CBD Oil and Cannabis for ADHD

Timothy Culbert, MD, IFMCP

The Potential Benefits of CBD Oil and Cannabis for ADHD*

The only clear thing we know is that more research is needed to truly understand what benefits, if any, CBD may pose in ADHD management. The same holds true for cannabis. We know that's not helpful for most folks searching for relief from ADHD symptoms. If your physician has recommended CBD oil for ADD/ADHD, then see below for common dosing suggestions and what the science says about both CBD oil and cannabis.

CBD Oil Dosage for ADD/ADHD*

A physician may recommend CBD oil as a preventative tool for ADD/ADHD. It may help to manage acute symptom flare ups, but the preventative maintenance is likely most important. Similar to a dietary supplement or medication, it may work best to establish a baseline concentration in the system.

A trusted, high quality, full spectrum CBD oil could be taken daily in the form of tinctures or gel capsules. The ingredients in the two products are the same; the only difference between the two is the form factor and dosage: pills vs. sublingual tinctures.

Most suggestions for ADD or ADHD note to start with 15 mg per day of CBD oil. If relief is not felt at this dosage, then increasing by 5-10 mg until the desired effects are achieved may work.

The Science*

There is sparse evidence that CBD oil can improve the core symptoms of ADHD, and the evidence that exists is mostly anecdotal. Nonetheless, that isn’t stopping patients from trying it.

The current concern is that consumer/patient use has sped past scientific evidence for use and regulation on product quality. That means long-term effects are virtually unknown and snake-oil companies continue to pop up with CBD products that are not pure. 

An article in ADDitude magazine summarized this:

“During [a person’s] development, I worry about cannabinoids, both CBD and THC,” says UCLA’s Evans. “There are adenosine receptors (and CB2 receptors) on the microglia that are critical for brain development, and CBD inhibits adenosine uptake. This may be a beneficial factor for epilepsy and autoimmune and inflammatory diseases, but who knows for ADHD.” 

The article continues,

"Once CBD enters the body, no one yet knows how it works. Its long-term effects are a mystery. Exactly how does CBD work — in the brain and over many years? As Dr. Carson bluntly puts it: “We don’t know and we don’t know.”

Does Cannabis Help Relieve Symptoms of ADHD?*

Cannabis use and ADHD are both independently associated with impaired attention, inhibition, and functioning. Because of this, many researchers believe that cannabis use would exacerbate existing ADHD symptoms. However, there isn’t any evidence to support or contradict this.

It's also important to consider that some people with ADHD struggle with anxiety, which can make their symptoms worse. There is minor evidence to show that CBD oil and cannabis may help with symptoms of anxiety.

A 2016 case study backed up earlier claims by researchers that CBD may help with anxiety and sleep problems in children. Further research will need to explore this effect in a large cohort.

A 2013 study also explored the relationship between symptoms of ADHD and cannabis use. People with subtypes of ADHD that involve symptoms of hyperactivity and impulsivity were more likely to use cannabis daily to manage their symptoms than people with inattentive subtypes of ADHD.

One 2015 study explored the relationship between ADHD, depression, and marijuana use in undergraduate students. Although the researchers established that some students used marijuana to cope with depressive symptoms, its overall effect on these symptoms was unclear. 

A 2013 study on ADHD subtype and cannabis use also posed interesting results. After collecting data from 2,811 current cannabis users, researchers found that people who used cannabis daily self-reported symptoms of hyperactivity-impulsivity when not using cannabis. 

One 2014 study assessed cannabis use and ADHD symptoms in 376 undergraduate students. The researchers found that current and childhood inattention were associated with more severe cannabis use and dependency. They also found that participants who demonstrated hyperactive-impulsive behavior as children began to use cannabis earlier than participants who did not.

CBD Supplements at Natural Mental Health

Sleep CBD is a blend of broad-spectrum CBD (30 mg per serving) combined with 5 mg of CBN (cannabinol) and 3 mg of melatonin. CBN is a form of phytocannabinoid shown to be more specifically helpful for sleep, and melatonin is nature’s internal timekeeper, helping set a more consistent bedtime. CBD Sleep may improve a variety of challenging sleep issues, and is especially helpful for those who have trouble falling asleep. 

Calm CBD combines 30 mg of broad-spectrum CBD with 200 mg of l-theanine, an amino acid that can also help reduce anxiety and stabilize mood. Together, they may improve stress resilience and calm anxiety without sedation. Taken at bedtime, CBD Calm may also be helpful for those who tend to wake in the middle of the night.

