by Seshata on 04/09/2015 | Medicinal

Cannabis as a treatment for ADD/ADHD

Medicinal Attention deficit disorder or attention deficit hyperactivity disorder (ADD/ADHD) is a neurological disorder characterized by impulsiveness, inattention and hyperactivity. ADD/ADHD is one of a group of neuropsychiatric conditions (that also includes schizophrenia and autism) now linked to a dysfunctional endocannabinoid system.


Cannabis as a treatment for ADD/ADHD

What is ADD/ADHD?

ADD is the previous term for what has since 1987 been almost exclusively known as ADHD. ADHD is a complex disorder that manifests in childhood (typically between the ages of six and twelve) and is three times more likely to be diagnosed in boys (although it has been suggested that symptoms manifest differently in girls, and thus is often missed).

Children diagnosed with ADHD exhibit several atypical social behaviours, such as incessant talking, inability to read social cues, fidgeting, and inability to focus on quiet tasks. ADHD-diagnosed individuals may also be impatient and prone to interruptions or inappropriate behaviour. It is thought that ADHD is caused by a combination of environmental, genetic and potentially viral or bacterial factors.

Twin studies suggest that up to 75% of ADHD cases are genetic in origin, and various studies have shown that the many genes implicated in ADHD are mostly involved in dopaminergic signalling—which is now known to be modulated in part by compounds related to the endocannabinoid system, such as anandamide. There has also been at least one study indicating that infection or trauma to the brain can later lead to development of ADHD.

Adderall, a common prescription medication for ADHD-diagnosed children in the U.S. (© Tony Webster)
Adderall, a common prescription medication for ADHD-diagnosed children in the U.S. (© Tony Webster)

The role of the endocannabinoid system in ADHD

It appears that prenatal disruption of the endocannabinoid system may be an underlying cause of ADHD. Correct functioning of the endocannabinoids anandamide and 2-AG, along with the cannabinoid receptors themselves, have been repeatedly demonstrated to play a fundamental role in the normal cognitive and psychomotor development of developing infants, not just in humans but also in various animal models.

The balance between novelty-seeking behaviour and the development of risk-averse behavioural inhibition is fundamental to normal psychomotor development, and it is known that the endocannabinoid system has an integral role to play in the management of this important balance. Excessive novelty-seeking coupled with reduced behavioural inhibition is a key feature of ADHD.

A study investigating two types of mice bred to lack CB1-receptors either in the glutaminergic or the GABAergic neurons (brain cells that produce glutamine and gamma-Aminobutyric acid respectively) found that glutaminergic CB1-deficient mice exhibited reduced novelty-seeking while those lacking in GABAergic neurons exhibited reduced behavioural inhibitions.

ADHD-diagnosed children have extreme difficulty with focusing on quiet tasks for extended periods (© WoodleyWonderworks)
ADHD-diagnosed children have extreme difficulty with focusing on quiet tasks for extended periods (© WoodleyWonderworks)

Thus, activation of the CB1-receptors exerts opposite functions on novelty-seeking and behavioral inhibition depending on the type of neuron in question. This demonstrates that the correct functioning of the ECS in relation to impulsive behaviours is a finely-tuned and complex system, and that disorders such as ADHD can result if the balance is disrupted.

The genetic basis for ADHD

It is well-known that there is a strong genetic basis for ADHD, and it may also prove to be the case that genetically-derived differences in endocannabinoid function alter the individual response to cannabinoids.

In a recent study (Pandolfo et al. 2009), the synthetic CB-receptor agonist WIN55,212-2 was administered to two distinct genetic lineages of study animal, Wistar and SHR rats. The SHR strain of rats is well-known to exhibit ADHD-like symptoms.

It was demonstrated that in the SHR rats, administration of WIN55,212-2 caused conditioned place preference in both adolescent and adult rats, while in Wistar rats, WIN55,212-2 caused place aversion in adult rats only. The contrasting effects found in the two different lineages suggest that genetic makeup is responsible, and the difference between adolescent and adult SHR rats indicates that age-related genetic expression also has a part to play.

The importance of anandamide uptake inhibitors

Compounds that inhibit the uptake of anandamide (either directly or by inhibiting the release of the anandamide-degrading enzyme, fatty acid amide hydrolase or FAAH) cause levels of naturally-produced anandamide to increase in the bloodstream, and are increasingly being found to exert a range of important effects.

Anandamide is fundamentally important to countless developmental processes necessary for normal cognitive and psychomotor performance. It has been repeatedly shown that anandamide has a role to play at every stage of the reproductive process, from influencing parental fertility, to overseeing embryonic implantation into the uterus, to guiding the development of the brain and central nervous system in the foetus.

