Can cannabis help with Down's Syndrome?

In recent years, parents have reported improvement in children with Down syndrome’s inattention, speech problems, and other symptoms after using CBD oil.

Recent studies suggest that the potential benefits of cannabis-based products in Down syndrome symptoms are due to the involvement of the body’s endocannabinoid system in the disorder. Most notably, researchers have found that people with Down syndrome have excessive endocannabinoid receptor activity in the hippocampus, the part of the brain associated with memory and that blocking this overstimulation may provide cognitive benefits.

There’s also research evidence that cannabis can relieve some symptoms that occur in this condition, such as impulsivity, digestive issues, and seizures. Cannabis may also be able to help by protecting people with Down syndrome from amyloid plaques, which has been linked to the cognitive deficits which also occur in those suffering from Alzheimer’s disease.

Although more human-based studies are sorely needed, current findings highlight the potential of cannabis-based medicines in DS. Here’s what the research says.

How cannabis works on Down Syndrome

The endocannabinoid system (ECS) exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces its own cannabinoids, which modulate and activate its various functions, but as its name suggests, the endocannabinoid system can also be modulated and activated by cannabinoids found in the cannabis plant. Because the entire system was only discovered in the past 30 years, scientists still have much to learn about the myriad ways cannabis affects the human body.

The ECS plays an essential role in cognitive health and function, particularly through the activity of the cannabinoid type-1 (CB1) receptor, which is abundant in the brain. ECS dysfunction has been linked to depression and other neurological disorders, and recent research suggests that the ECS may be also involved in Down syndrome.

For starters, a 2008 study that examined Down syndrome brain tissue found a link between beta-amyloid plaques and the ECS. The brain cells associated with these plaques had increased activity of CB2 receptors and the enzyme FAAH, which breaks down the endocannabinoid anandamide. 

Meanwhile, a 2014 animal study found that blocking MAGL, an enzyme that breaks down the endocannabinoid 2-AG, reduced beta-amyloid levels, and improved long-term memory and some other cognitive deficits in mice with Down syndrome.

A 2019 animal study also made several connections between CB1 receptors and Down syndrome. The researchers examined two mouse models, discovering the following:

• Down syndrome mice had more CB1 receptors in the hippocampus region of the brain, which is particularly important for memory
• Blocking CB1 receptors with medication or gene therapy restored Down-related deficits in memory, synaptic plasticity, and adult neurogenesis (the growth of new brain cells in the adult brain)

These findings do not make it clear whether the ECS is actually dysfunctional in Down syndrome or simply acting as a defense mechanism. However, they do suggest that therapies that target the ECS — including cannabis — could potentially improve some symptoms.

Medical studies on Down syndrome and cannabis

There have been no animal or human studies looking at the use of cannabis for Down syndrome. However, there is still evidence that cannabis-based products can improve some symptoms and protect the brain against amyloid plaques that may contribute to cognitive issues in both Alzheimer’s disease and Down syndrome.

For starters, studies show that cannabis may help with some Down symptoms, including impulsivity, inattention, gastrointestinal issues, sleeping problems, and seizures.

One 2017 clinical study found that cannabis-based medication Sativex improved hyperactivity, impulsivity, and other symptoms in people with ADHD. Since difficulty focusing and impulsive behavior is a common issue for children with Down syndrome, this is quite significant.

Furthermore, people with Down syndrome often suffer from gastrointestinal symptoms such as vomiting, diarrhea, abdominal pain, and constipation, and have an increased risk of developing GI disorders. There’s evidence that cannabis can be helpful here as well. For one, a 2015 review of 23 clinical studies concluded that cannabis-based medicines may relieve nausea and vomiting caused by chemotherapy. 

There’s also evidence that cannabis may help relieve other GI symptoms. One 2011 study of people with inflammatory bowel diseases (IBD) found that cannabis was commonly used to relieve symptoms of abdominal pain, diarrhea, and bloating. Similar results were reported by a 2019 study. Additionally, the pain-relieving effects of cannabinoids are supported by a large body of evidence. 

Furthermore, there’s some evidence that the non-psychoactive cannabinoid CBD may help with poor sleep. For example, a 2019 study found that CBD improved sleep issues in 67% of the 72 study participants. 

CBD can also help with the seizures that occur in about 8% of people with Down syndrome. In fact, CBD has been shown to be an effective seizure treatment and CBD-based drug Epidiolex received FDA approval for treating specific seizure conditions including Dravet Syndrome and Lennox-Gastaut in 2018. The research in this area is quite promising, suggesting that CBD may treat a variety of seizures:

• A 2017 study found that CBD in addition to antiepileptic drugs significantly improved seizures in children with Dravet syndrome
• A 2018 study reported that CBD taken alongside antiepileptic medication improved seizures in people with Lennox-Gastaut syndrome
• A similar 2018 study reported improvements in Lennox-Gastaut syndrome sufferers taking CBD

Yet another way that cannabis can help with Down syndrome is by protecting the brain against beta-amyloid plaques and neurodegeneration. These plaques may play a role in the cognitive deficits seen during development and aging in people with Down syndromes. The neuroprotective effects of cannabinoids have been demonstrated in several studies:

• A 2004 study found that CBD protected nerve cells exposed to beta-amyloid
• A 2016 study reported that cannabinoids such as THC help remove amyloid plaques from cells and reduce the related inflammation
• Similarly, a 2018 review highlighted the neuroprotective effects of CBD and THC and discussed an animal study that reported that THC reduced amyloid plaques and damaged neurons

Lastly, there’s anecdotal evidence that hemp-based (low THC/high CBD) preparations such as CBD oil may improve Down symptoms. In particular, parents of children with Down syndrome have reported improvements in speech (being able to speak more clearly and in longer sentences), attention and focus, mobility (improved ability to walk and play/exercise), and seizures. 

This all amounts to a patchwork of evidence that cannabis-based medicines can help children and adults with Down syndrome by improving some symptoms and protecting against amyloid plaques and neurodegeneration. However, it’s too early to say anything more substantial. More research is needed, particularly human studies of cannabis-based medicines in people with Down syndrome. 

Potential side effects of cannabis use

Although cannabis shows early promise in the treatment of Down syndrome, it does have some side effects. These tend to vary depending on whether you’re using a THC- or CBD-heavy preparation.

Regular, THC-rich cannabis (commonly known as marijuana) can cause dry mouth, red eyes, sleepiness, dizziness, impaired memory and reaction time, and increased heart rate. Some individuals might also experience feelings of paranoia and anxiety.

Meanwhile, CBD-rich preparations (especially those made from hemp), such as CBD oil, have too little THC to cause mind-altering effects. They can cause minor side effects including diarrhea, low blood pressure, dry mouth, lightheadedness, sleepiness, and changes in appetite. However, these effects are unlikely to occur at the doses taken by most people and have only been reported in studies using extremely high doses.

Overall, although cannabis is a relatively safe option with temporary side effects, it’s always best to consult with a healthcare professional before starting treatment.