CBD Oil for ADHD: Research on Treating Symptoms
IF YOU FEEL LIKE YOU’VE been hearing an awful lot about CBD lately, you’re not alone. Short for cannabidiol, CBD has begun cropping up in a wide range of consumer products, from topical oils to edible gummies. These products purport to treat or improve a vast number of health conditions and symptoms. But many medical professionals caution that it’s too soon to say that CBD oil and other products that contain this component derived from the cannabis plant can treat certain conditions. Evidence of their medical efficacy is limited, and most of these products are unregulated by the FDA.
CBD vs. THC
CBD is short for cannabidiol, one of many cannabinoids that are produced by plants in the cannabis family. Another cannabinoid is tetrahydrocannabinal, or THC, the primary psychoactive element in marijuana, which is responsible for making you feel high after using marijuana. Unlike THC, CBD doesn’t produce this high.
Despite these differences, CBD, like THC, interacts with your endocannabinoid system, a natural part of the body that produces naturally occurring cannabis-like molecules. These compounds, called endocannabinoids, act like neurotransmitters to maintain balance in the body. Using CBD or THC can stimulate the production of more of the body’s own endocannabinoids, which some patients find helps reduce anxiety, pain and inflammation.
Dr. Jordan Tishler, a member of the medical advisory board for cannabisMD and president of the Association of Cannabis Specialists, says that there are more than 100 chemicals in cannabis. THC and CBD are just two of them. “Frankly, CBD hasn’t been researched nearly as much as THC,” he says. Some of that is related to the fact that cannabis, the plant from which both CBD and THC derive, has long been illegal across the United States and much of the funding for new medicines comes from the federal government. But as more states legalize the use of both medical and recreational marijuana, these CBD products are entering mainstream usage and being considered as a potential treatment for many diseases and conditions.
What Is CBD Oil?
Dr. Harrison Weed, an internal medicine specialist at the Ohio State University Wexner Medical Center, explains that CBD oil is an extract of the cannabis sativa plant. “Cannabis sativa can have a high content of the psychoactive chemical THC,” short for tetrahydrocannabinol, in which case it’s referred to as marijuana. In lower concentrations, it’s referred to as hemp. “Extracts that contain mostly CBD and only very small amounts of THC are referred to as CBD oil.”
Daniele Piomelli, professor of anatomy and neurobiology at the UCI School of Medicine and director of the UCI Center for the Study of Cannabis at the University of California, Irvine, says that “in the case of cannabis and CBD, we do not know a lot of what we think should be pretty clear. When we talk about CBD oil, one would expect that there should be a definition of CBD oil using a pharmaceutical or medicinal context. One would expect the appropriate authorities to define what it is. But right now, we have a situation where there as many definitions as there are companies that are marketing CBD oil.”
That said, Piomelli adds that “in very general terms, CBD oil is an oil extract of a hemp plant or hemp variety that produces mostly CBD,” instead of the more psychoactive THC compound.
When it comes to using CBD oil to treat any medical condition, the jury is still out, Piomelli says. He draws the distinction that while the compound CBD may eventually be proven effective in treating a few conditions, such as anxiety disorders and epilepsy, the CBD oil that we see on convenience store shelves today that claims to treat everything from insomnia to Alzheimer’s is unlikely to be of much use. “A lot of those things are wishful thinking right now,” Piomelli says.
More research needs to be done and a standardization of terms and dosages across the industry would go a long way toward making clear what people are buying when they pick up a CBD oil product.
CBD Oil As Treatment
The use of products that contain CBD, such as oils, to treat medical conditions is considered controversial, and many doctors, like Piomelli, warn that CBD oil is just a 21st-century version of snake oil that only cures people of a heavier wallet.
Still, because CBD works on the endocannabinoid system and has demonstrated anti-inflammatory effects, it’s been theorized that it could potentially be useful in treating a range of disease and disorders including:
- Epilepsy. The neurological condition epilepsy, which causes seizures, is the only condition for which CBD has been proven an effective treatment. In 2018, the FDA approved Epidiolex, a pure CBD oil medication for the treatment of a rare form of severe epilepsy.
- Anxiety disorders. A 2018 study in the journal Epidemiological and Psychiatric Sciences concluded that CBD could be helpful in reducing anxiety symptoms, but that more research needs to be done.