ADHD-diagnosed children are 'constantly in motion', fidget uncontrollably, and often run excessively (© peace6x)
ADHD-diagnosed children are ‘constantly in motion’, fidget uncontrollably, and often run excessively (© peace6x)

Due to this growing awareness of the importance of anandamide, serious consideration is now being given to the hypothesis that prenatal disturbances to the endocannabinoid system underlie the later development of a range of neuropsychiatric conditions including autism, schizophrenia and ADHD.

An Italian study (Viggiano et al. 2008) investigated the relationship between anandamide and ADHD by administering the anandamide reuptake inhibitor AM404 to pregnant rats from the Naples High Excitability (NHE) lineage, which is well-known to exhibit hyperactivity and other ADHD-like symptoms. The researchers found that NHE rats administered with AM404 exhibited reduced hyperactivity and increased attention spans compared to NHE rats given placebo.

These data suggest that reduced anandamide levels in pregnant NHE rats may underlie ADHD-symptoms, and that elevating anandamide levels are likely to have therapeutic potential in human ADHD.

Where does dopaminergic signalling come into this picture?

Atypical dopamine signalling in the striatum (an area of the brain related to fine-motor function and social interactions) plays a fundamental role in ADHD, and is also known to modulate the activity of the endocannabinoid system. A study (Castelli et al. 2011) investigating CB1-receptor function in mice bred to exhibit symptoms of ADHD via a mutation in the dopamine transporter (DAT) gene found that DAT-deficient mice also lacked the usual ability of the CB1-receptor to control important synaptic functions in the striatum.

Another study (Tzavara et al. 2006) investigating DAT-deficient mice found significantly-reduced levels of anandamide in the striatum, and also found that three indirect endocannabinoid agonists (compounds that indirectly increase levels of direct agonists such as anandamide, and via this mechanism activate the CB-receptors), AM404, VDM11, and AA5HT reduced spontaneous hyperlocomotion (excessive movements such as fidgeting or uncontrollable running).

ADHD children can become bored easily, and are often more enthused by active, outdoor play (© John-Morgan)
ADHD children can become bored easily, and are often more enthused by active, outdoor play (© John-Morgan)

However, the effects of AM404, VDM11, and AA5HT were also found to be significantly reduced when capsazepine, a TRPV1 antagonist, was co-administered—but not when the selective CB1-receptor antagonist AM251 was co-administered. This indicates that dysfunctional endocannabinoid signalling in the striatum is associated with increased dopamine levels, and that the TRPV1 receptors are the primary modulators of this effect. Thus, therapies that activate the TRPV1 receptors may be a promising area of research for ADHD and other disorders characterized by hyperactivity.

ADHD and use of cannabis

It has been estimated that 17% to 45% of ADHD-diagnosed adults abuse or are dependent on alcohol, and 9% to 30% abuse or are dependent on drugs other than alcohol. Anecdotal evidence suggests that a significant proportion of ADHD sufferers use cannabis to self-medicate, and report that their symptoms are reduced and their feelings of “internal restlessness” calmed.

The existing evidence suggests a potential ability of CB1-receptor agonists such as THC, anandamide and WIN55,212-2 to mediate some of the effects of ADHD, as CB1-knockout mice demonstrated reduced novelty-seeking behaviour; however, as mice lacking CB1-receptors in the GABAergic neurons displayed reduced behavioural inhibition, the beneficial effect is compromised. Further research will no doubt elucidate the complex relationship between the ECS, impulsive behaviour and disorders such as ADHD.

Comment Section

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yolanda chavez

My son has really bad adhd do y'all think that would work for my son?

04/09/2015

Potato Johnson

too bad the picture depicting the adderall isn't a real pill, nor is it adderall. the journalist who posted this is a complete fucking idiot. The real pill in that picture is blue (photoshopped to look green) and the pill is an amphetamine used to treat narcolepsy/adhd (but not adderall)

04/09/2015

margaret anderson

Who cares, Potato Johnson, lighten up! Geez....

30/05/2016

Scarlet Palmer

Hello Potato

The pills in the picture have not been photoshopped, they appear green because of the light shining through the yellow container (blue and yellow make green). They are generic Adderall equivalents made by a company called Tyva, and are used to treat the same issues as Adderall, which is itself an amphetamine. Due to the prevalence of the prescription of Adderall and generic Adderall equivalents, the name Adderall has come into popular usage to mean any medication that meets the same chemical parameters, is prescribed for the same reasons and causes the same effects - much as the name Hoover has come to mean 'a vacuum cleaner'.

You should really do some research before you start insulting journalists.

Best wishes,

Scarlet

30/05/2016

Sandra McCollum

Very interesting reading more information would be good

04/09/2015

duanecole

I have adhd i get real Moody

04/09/2015

D. Farang

As a special needs teacher (and Carpenter and a former Peace Officer), I can really relate to this article.

You did your due diligence Seshata, and I respect your journalistic ability and professionalism.

