The potential for medicinal cannabis to help manage challenging behaviour in people with intellectual disability: A perspective review

Laura Korb, Samuel Tromans, Bhathika Perera, Nagina Khan, Lisa Burrows, Richard Laugharne, Angela Hassiotis, Victoria Allgar, Daryl Efron, Ian Maidment, Rohit Shankar

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Around 2% of the population have intellectual disabilities. Over one-third people with intellectual disabilities (PwID) present with 'challenging behaviour', which nosologically and diagnostically is an abstract concept. Challenging behaviour is influenced by a range of bio-psycho-social factors in a population, which is unable to suitably comprehend and/or communicate concerns. This predisposes to poor health and social outcomes. There is no evidence-based treatments for managing challenging behaviour. Cannabidiol (CBD) and tetrahydrocannabinol (THC) are being trialled for a range of disorders, which are over-represented in PwID and provoke challenging behaviours, such as severe epilepsy, spasticity, post-traumatic stress disorder, social phobia, pain, etc.

METHODS: This perspective review explores the different conditions, which benefit from medicinal CBD/THC preparations, by analysing recent literature from neurobiological, pre-clinical and clinical studies related to the topic. The evidence is synthesised to build an argument of the therapeutic benefits and challenges of medicinal cannabis to manage severe challenging behaviour in PwID.

RESULTS: There is developing evidence of medicinal CBD/THC improving psychiatric and behavioural presentations in general. In particular, there is emergent proof in certain key areas of influence of medicinal CBD/THC positively supporting challenging behaviour, for example in children with neurodevelopmental disorders. However, there are significant challenges in employing such treatments in vulnerable populations such as PwID.

CONCLUSION: Further clinical research for the considered use of medicinal CBD/THC for challenging behaviour management in PwID is needed. Strong co-production with experts with lived experience is needed for further testing to be done in this exciting new area.

Original languageEnglish
Pages (from-to)1201-1208
Number of pages8
JournalJournal of Psychopharmacology
Issue number12
Early online date8 Nov 2023
Publication statusPublished - Dec 2023

Bibliographical note

Copyright © The Author(s) 2023. This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (


  • Medicinal cannabis
  • challenging behaviour
  • developmental disorders
  • intellectual disability
  • polypharmacy


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