Restore CBD gummies are infused with the highest quality, all-natural, US-grown hemp. Each gummy offers a precise dose of broad-spectrum CBD to support your endocannabinoid system with naturally occurring, plant-based ingredients. This synergy of multiple cannabinoids work together for the greatest impact to restore your natural resilience. 

^{*Note: Some of the supplements discussed in this article can cause side effects, but many people tolerate them much better than prescription medications. They are generally considered safe, however, they should not be started without your doctor’s knowledge and supervision. If you are taking medication already, be sure to talk with your doctor before adding any of these items. If you are considering going off medication, remember never to stop your medication suddenly—always consult with your doctor about how to safely taper off any psychiatric medication. See terms. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.}

RELATED ARTICLE

CBD Oil for Kids and Teens

The World Health Organization's Comprehensive Report on CBD (2018) concluded that “CBD is generally well tolerated with a good safety profile.” The WHO report found no evidence that CBD has the potential for abuse or dependence. The experts were optimistic that that preliminary evidence suggests that it may be a “useful  treatment for a variety of medical conditions.” Some claims for use of CBD oil with children include benefits such as improved focus, better memory, higher daytime alertness, less agitation, and boosted immune function. Read the article.

SOURCES

1. Abrams, D. (2018). The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report. European journal of internal medicine, 49, 7-11.
2. Atakan, Z. (2012). Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic advances in psychopharmacology, 2(6), 241-54. doi:10.1177/2045125312457586
3. Atalay, S., Jarocka-Karpowicz, I., & Skrzydlewska, E. (2019). Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants, 9(1), 21. https://doi.org/10.3390/antiox9010021
4. Ballard, C. R., & Junior, M. R. M. (2019). Health benefits of flavonoids. In Bioactive compounds (pp. 185-201). Woodhead Publishing.
5. Bridgeman, M. B., & Daniel T. A. (2017). Medicinal cannabis: History, pharmacology, And implications for the acute care setting. P&T: A peer-reviewed journal for formulary management, 42(3), 180-188.
6. Cox-Georgian, D., Ramadoss, N., Dona, C., & Basu, C. (2019). Therapeutic and medicinal uses of terpenes. In Medicinal Plants (pp. 333-359). Springer, Cham.
7. García-Gutiérrez, M.S., Navarrete, F., Gasparyan, A., Austrich-Olivares, A., Sala, F., & Manzanares, J. (2020). Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders. Biomolecules, 10(11). https://doi.org/10.3390/biom10111575  
8. Kocis, P, T., & Vrana, K, E. (2020). Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions. Med Cannabis Cannabinoids, 3:61-73. doi: 10.1159/000507998
9. Lee, C. H., & Giuliani, F. (2019). The Role of Inflammation in Depression and Fatigue. Frontiers in immunology, 10, 1696. https://doi.org/10.3389/fimmu.2019.01696
10. Leonard, B. E. (2014). Impact of inflammation on neurotransmitter changes in major depression: An insight into the action of antidepressants, Progress in Neuro-Psychopharmacology and Biological Psychiatry, 48. 261-267. https://doi.org/10.1016/j.pnpbp.2013.10.018.
11. Morales, P. et al. (2017). Molecular targets of the phytocannabinoids: A complex picture. Progress in the chemistry of organic natural products, 103, 103-131. doi:10.1007/978-3-319-45541-9_4
12. Noreen N., Muhammad, F., Akhtar, B., Azam, F., & Anwar, M. I. (2018). Is cannabidiol a promising substance for new drug development? A review of its potential therapeutic applications. Crit Rev Eukaryot Gene Expr, 28(1), 73-86. doi: 10.1615/CritRevEukaryotGeneExpr.2018021528. 
13. Sales, A. J., Crestani, C. C., Guimarães, F. S., Joca, S. (2018). Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 86. 255-261. https://doi.org/10.1016/j.pnpbp.2018.06.002.
14. Sales, A. J., Fogaça, M. V., Sartim, A. G., et al. (2019). Cannabidiol induces rapid and sustained antidepressant-like effects through increased BDNH signaling and synaptogenesis in the prefrontal cortex. Mol Neurobiol, 56, 1070–1081. doi:10.1007/s12035-018-1143-4. 
15. Sarris, J. et al. (2020). Medicinal cannabis for psychiatric disorders: A clinically-focused systematic review. BMC Psychiatry, 20(1). doi:10.1186/s12888-019-2409-8
16. Wong, S. S., & Wilens, T. E. (2017). Medical cannabinoids in children and adolescents: a systematic review. Pediatrics, 140(5).