cbd oil for adhd reviews

Best CBD Oil for ADHD

Is your child suffering from ADHD? Are you looking for an all-natural supplement that will help your child get better? You should get the best CBD Oil for ADHD !

CBD oils have suddenly gained so much popularity and attention from both the general public and researchers. CBD has been reported to have some therapeutic effect, but the range of CBD is unclear. It is unclear whether CBD can actually help with ADHD treatment.

We’ve shortlisted a few essential points for you to go through before opting for one. Let’s take a look at the best CBD oil for ADHD available in the market so that you can make an informed decision!

Our Overall #1 Rated Pick

Spruce-750MG lab-grade CBD Oil

  • Natural
  • Vegan
  • Gluten-free
  • Full Spectrum

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Spruce is a well-known company that makes CBD Oils. ADHD is a disorder that is mainly present in children. They need care and attention. These additional supplements will help them overcome the disorder.

You can feed them the natural flavors separately or with food. The dropper measures the exact dose for one time. You can increase the dose eventually from one time per day to twice per day. Make sure to give the supplement with consistency.

The 10 Best CBD oil Comparison Chart

The 10 Best CBD oil Out There

In this section, we review the Top 10 CBD oil for ADHD.

Spruce-750MG lab-grade CBD Oil

15% Discount and Free Shipping when you use the coupon code MEMORY.

Spruce is a well-known company that makes CBD Oils. ADHD is a disorder that is mainly present in children. They need care and attention. These additional supplements will help them overcome the disorder.

You can feed them the natural flavors separately or with food. The dropper measures the exact dose for one time. You can increase the dose eventually from one time per day to twice per day. Make sure to give the supplement with consistency.

The Spruce CBD oil is tested safe from harmful chemical and artificial additives. However, it is not THC free. There are slight traces present. Suggest your doctor before feeding the oil. The best thing about the oil is natural, vegan ingredients.

It comes with gluten-free, non-GMO, and dairy-free ingredients. The hemp is extracted from the organic farms by safe extraction. The extraction method will not harm the quality of hemp extract. It will enhance and boost brain activity and help children suffering from hyperactivity disorder.

  • Natural
  • Vegan
  • Gluten-free
  • Full Spectrum
  • No artificial flavor
  • No added preservatives
  • Chemical-free
  • Lab Grade
  • Third-Party tested
  • It is not THC free


15% Discount and Free Shipping when you use the coupon code MEMORY.

ADHD is a very complicated disorder; if not solved in the early stages might cause life-ruining problems. Children are complex human beings; they need attention and care along with the supplements to help them get over ADHD.

Spruce 4800 mg CBD Oil is an extra-strength oil which is good for kids who have ADHD. The ingredients used in this oil are organic, vegan, and safe.

It has organic hemp extract that is extracted carefully. The extraction is done using CO 2 for extra safety and purity of the product. It is tested in the local lab and is then sent for third-party testing to make sure it is safe. The oil is non-GMO, gluten-free, and has no preservatives.

Furthermore, the antioxidants present in the oil will remove the toxins from your body. It is a very effective way to promote a healthy lifestyle. The oil comes with a dropper that will measure the exact dose. You can increase and decrease the dose according to your needs.

  • Vegan
  • Natural
  • Non-GMO
  • Gluten-free
  • Full Spectrum
  • No added preservatives
  • No artificial sweeteners
  • Lab-tested
  • Third-party tested
  • You should not take it if subjected to a drug test


15% Discount and Free Shipping when you use the coupon code MEMORY.

Spruce CBD Oil is one of the major CBD oil manufacturers. This CBD oil from spruce has natural, vegan, and healthy ingredients. It is available in different potency ranges. This is a specific sample size. It is made for people who are trying the product for the first time.

The children who have ADHD need to consume additional supplements, and CBD Oil is best for them. It has a dropper to measure the perfect one-time dose. You can increase or decrease the dose accordingly. The key to cure is consistency.

You can give the oil separately or with food to your kids. The oil has been tested for safety and heavy chemicals. It has plant-based, gluten-free, and non-GMO ingredients. The hemp is extracted from organic farms. It is dairy-free, and you can easily consume it.

The oil has average pricing, even though its quality is top-notch. Since it is directly absorbed into the bloodstream, you need to place it under the tongue. This is why it will get absorbed quickly and will act quickly.