The bottom line is - you have a new fan in your corner.

Kindest Regards,

D. Farang

04/09/2015

Will

Great article!

05/09/2015

Jayne

Is this available in Australia yet as I a a daughter that has adhd

05/09/2015

Dan K

I was diagnosed with adult ADHD about two and a half years ago at the age of 30 and I too use cannabis to help alleviate my symptoms in conjunction with more 'typical' prescribed ADHD medications (previously Methylphenidate and now Atomoxetine).

I personally find that Sativa dominant strains work much better for my symptoms than Indica, but that's not at all surprising to me when taking into account Sativa's more stimulant properties

05/09/2015

ADHD guy

Most likely, you should atleast give it a go, however listen to your son, and do what he thinks works best, i wish my mother did.

07/09/2015

Iqbal Groenewald

I would like to find out more about this product.

07/09/2015

carla

I have dealt ith add most of my life and also my children and I know from experience that weed help calm you down in both me and my adult children I just wish people could stop looking at weed as a drug that hurts people like herion and look at it as a natural remedy for many of todayhealth issues

07/09/2015

jeremy aycock

i am 36. when i was about 10 i was diagnosed with add/adhd. when i was 13 i found cannabis. and i have been using it everyday since.

07/09/2015

Erick

Is good to read articles and stuff, but can you Seshata please tell me where do you find all this information? I mean, is it endorsed by a scientist?

08/09/2015

Miranda

i have add and smoking marihuana helps

08/09/2015

cameron

I am living proof

09/09/2015

J.J.

I had been diagnosed with" bad"ADD at age 40.

I have done skydiving, scuba etc. Super focus probably helped regarding that.

Tried concerts but got symptoms like a speed user.

Tried stratigraphy as well yet got a lot of side-effects from it. Maybe I am just more aware of my environment...

What strain or oil should I try?

23/09/2015

J.J.

Stratigraphy is strattera

23/09/2015

Christopher Edens

I have been looked down on most of my life, once labeled in school as a child, school was the worse because I was diagnosed as ADHD and Bipolar disorders and was placed in special Ed or EBD all the way through till I dropped out cause I still didn't feel I was getting the education I needed, the medication never helped although my mother always said different. later on I did prove everyone wrong by earning my GED and attended some college for my bachelors in photography without special help. Anyhow my mother forced me to take Ritalin, Paxil, deppicote and so many other pills and tests from the age of 3 until age 16 when I was first introduced to cannabis by a cousin before school. I remember skipping out on meds for a few days and replacing it with little smokes, at age 17 I moved out of home quit all perscribed medicines and got simple work and made it happen, continued smoking most of time. Still to this day I continue to beat all statistics against me by yes staying out of legal trouble, holding stable jobs no matter how bad that boss pisses me off, trying to finish college while enjoying my illegal cannabis use. I have never used any other drugs and I don't drink alcohol, I stay out of trouble mind my P's and Q's but take that massive risk everyday to self medicate herbaly instead of taking man mixed and altered chemicals with tons of side effects like depression and sucide sounds fun Doc:)
Cannabis has helped me for 12+ years with both issues, specially my bipolar which is most noticeable by my mood swings that go full swing around time changes and my messed up sleep patterns. Without my herbs only God knows where'd I be, and it's my body so I feel it's my choice what goes in, my childhood memories were lost due to the medications but my experiences made me who I am today. Happy, free and ready for that next step.

25/09/2015

Joanne

My son has ADHT we live in SA could i not get the tablets? would really help him
thanks

01/10/2015

John

Who cares if the pill is one thing or another. Just a pic for reference...

05/10/2015

ashley palmer

i use to smoke right before school and my first two class i went to i could focuse more

05/10/2015

Billie Cyprian

I would like some more info on this my 11 yearold son id adhd

05/10/2015

Annette

being bipolar, PTSD , and ADHD/Add, I just can't stand the pills. I don't smoke or do heavy drugs. I've been hospitalize (mental health) , because I quite pills or the dosage is wrong. Please work on this pill if not for me then my kids.
Thank you

06/10/2015

Mandee

Works for me.

I wasn't diagnosed until a few years ago and by then I had already suffered from addiction 15 years. Cannabis has replaced both ADD and anxiety meds, helped me get sober, and saved my life.

Thank you for this article.

08/10/2015

Adrian Columb

Amazing article.... are there plans for an updated version that includes new research since this was written?

10/07/2016

Howard

I have add I would like to try some.

24/08/2016

Zachary Archambault

I was diagnosed with add/adhd at age 11 i tryed cannabis for the first time at age 13 im 25 now i still smoke everday i will always choose cannabis instead of takingung adderal when i was prescribed those i never uste to eat sleep your always ao quit i love my cannibis and i suggest it to everyone with this medical symptom

30/09/2016

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