The symptoms of ADHD are now relatively successfully treated with methylphenidate, does CBD oil from the THC free hemp variant offer an alternative?
What is ADHD?
ADHD is nothing but attention deficit hyperactivity disorder. Children with ADHD are restless, unconcentrated, forgetful, have increased impulsiveness in actions and decisions, and reduced extrinsic (from outside) motivation. There is motor restlessness or a strong movement urge and often a reduced awareness of danger. ADHD does not disappear, as is often assumed, in adults it will continue in the adult age, even if behavior changes. ADHD is diagnosed as an exclusion diagnosis based on the symptoms and descriptions of the social environment.
Before diagnosis should be excluded in any case:
- Thyroid diseases, also autoimmun
- iron deficiency
- Any vitamin deficiency, especially B
- stress disorder
- IQ> 130 (can also be comorbid)
- Minority IQ <80
- Visual disturbances, hearing disorders (can also be comorbid)
- Partial performance problems (can also be comorbid)
- Consequences of sleep apnea syndrome
- Autism spectrum (now diagnosed as comorbid)
- Fragile X syndrome
- Neurofibromatosis type 1
What is the cause of ADHD
The cause of the disease is not clear, just as the exact physiological and neurological processes behind the symptoms. Causes seem predominantly genetic. Because of the paradoxical efficacy of the drug methylphenidate, an amphetamine, it is thought that dopamine is involved in the development of the symptoms. The theories are not entirely agreed on how this is to be. The current state of the medicine assumes that the dopamine reuptake is too quickly and therefore can not act effectively enough.
The approved therapy for ADHD
Notorious is Ritalin, a preparation with the active substance Methylphenidate, short MPH. Methylphenidate is an amphetamine, usually it boosts the body and mind, but it has a calming effect in people with ADHD. Often, the drug is regarded critically, especially since it brings not insignificant side effects. Very crucial however for many parents, it is a medication attempt! The doctors do not know exactly how it works, even if it does work or not , they can´t say with certainty. Sure, it’s a purely symptomatic treatment. For the protection and justification of many parents, however, it is noted that hardly any of the parents makes the decision easy. The often unfortunate situation, which is caused in particular by pressure from institutions on the child and the parents, sometimes requires a responsible decision for the drug to prevent secondary problems for the child. Also, medicine does not provide alternatives. However, drug therapy should always be flanked by behavioral therapy and parent training, and the schools should also show more competence and tolerance.
What is CBD?
CBD oil is an oil made from hemp. However, not like hemp oil, from the seeds, but from a macerate or other extract from flower buds and their distillation. Important here is, the plant is free from the psychoactive substance THC, respectively, the content of THC is extremely low (0.2%). Thus, CBD oil does not have any effects of the drug cannabis or marijuana. And is also not under the law of narcotics (Just check for your country, this is by the law of Germany). Hemp contains over 80 so-called cannabinoids.
The main active substance of the CBD oil is the cannabidiol, but the main substance of the hemp is in cannabidic acid. The proportion of one or other active substance is dependent on many factors, depending on the harvest of the plant, processing and storage. Early harvest, low light and low temperatures increase the content of cannabidiolic acid (CBDA). This is especially important when it comes to inflammation-inhibiting effects or the interaction with the serotonin receptor. It is also important that CBDA increases the bioavailability of CBD, so a natural oil promises higher efficacy than pure CBD extract. Other canabinoids are: CBDA – Cannabigerol, CBC – Cannabichromes, THCA – Tetrahydrocaanabinoloic Acid, THCV – Tetrahydrocannabivarin, CBN – Cannabinol. All of these active ingredients are effective and contribute to the therapeutic benefit of the oil as far as it is not chemically purified oil.
What is the effect of cannabidiol?
CBD has been shown to be beneficial in the Dravet syndrome and in the Lennox Gastaut syndrome, and in multiple sclerosis.