Keep the oil away from heat, humidity, and moisture to maintain freshness and quality. The best thing about the oil is it supports the immune system and boosts cognitive activity, which makes it perfect for kids who have ADHD.

  • Organic
  • Enhanced neuron activity
  • Vegan
  • Full Spectrum
  • High potency
  • Gluten-free
  • Non-GMO
  • Lab-tested
  • Third-party tested
  • Small-sized bottle


15% Discount and Free Shipping when you use the coupon code MEMORY.

This is another quality product from Spruce oils. It has natural, vegan, and healthy ingredients. The children who have ADHD need to consume additional supplements, and CBD Oil is best for them. It has a dropper to measure the perfect one-time dose.

It enhances the mood, promotes calmness, and increases neural activity. Moreover, this oil is gluten-free and non-GMO. The hemp is extracted from organic farms and CO 2 for extraction to ensure product purity. It should be placed under the tongue so that it is directly absorbed into the bloodstream.

Keep the oil away from heat, humidity, and moisture to maintain the freshness and quality. Check with your physician before you start using this oil to ensure that it is perfect for your needs.

  • Organic
  • Enhances brain activity
  • Vegan
  • Organic hemp extract
  • Full Spectrum
  • Gluten-free
  • Non-GMO
  • No pesticides
  • No preservatives
  • No artificial additives
  • Lab-tested
  • Third-party tested
  • Not THC free

CBDistillery Full Spectrum CBD Oil

The CBDistillery is a well-known company that produces high-quality CBD Oil. ADHD is a very complicated disorder if not solved in the early stages might cause life-ruining problems. This oil was introduced in 2016, and until then, it has benefited many people.

The Ingredients used are organic, vegan, and safe. It has organic hemp extract that is extracted carefully. The extraction is done by CO 2 for extra safety and purity of the products. It is tested in the local lab and sent for third-party testing to make sure it is safe.

CBD Oil is THC free and will not make you high. It has non-GMO, gluten-free, and no preservatives. The oil comes with a dropper that will measure the exact dose. You can increase and decrease the dose according to your needs.

The children are complex human beings. They need attention and care along with the supplements. It is exceptionally affordable oil. It will control hyperactivity in children.

  • Organic
  • Full-spectrum
  • THC-free
  • Third-party tested
  • Organic hemp extract
  • CO 2 Hemp extraction
  • No artificial additives
  • No added preservatives
  • Non-GMO
  • Gluten-free
  • No flavor ranges
  • The oil is not tested for heavy metals

cbdMD CBD Oil

CbdMD is a high-end brand. It does not compromise on the quality of the oil. The oil has natural, vegan, and healthy ingredients. It is available in different flavor ranges. The children who have ADHD need to consume additional supplements, and CBD Oil is best for them.

It has a dropper to measure the perfect one-time dose. You can increase or decrease the dose accordingly. The key is consistency. You can give them oil separately or with food. The oil has tested for safety and heavy chemicals.

The oil is THC free. It has vegan, gluten-free, and non-GMO ingredients. The hemp is extracted from organic farms. It is dairy-free, and you can easily consume it. The oil has average pricing, even being high-quality.

It should be placed under the tongue. It is directly absorbed into the bloodstream. That is why it is acting and high absorbing. Keep the oil away from heat, humidity, and moisture to maintain the freshness and quality.

  • Organic
  • Enhance brain activity
  • Vegan
  • Organic hemp extract
  • Broad-spectrum
  • High potential
  • THC-free
  • Gluten-free
  • Non-GMO
  • Lab-tested
  • Third-party tested
  • None as such

Super Good Vibes CBD Oil

The Super Good Vibes CBD Oil is packed with natural and high-quality ingredients. Children have ADHD, and they need proper care and treatment. The oil has shown effective results. You have to be consistent in consuming the oil.

The dropper is used to measure the exact amount of dose. You can increase the dose eventually. Make sure to check the product for being tested. It will ensure purity and safety. The hemp in the oil is extracted from organic farms.

The oil is four times effective as compared to other oils. You have to hold it under the tongue. The oil is absorbed directly into the bloodstream and acts fast. It is a high-potential and effective oil: the fatty acids and omega 3 enhance brain activity.

It has natural, vegan, non-GMO, gluten-free, and dairy-free ingredients. Further, there are no additives or artificial colors used in manufacturing. The oil has less than 0.3% THC, which means it is not completely THC Free. It is tested in the local lab of the company as well as by a third-party for purity.

