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CASE REPORT article

Front. Psychiatry
Sec. Autism
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1463849
This article is part of the Research Topic Case Reports in Autism: 2023 View all 4 articles

Assessing the Biobehavioral Effects of Ultramicronized-Palmitoylethanolamide Monotherapy in Autistic Adults with Different Severity Levels: a Report of Two Cases

Provisionally accepted
Riccardo Bortoletto Riccardo Bortoletto 1*Fabiana Piscitelli Fabiana Piscitelli 2Marta Basaldella Marta Basaldella 1Claudia Scipioni Claudia Scipioni 1Carla Comacchio Carla Comacchio 1Roberta Fiorino Roberta Fiorino 3,4Stefano Fornasaro Stefano Fornasaro 5Pierluigi Barbieri Pierluigi Barbieri 5Daniele Pagliaro Daniele Pagliaro 1Orietta Sepulcri Orietta Sepulcri 6Martina Fabris Martina Fabris 3,4Francesco Curcio Francesco Curcio 3,4Matteo Balestrieri Matteo Balestrieri 1Marco Colizzi Marco Colizzi 1,7
  • 1 Unit of Psychiatry, Department of Medicine (DMED), University of Udine, Udine, Italy
  • 2 Institute of Biomolecular Chemistry, Department of Chemical Sciences and Materials Technologies, National Research Council (CNR), Pozzuoli, Campania, Italy
  • 3 Department of Medicine (DMED), University of Udine, Udine, Italy
  • 4 Institute of Clinical Pathology, Friuli Centrale Health University Authority (ASUFC), Udine, Italy
  • 5 Department of Chemical and Pharmaceutical Sciences, University of Trieste, Trieste, Friuli-Venezia Giulia, Italy
  • 6 Unit of Psychiatry, Friuli Centrale Health University Authority (ASUFC), Udine, Italy
  • 7 Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom

The final, formatted version of the article will be published soon.

    Despite promise of its supplementation as both monotherapy and add-on treatment in autism spectrum disorder (ASD), the biobehavioral effects of Palmitoylethanolamide (PEA) in autistic adults have never been explored so far. We discussed the cases of two autistic adults with different degrees of severity (level 1 and level 2) presenting with symptoms of psychic distress, who were treated with ultramicronized-PEA (um-PEA) 600 mg/day monotherapy for a sustained period of 4 months. The level 1 autistic patient showed improved depressive symptoms and social engagement at a 12-week follow-up, in parallel to a tendency towards reduced inflammatory response and enhanced endocannabinoid (eCB) signaling, partially relapsing after um-PEA discontinuation at four months. Opposedly, the level 2 autistic patient exhibited a generally stable psychosocial functioning for the initial 12 weeks, consistent with basically unchanged immune and eCBs levels, abruptly deteriorating and leading to antipsychotic initiation afterwards. No significant side effects were reported in both cases during the observation period. The two cases suggest that um-PEA could be an effective option for the treatment of psychic distress in level 1 autistic adults, warranting further investigation of its age-and level-specificity and of the biological underpinnings of its therapeutic effect in ASD.

    Keywords: Neurodevelopmental Disorders, Peroxisome proliferator activated receptor alpha, Glutamate Signaling, nutraceutical, supplementary food, Cannabinoids, Entourage effect

    Received: 12 Jul 2024; Accepted: 13 Sep 2024.

    Copyright: © 2024 Bortoletto, Piscitelli, Basaldella, Scipioni, Comacchio, Fiorino, Fornasaro, Barbieri, Pagliaro, Sepulcri, Fabris, Curcio, Balestrieri and Colizzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Riccardo Bortoletto, Unit of Psychiatry, Department of Medicine (DMED), University of Udine, Udine, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.