- Migraines and frequent headaches. CBD and CBD oil products are often touted as being beneficial for pain relief, and when it comes to headaches and migraines, it could potentially be a useful treatment, according to one 2017 literature review.
- Psychiatric diseases such as schizophrenia. Because of its ability to reduce anxiety in some people, CBD has been suggested as a possible means of treating schizophrenia and other psychiatric disease that can trigger severe anxiety and psychotic episodes. A 2012 review noted that while more work needs to be done, CBD has potential to be used as an antipsychotic.
- Neurodegenerative disorders, such as Alzheimer’s disease. Cognitive decline and other neurodegenerative disorders are often related to inflammation and oxidative damage to brain cells. A 2014 study in the Journal of Alzheimer’s Disease suggested that CBD could slow some of this damage and prevent the development of memory issues and deficits in facial recognition among mice.
- Cancer. A 2019 review conducted in Slovenia noted that CBD has earned a place in palliative care for cancer treatment – to aid in pain management and to reduce anxiety and nausea. In addition, some studies have also suggested that it might inhibit the growth and spread of certain types of cancer cells.
- Diabetes. A 2016 study showed that CBD could reduce inflammation in the pancreas, which could benefit those with type 1 diabetes.
Can CBD Treat ADHD?
Attention deficit hyperactivity disorder, better known as ADHD, causes an inability to pay attention and a physical restlessness that may be inappropriate or disproportionate to the situation. ADHD can also cause people to act impulsively and may lead to difficulty in personal relationships and trouble at school or work.
Because CBD has been shown to alleviate anxiety in some people, it’s thought that it might have applications in the treatment of ADHD. “CBD receptors are found on nervous system cells, and CBD can be sedating,” Weed explains. “Some people find that CBD reduces their anxiety,” and when you’re desperate for some relief, some folks may become “susceptible to hoping that some ‘new’ treatment will help.”
But Piomelli says “it’s too soon” to conclude that CBD oil could be a treatment for ADHD. Weed agrees. “There is no current research supporting the use of CBD oil in the treatment of ADHD.”
Weed points to a few studies that indicate there could be promise to the idea of eventually using CBD oil to treat ADHD including:
- A 2012 paper reported that mice with “reduced social investigative behavior, hyperactivity, as well as reduced attention span,” were “normalized” when treated with cannabidiol.
Weed says this adds up to a lot of hope and some grounds for future investigation, but not a lot of hard evidence right now. “There is no reliable evidence that CBD reduces symptoms or improves cognition or behavior for people with ADHD.”
Staying Safe
While there’s some hope that CBD oil could become a more common treatment for several diseases, Weed warns that “CBD can be dangerous.” Adverse effects that have been commonly associated with CBD include:
- Sedation.
- Fatigue.
- Dizziness.
- Nausea.
- Irritability.
- Dry mouth.
- Liver enzyme increases to abnormal levels.
Because it’s metabolized in the liver, CBD can increase the effects of other medications that are also metabolized in the liver, including:
- Warfarin (Coumadin), a blood thinner used to reduce the risk of blood clots, stroke, heart attack and other conditions.
- Cilostazol (Pletal), a vasodilator used to treat peripheral artery disease.
- Citalopram (Celexa), an anti-depressant used to treat depression, obsessive compulsive disorder and other anxiety disorders.
“Therefore, people who take medications should talk with their doctors about possible effects of CBD on their medications before taking CBD,” Weed says.
Weed also raises the same concern Piomelli does about the lack of regulation over many sources of CBD and CBD oil products. Unless you’re using Epidiolex or purchasing medical marijuana that’s been tested and regulated, “CBD supplements are not regulated for purity and content.”
In fact, there might be little relation between the label on the packaging and what’s inside. “Testing of popular, commercially-available CBD products found that only 15% contained what was on their labels, and 40% contained less than one-fifth of the amount of CBD claimed on their labels, one-fourth of those (10% of the total) with no detectable CBD at all,” Weed says.
It’s not just about what’s missing, either. “Some of the products contained high levels of solvents and dangerous gasses,” Weed says, pointing to a 2019 case of an 8-year-old boy with a seizure disorder who had a dramatic increase in seizures (14 in 24 hours) after taking a CBD oil product that contained a synthetic cannabinoid known to cause seizures.
“Therefore, when you take commercially-available CBD, it can be difficult to know if you are unintentionally taking other drugs, and to know how much CBD you are actually taking, if any,” Weed concludes.