  • Organic
  • Vegan
  • High potential
  • Natural hemp extract
  • Pure cannabidiol
  • Fatty acids
  • Vitamins
  • Omega 3
  • Enhance cognitive activity
  • It is not THC Free

Lazarus Naturals CBD Oil

The Lazarus Naturals is a famous CBD Oil manufacturer. It has been effective in treating ADHD in children. It is a complicated disorder and needs to be treated well. You can use the oil with consistency for visible results.

The hemp extract is organic taken from the domestic farms of hemp. It has a dropper that measures the exact one-time dose. The best thing about oil is its fast and quick action. It has a high absorbing consistency.

The oil must be placed under the tongue. It is then absorbed directly into the bloodstream. The ingredients are natural, vegan, non-GMO, gluten-free, and dairy-free. There are no signs of artificial preservatives or flavors being used in the oil.

The oil has small traces of coconut oil and natural flavors. The chocolate mint flavor is easy to consume. The extraction is done by the ethanol process that makes it pure and safe. It is tested in the local lab and also by third-party for enhanced protection.

  • Vegan
  • Non-GMO
  • Gluten-free
  • Enhance brain activity
  • Organic hemp extract
  • No added flavors
  • No preservatives
  • No harmful chemicals
  • Lab-tested
  • Third-party tested
  • Some people might be allergic to coconut oil
  • FDA has not evaluated the oil

Nuleaf Naturals CBD Oil

The Nuleaf Naturals CBD Oil is very beneficial against ADHD. The children who suffer from hyperactivity disorder need care, attention, and additional supplements. CBD Oil has proved to show beneficial results. The hemp in CBD Oil is extracted by CO 2 extraction.

It will maintain the purity and health of hemp. The ingredients are natural, vegan, and non-GMO. The Full Spectrum cannabinoids will help enhance cognitive activity. You can increase and decrease the dose accordingly, but make sure to consult the doctor before buying the oil.

The oil has no added harmful chemicals. It is safe to consume for children and teens. The oil is high-potency and pure. The dropper that comes with the bottle measures the exact dose. You need to be consistent.

The oil, when placed under the tongue, acts fast. It is directly absorbed into the bloodstream. The gluten-free, plant-based, and dairy-free mixings are just perfect. Store it in a cool and shady place.

  • Natural
  • Vegan
  • No artificial additives
  • Chemical safe
  • Organic hemp
  • Full Spectrum
  • Third- party tested
  • It has no flavor

Joy Organics CBD Oil

The Joy Organics CBD Oil is a premium-quality oil. People suffering from ADHD find it beneficial. The only key to the betterment is consistency. You can take the oil with or without food. It depends on your taste buds.

The best thing about this oil is that it is THC free. Hyperactivity disorder can ruin your life. It is better to handle it before time is out. The hemp is extracted from the organic farm under CO 2 extraction. It will maintain the safety and purity of the product.

The oil is fast action and quick absorbing. You have to place it under the tongue. The oil is directly absorbed into the bloodstream. It is tested in the local lab and also by third-party for purity. There are no signs of harmful chemicals and heavy metals present in the oil.

The oil has natural, vegan, gluten-free, and non-GMO ingredients. It should be placed in a cool place away from heat and moisture. In this way, the purity and effectiveness are maintained.

  • Natural
  • Vegan
  • Gluten-free
  • Non-GMO
  • Lab-tested
  • Third-party tested
  • THC free
  • Broad Spectrum
  • High absorption
  • None

Buying Guide

Before buying CBD Oil for ADHD, you need to know what it is, how it works, and how it will help kids who are suffering from ADHD. We have put together a compact yet comprehensive buying guide for you.

Let’s get started!

What is CBD Oil?

Cannabidiol, usually abbreviated as CBD, is an active compound of a very notorious plant, Cannabis. Cannabis plants and its extracts have a very negative stigma due to the marijuana being one of its extracts.

Marijuana is very well known to have a recreational effect and its abuse to get “euphoria” or “high.” This high sensation is due to an active chemical present in it, known as THC or tetrahydrocannabinol. How THC works are by attaching itself to the cannabinoid receptors already present on the brain.

