of cannabis such that the CBDA is present at greater than 95% of the total extract (w/w).
7. The method according to claim 6 , wherein the symptoms or disease characteristics of (a) persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays include one or more of: (i) deficits in social-emotional reciprocity; (ii) deficits in nonverbal communicative behaviours used for social interaction; and (iii) deficits in developing and maintaining relationships.
8. The method according to claim 6 , wherein the symptoms or disease characteristics of (b) restricted, repetitive patterns of behaviour, interests, or activities include one or more of: (i) stereotyped or repetitive speech, motor movements, or use of objects; excessive adherence to routines, (ii) ritualized patterns of verbal or nonverbal behaviour, or excessive resistance to change; (iii) highly restricted, fixated interests that are abnormal in intensity or focus; and (iv) hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment.
9. The method according to claim 6 wherein the symptoms or disease characteristics associated with autistic spectrum disorder comprise all three of (i) deficits in social-emotional reciprocity; (ii) deficits in nonverbal communicative behaviours used for social interaction; and (iii) deficits in developing and maintaining relationships together with two or more of (i) stereotyped or repetitive speech, motor movements, or use of objects; excessive adherence to routines, (ii) ritualized patterns of verbal or nonverbal behaviour, or excessive resistance to change; (iii) highly restricted, fixated interests that are abnormal in intensity or focus; and (iv) hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment.
10. The method according to claim 1 , wherein the ASD-associated disorder is Fragile X syndrome.
11. The method according to claim 1 , wherein the ASD-associated disorder is Rett syndrome.
12. The method according to claim 1 , wherein the ASD-associated disorder is Angelman syndrome.
13. The method according to claim 1 , wherein the CBDA is administered in combination with one or more concomitant medications.
14. The method according to claim 13 , wherein the one or more concomitant medications is an anti-epileptic drug (AED), an anti-psychotic drug, melatonin, an SSRI, or methylphenidate.
15. The method according to claim 1 , wherein the extract comprises less than 0.15% THC.
16. The method according to claim 1 , wherein the dose of CBDA administered is greater than 0.01 mg/kg/day.
17. The method according to claim 16 , wherein the dose of CBDA administered is between 1 to 30 mg/kg/day.
18. The method according to claim 1 , wherein the CBDA is administered as an oral formulation.