For cannabidiol numerous therapeutic effects have been described, e.g.. REM sleep disturbance disorder (RBD). Its anti-oxidant effect as well as anti-inflammatory, antibacterial, antiepileptic, neuroprotective, anticonvulsiv, antiemetic, anxiolytic or antipsychotic effects give perspective for treating certain nerve infections, epilepsy, dizziness, vomiting, anxiety and schizophrenia as well as neurodegenerative or cancer diseases. Cannabidiol pharmacological effects are mediated through G protein coupled receptors, cannabinoid type I (CB1) and cannabinoid type II (CB2), which are highly expressed in the hippocampus and other parts of the central nervous system. When activated, CB1 receptors inhibit synaptic transmission through action on voltage-gated calcium and potassium channels, which are known to modulate epileptiform and seizure activity. CB2 receptors are primarily expressed in the immune system and have limited expression in the central nervous system. The effects of CBD are CB2 receptor independent.Studies have demonstrated that CBD has a low affinity for the CB1 receptors, but even at low concentrations, CBD decreases G-protein activity. CB1 receptors are expressed on many glutamatergic synapses. CBD may act at CB1 receptors to inhibit glutamate release. CB1 receptor expression is upregulated at GABAergic synapses and shown to be downregulated at glutamatergic synapses.
Other targets for CBD include transient receptor potential (TRP) channels that are involved with the modulation of intracellular calcium. Cannabinoids are highly lipophilic, allowing access to intracellular sites of action, resulting in increases in calcium in a variety of cell types including hippocampal neurons. CBD actions on calcium homeostasis may provide a basis for CBD neuroprotective properties. Another for ADHD perhaps very crucial effect is the inhibition of reuptake of noradrenaline, dopamine, serotonin and gamma butyric acid.
Are there researches on CBD and ADHD?
To make it clear and disillusioning: no. There is currently no approved research that studies the efficacy of cannabidiol or CBD oil in ADHD. For cannabis, however, there are 2 studies with interesting results that demonstrate the efficacy of cannabis (with THC) in adults with ADHD. According to these studies, even it is under discussion if patients with ADHD react differently to cannabinoids than healthy patients. Animal model confirming the involvement of the CB1 receptor (cannabinoid receptor of the endocannabinoid system) hinting in the direction.Some private success reports on the use of CBD oil can be found. Unfortunately, considerable research is needed. Whether you want to try the oil or not you have to weigh well in the unclear research situation, it would, as with methylphenidate, an attempt. Although the side effects are estimated to be lower, the data is not exhausted.
Ok then I take hemp oil …
Even hemp oil can have a quite positive effect on ADHD in case of a lack of omega 3 fatty acids. But and I would like to mention here, hemp oil is not a CBD oil and does not have the same active ingredients. Hemp oil is extracted from the seeds, is extremely healthy with regard to omega 3 fatty acids. However, there are also preparations in which the extract of the plant is dissolved in this oil.
What I look for when buying
- There are many arguments and criteria that can be decisive for the purchase. Of course, this also depends on the desired effect. Criteria for decision should be:
- The solvent
- The content of CBD
- The content of CBDa
- The content of THC
- the carrier oil
- Natural oil with other ingredients instead of chemically purified
CBD How do I apply CBD oil?
Oils with different CBD contents are available. They are usually taken by drops under the tongue, but transdermal application is also possible. The recommended dose is very individual and depends on body weight. CBD is effective from doses of 10 to 40 mg. Depending on the treatment goal, it can also be used with a high dosage (up to 800 mg for adults). For children, dosages between 2 and 10 mg per kg of body weight are mentioned. The experience with children with epilepsy show that everyone reacts differently to CBD. It is therefore always started with a small dose, which is increased to the desired effect. Best is 3 daily doses. Transdermal administration results in continuous uptake while sublingual intake is faster but shorter.
It is important to note that CBD is broken down by cytochromes. This results in interactions with other medicines. Genetic defects in the area of cytochromes can also affect the dose viability of CBD. Simultaneous administration of CYP3A4 inhibitors (eg ketoconazole, itraconazole, ritonavir or clarithromycin) may lead to an increase in cannabidiol levels. Simultaneous use of CYP3A4 inducers (eg rifampicin, carbamazepine, phenytoin, phenobarbital or St. John’s Wort) can lead to a reduction in cannabidiol levels. By the same cause other medicaments can be affected these include pantoprazole, clobazam (CYP2C19), ondansetron and risperidone (CYP2D6). During pregnancy, CBD should not be taken.