This binding leads to over-exaggeration of the sensation of pleasure, movement, thinking, and coordination. It creates a sense of disconnection between reality and fantasy. Rather than over stimulating the feelings, CBD works by creating a balance between the body and mind.

CBD encourages the body to produce the endocannabinoids that reduce anxiety, inflammation, and pain in some people, without creating a euphoric effect. However, both THC and CBD come from the same plant. Both have drastically different working mechanisms and effects.

Cannabis, being the plant of origin, has given CBD so much attention in the research field. CBD is more of a therapeutic compound that has slowly but readily been accepted in the medical field. There is still a long way to observe the full potential of CBD and its effects on different diseases.

What does it do?

There has been much research and trial work done on THC, but not so much on CBD. But several reported cases have shown that CBD does have some type of anti-inflammation and pain-relieving effect on the brain and even can manipulate protein accumulation and production in the body.

Both THC and CBD are extracts of the same plant, and both are cannabinoids. Despite these similarities, both compounds have slightly different modes of action and medicinal effects. CBD works by encouraging the body’s natural endocannabinoid system.

This system is responsible for producing natural Cannabis like molecules that account for the innate wakefulness, activeness, and health of the body. This also helps to reduce stress, anxiety, inflammation, and pain.

CBD is also seen to have relieving effects on the central nervous system, which means that it has relaxing or calming effects. This is because CBD doesn’t add more cannabinoid in the body; neither does it affect the cannabinoid receptors (i-e CB1 and CB2) in the brain.

CBD acts as an instigator to help with the body’s own endocannabinoid system and boost the formation of cannabinoids. This excess cannabinoid has proven to be relieving for some people.

Effects on ADHD

ADHD or Attention deficit hyperactivity disorder is a mental health disorder. This disorder deals with the ongoing patterns of impulsive behavior and the inability to focus on one thing for a more extended period. This includes being unable to sit still for a more extended time. This disorder can occur in both children and adults. However, it is a lot difficult to diagnose in children as they are already inherently hyperactive and have a shorter attention span. ADHD is usually diagnosed in either of the 3 categories.

  • Inattentive type
  • Impulsive type
  • Combination of both types

Unlike most mental diseases, the diagnosis of ADHD happens for 6 months. The symptoms vary from type to type. Cause of this disorder is not clearly known, but genetics is seen to have a hand in these diseases’ onset.

CBD oils don’t correctly cure the disease, but they help in relaxing the symptoms. People who suffer from ADHD usually also show signs of anxiety.

CBD has been studied to ease the symptoms of anxiety. Since CBD often deals with relaxing and aids in hypersensitivity, they are thought to be more helpful for impulsive type rather than inattentive type. CBD oil also helps in inattentive type by triggering a reaction from dopamine receptors.

Dopamine acts as a neurotransmitter and is mainly responsible for memory and focus. Lack of attentive behavior can lead all the way back to a lack of neurotransmitters. This can lead to a higher attention span and proper focus.

Medicinal treatments of ADHD depend on the type of ADHD being dealt with. There are stimulant pills for inattentive type and non-stimulant pills for impulsive nature. While CBD cannot wholly replace these medicines or their placebos, they can help in symptoms relieving.

How does it work?

Despite less research on the effects of CBD on ADHD patients, whatever tests are done usually yield, positive results are obtained. Almost all the tests that have been done have concluded that CBD oils do have a calming effect that can remedy anxiety and stress symptoms of ADHD and help calm the nervous system that can help in the betterment of several other disorders such as insomnia.

One of the few things science is sure about CBD is that it does not deteriorate the existing condition. CBD oil was tested to see if they’d hurt patients dealing with ADHD or depression. Both showed negative results, making it safe for use.

In 2016, an experiment was conducted that showed mild improvement in the symptoms of ADHD in patients when treated with CBD oil in a study group. Not only ADHD but several other symptoms from disorders like ODD (Oppositional Defiant Disorder) and CD (Conduct disorder).

In another study , almost 2000 cannabis users who had ADHD were observed. Those that used Cannabis in a moderate amount showed positive outcomes.

There needs to be valid research regarding all the positive effects and the side effects of the Cannabis plant and its cannabinoid. This will help provide perspective to all the kids, teens, and young adults who may be tempted to try to self-medicate to know all the outcomes of this plant’s usage.

Side Effects

All in all, CBD has its cons and side effects as well, just like any other therapeutic compound. The side effects are thankfully very mild, and light and nothing serious ever really occurs. Some of these side effects include

  • Weight loss
  • Weight gain
  • Change in appetite
  • Fatigue
  • Nausea
  • Headaches
  • Digestive issues
  • Vomiting

Scientists have been unable to predict the aftereffects of long term usage of CBD. CBD is also checked to have shown interaction with other medicinal drugs taken by the person. In this regard, several researchers and doctors believe that it is better to get in touch with your doctor and talk about your drugs beforehand, so there are no cases of a severe harmful interaction.

For instance, CBD can also affect the metabolism of some of the drugs in the liver. CBD can either cause the liver to metabolize some drugs way quicker than needed. This will render the drug useless. It can also cause the medicines not to metabolize at all.

This will force the drug to remain in the body for a more extended time than needed. Citalopram, cilostazol, and warfarin are known drugs to interact with CBD and should not be used simultaneously as CBD.

Researchers have also shown concern that CBD may have some type of link to hormone imbalance. This may become a more significant issue in young teens and kids who are at a growing age.


Cannabis is banned in several countries. Mostly due to their abuse and misuse for recreational purposes. This has created a stigma around the plant that everything coming from the plant has to have some sort of psychoactive compound that will create a “high” effect.

Unlike cannabis THC, CBD is not classified as a schedule 1 drug either. This means that they can easily be bought online or any other retail store and used. Laws vary from state to state, so it is better to make sure that the product you’re using or thinking of using doesn’t have an illegal ingredient in your country. One should check the local rules of possession and regulations that apply for the drug’s medicinal uses.

As you should with any other medicinal drug, check. Check and research everything about the drug, from the ingredients to the retailers, to the purity. You should do your proper research. We would advise you to check the product if it was tested for purity and safety.

Most medicinal drugs are tested by the manufacturing company themselves; they are also sent for testing to a third party. This is done to ensure that the product, in fact, is entirely safe and in its pure form.

One drawback of this CBD oil is that it does come out as marijuana in a drug test. It is advised to either keep a prescription close by when you’re driving.


Other than legality, you should consider a few other points as well. You need to make sure that there is more good being done rather than harm. For instance,

  • Make sure that the plant used to extract CBD was organic and completely GMO-free. How do we know that? Check the packaging for a certified stamp from the US department of agriculture.
  • Ensure that the product is tested for residual content of herbicides and pesticides to make sure there are no harmful chemicals present in the oil itself.
  • Ensure that the manufacturing process is approved by the FDA to make sure that there are no chances of contamination.

When given a choice, it is usually better to opt for European-based products to ensure that the product is safe from contamination. Europe has a much better and much more well-established system for the regulation of medicinal drugs like CBD.

They have a 0.2% THC content in their CBD oils, while the US has 0.3%. Although it is not much of a difference, it is better to opt for a better option and be safe.

How to use CBD Oil for ADHD

Parents usually hesitate to opt for herbs based oils and drugs due to the stigma surrounding its use and the plants itself. The use of herbs for treatment without proper knowledge is generally discouraged, especially by people in the medical field.

In 2013, a Facebook poll was created to see the level of satisfaction parents had towards their kids’ conditions after CBD. Almost 117 of the parents showed a positive response, saying that their child has improved symptoms such as more wakefulness, regular mood balances.

There is no prescribed dose of CBD again due to a lack of research. Especially for ADHD patients. CBD oil is given in 2 ways.


Oral administration of CBD is thought to have fewer side effects and is usually advised to beginners. The patient can take 1 to 2 drops under their tongue. There are also CBD infused tablets for picky kids and even CBD capsules available.


Inhaling CBD will help these active compounds in the CBD oil to reach your bloodstream faster and show effects quicker. This is the most effective way yet, but the involvement of taking in smoke or vaping again has created harmful air around the use of inhalable CBD.

Scientists and researchers are still unclear whether vaping is safe or not as it’s aftereffects are not well known yet. We advise starting with the smallest dose to be safe and always keep the patient under the radar to notice any side effect quickly before it gets more serious.


Several people having ADHD have shared their experience as a CBD user. There are also a few study trials available with positive outcomes. A blogger who has two sons suffering from ADHD writes that their 6-year-old and 3 years old have been able to sleep better, have balanced moods, and have been able to focus more, and even fewer tantrums followed by quick de-escalation.

They also reported good appetites and stable moods throughout the day. Blogger’s oldest son was also on medication at that time, and the results are due to both the drugs and the CBD oil, while her youngest, with no medicines and just CBD oil, has shown massive improvement in his behavior.

An adult, Brett Bartel, suffering from ADHD, has also shared his experience. Using CBD oil has helped him stay more alert and focused throughout the day. According to the patient himself, he has seen a remarkable change in himself and his ability to stay focused for a prolonged period has really changed his outlook on life.

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Can Cannabis or CBD Improve ADHD Treatment Gaps?

A review of the pharmacological evidence base for cannabidiol and cannabis in the management of attention deficit/hyperactivity disorder symptoms.

While ADHD affects many children and adolescents, 15% of them still meet full DSM-5 diagnostic criteria in adulthood. 1 Untreated or under-treated ADHD can result in impaired quality of life, relationships, the ability to achieve or maintain employment, and driving safety. The disorder also puts individuals at increased risk of depression, anxiety, accidental death, and suicide. 2,3

These concerns have led many patients and caregivers to seek out other means of symptom control, including cannabidiol (CBD) and/or cannabis. Here’s what recommending clinicians need to know.

Is CBD or Cannabis a Wise Choice for ADHD Treatment?

Current Medication Gaps

Since the 1930s, stimulants have remained the first-line pharmacotherapy for managing ADHD symptoms in both children and adults. Poor adherence to treatment, however, is an ongoing issue, often due to tolerance, stigma, and patient-specific barriers. 1 Adverse effects (AE) of stimulants include insomnia, reduced appetite, nervousness, increased blood pressure, dry mouth, difficulty urinating, nausea, drowsiness, erectile dysfunction, and headache. 2,3 Long-term stimulant use is associated with growth suppression, misuse/abuse potential, and sudden cardiac death. Alternative or new agents with increased tolerability, improved patient satisfaction, and long-term efficacy are desirable. 1 CBD is one such proposed option.

CBD’s Therapeutic Properties & Risks

Preclinical studies have proposed that CBD possesses numerous potential therapeutic properties: anti-inflammatory, neuroprotective, analgesic, anticonvulsant, antioxidant, and more. Yet, research remains inadequate regarding the use of CBD to treat a range of psychiatric and neurologic conditions, ADHD included.

Pharmacokinetic and pharmacodynamic data illustrate the complexity of studying CBD given its variability in form and concentration – not to mention its lack of federal regulation which impacts quality and safety of the product across the country. For instance, the bioavailability of oral CBD is between 11% and 13%, while inhalational CBD has a 31% mean bioavailability. The half-life of oromucosal CBD ranges 1.4 to 10.9 hours but may last up to 5 days following chronic oral administration. 4

In March 2020, an official FDA statement highlighted the intricacy of researching, regulating, and marketing CBD products. 5

Potential harms associated with CBD include hepatotoxicity, damaged male fertility (per animal studies), altered cognition and mood, and gastrointestinal distress. 5 Pediatric CBD trials most commonly report diarrhea, somnolence, and decreased appetite as adverse effects, although this data is poorly quantified. 6

Caution should be taken with concurrent administration of CBD and medications that affect (or are affected by) CYP3A4, 2C19, and 2C9 enzymes. 4 However, in vivo evidence to corroborate these metabolic drug-drug interactions is minimal. 7 When considering CBD as an adjunctive ADHD therapy, clinicians should consider the potential drug-drug interaction with amphetamine, as in vitro data suggests one or more amphetamine metabolites act as mild CYP3A4 inhibitors. 8


P450 Enzyme Example Medications Effects
CYP3A4 substrate Benzodiazepines, z-hypnotics, opioids, certain antidepressants, antipsychotics Increased risk of substrate-mediated AEs
CYP3A4 inhibitor Protease inhibitors, ketoconazole, loperamide Increased risk of CBD-mediated AEs
CYP3A4 inducer Phenytoin, phenobarbital, carbamazepine, topiramate Decrease in therapeutic effects of CBD
CYP2C19 substrate Certain antidepressants, warfarin, antiepileptics, propranolol Increased risk of substrate-mediated AEs
CYP2C19 inhibitor Fluvoxamine, fluoxetine Increased risk of CBD-mediated AEs
CYP2C19 inducer Carbamazepine, phenobarbital, phenytoin, St. John’s wort Decrease in therapeutic effects of CBD
CYP2C9 substrate Buprenorphine, montelukast, naproxen, phenobarbital, phenytoin, warfarin Increased risk of substrate-mediated AEs

Cannabis’s Therapeutic Properties & Risks

Federally recognized as a Schedule I drug, cannabis is defined as any product containing greater than 0.3% THC (delta-9-tetrahydrocannabinol) according to the 2018 Agriculture Improvement Act. Oral or buccal spray cannabis is used as an analgesic and a treatment for rheumatoid arthritis or multiple sclerosis symptoms. Despite a lack of high-quality safety and efficacy data, medicinal cannabis is smoked for nausea, glaucoma, appetite stimulation, epilepsy, anxiety, Crohn’s, Lou Gehrig’s disease, and many other indications. 9

Like CBD, the pharmacokinetics of cannabis are complicated by the variety of available forms. Vaporized THC is absorbed more rapidly than smoked. Absorption from any inhalational route ranges from 2% to 56% and peak plasma levels are achieved just 10 to 30 minutes after use. However, orally, peak plasma levels occur 1 to 6 hours after ingestion. 9

The most common AEs of inhalational cannabis include headache, dizziness, drowsiness, fatigue, xerostomia, nausea, paranoia, and dissociation. Cannabis intoxication may result in impaired motor coordination and reaction time, blurry vision, panic, hallucinations, and emotional disturbances. Long-term cannabis use is associated with cognitive impairment, decreased memory, and increased risk of developing psychosis, seizures, cardiac arrhythmias, or myocardial infarction. 9

The same CYP interactions presented above for CBD are also present for THC. Again, evidence for these interactions is limited (either anecdotal, theoretical based on pharmacology, or based solely on animal/in vitro studies). 9

Evidence for CBD as an ADHD Treatment

Across all ages, a lack of evidence exists for assessing CBD or cannabis as a treatment for ADHD symptoms. However, a few CBD trials have offered ADHD-related secondary outcomes or studied cannabis use in relation to ADHD. While causal relationships can therefore not be drawn between CBD or cannabis and behavioral, social, educational, or psychological changes seen (or not seen) in patients with ADHD patients, the following studies may be used for hypothesis-generating purposes.

Recreational Use: A late 1990s retrospective survey study investigated the influence of recreational inhalational cannabis on patients living with Tourette’s Syndrome (TS). Sixty-four patients were interviewed, seventeen (27%) self-reported past marijuana use. Most participants were male (n = 15) and smoked occasionally (n = 15), with a mean age of 30.5 years. Ten patients had comorbid ADHD, only one of whom reported a marked reduction in attention difficulties. This patient smoked three to four marijuana cigarettes/day on a regular basis. No patients reported worsening symptoms in response to smoking. Due to the use of DSM-III criteria, the waxing and waning disease course of TS, the lack of statistical data analyses, a very small sample size, and recruitment from a single European mood disorder clinic, generalizability is extremely limited. 10

Medical cannabis and stimulants: In another study, adult Israeli patients with ADHD and an active medical cannabis (MC) license were surveyed regarding MC use, cannabis-related adverse effects, and comorbid psychiatric conditions. Multiple validated questionnaires, including the five-point ADHD self-report scale (ASRS), were used. Fifty-three patients completed the surveys and provided their MC monthly dose. Most smoked or vaped MC, and there was a wide duration of use. Sixteen (30%) participants used prescription stimulants as ADHD treatment. The high MC use subgroup self-reported greater incidence of ADHD pharmacotherapy discontinuation compared to those with low use (OR 5.8, 95% CI 1 to 60). When dividing the study sample into low ASRS score (score < 3.17, n = 30) and high (score > 3.18, n = 29), independent of high versus low use, the low score subgroup discontinued all ADHD medication at a greater rate (OR 0.22, 95% CI 0.04 to 0.84). 3

MC-related adverse effects were reported by 15 participants and did not differ between high and low use subgroups. Adverse effects were documented by affected system: CNS (n = 7), gastrointestinal (n = 7), psychological (n = 6), cardiovascular (n = 3), ophthalmic (n = 3), musculoskeletal (n = 2), and auditory (n = 2). However, a list of specific AEs would have been most useful. Investigators concluded that an ADHD medication-sparing effect was associated with MC use in the study population. 3

Oromucosal THC:CBD spray: Sativex oromucosal spray contains a 1:1 ratio of THC to CBD and was the focus of a double-blind, placebo-controlled RCT conducted at King’s College in London. 9 Sativex is not FDA-approved for any indication, despite gaining approval in many countries in 2011 – 2012 as an adjunctive therapy for multiple sclerosis-associated neuropathic pain/spasticity and moderate to severe advanced cancer pain. 7 The primary outcome was mean Quantitative Behavior Test (QbTest) score, a validated tool for analyzing cognitive performance in ADHD. Eligible adult participants attended baseline and 6-week follow-up evaluations. Patients stopped their prescribed stimulants one week prior to, and for the duration of, the study period. Participants using a non-stimulant ADHD medication were excluded. Also excluded where individuals with: a current or past diagnosis of manic depressive disorder, panic or anxiety disorders, bipolar I disorder, any psychotic disorder, obsessive compulsive disorder (OCD), TS, intellectual disability, known/suspected alcohol or substance use disorder, or a history of cardiovascular disease, renal disease, or hepatic dysfunction. 11

The randomized patients (n = 30) were instructed to “spread doses throughout the day as best suited them.” On average, patients in the treatment group used 4.7 sprays/day (range 1–13). There was no statistically significant difference between the Sativex and placebo groups in QbTest performance. One patient per arm suffered a serious adverse effect (muscle spasm/seizure in Sativex arm, tachycardia/chest tightness in control arm). Three Sativex-treated participants suffered mild adverse effects: lightheadedness (n = 2) and diarrhea (n = 1, resulting in therapy discontinuation for 4 days). 11

Due to the small study sample, ADHD symptoms not being evaluated as the primary outcome, and most patients being able to correctly guess if they were on active treatment vs. placebo (93% and 85% respectively), this pilot trial has many weaknesses. A larger study that elucidates a proper dosing regimen should be pursued. 11

CBD oil in adolescents: A randomized, controlled, double-blind, parallel-design pilot study evaluated the effects of CBD in patients age 8 to 16 with intellectual disability and severe behavioral problems. Eight participants received either oral placebo or 98% cannabidiol oil for 8 weeks. Dose titration occurred over 9 days to a target 20 mg/kg/day in two divided doses (max dose 500 mg). Three of four participants in the treatment arm and four of four participants in the control arm had an ADHD diagnosis. 6

One participant in the placebo group used methylphenidate, one in the CBD group used guanfacine, and one per arm used clonidine. Notably, the aim was to assess feasibility of a large-scale version of this trial. All other outcomes were simply preliminary findings and not adequately powered to assess efficacy. 6

Results did, however, indicate a greater reduction in baseline Aberrant Behavior Checklist Subscale (ABC-I) hyperactivity/non-compliance score in the treatment arm (mean reduction of 17 points) compared to placebo (mean reduction of 4.3 points). A clinically significant reduction was defined as a mean reduction of 7.9 points. No dose reductions were required in response to adverse events, nor were there any study withdrawals, serious adverse effects, or clinically significant abnormal lab values. Medication and study appointment adherence were 100% and all parents reported that they would recommend the study to families with children facing similar challenges. 6

Bottom Line: No Clear Answer on Use for ADHD

An easily accessible, product-rich marketplace of over-the-counter CBD is at the fingertips of patients living with ADHD, and regulations regarding medical/recreational cannabis use have loosened across many states. Yet, there is little supportive evidence regarding safe and efficacious use of these substances for ADHD management. In the pool of outcome data presented herein, no adults and just seven pediatric patients with ADHD have undergone an experimental CBD study,­ making a well-informed risk versus benefit comparison nearly impossible. Similarly, THC is not well-studied in patients with ADHD.

Clinicians may do well to consider other options for the management of ADHD symptoms in adolescents and adults, but should be prepared to discuss the limitations of CBD and cannabis with inquiring patients or caregivers.

Related Articles

More on the risks of marijuana use in patients with schizophrenia, and on the external factors associated with ADHD assessments.

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  4. Khan R, Naveed S, Mian N, et al. The therapeutic role of cannabidiol in mental health: a systematic review. J Cannabis Res. 2020:2(2).
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  8. Adderall XR label [Internet]. Wayne (PA): Shire US Inc.; 2013. Available at: www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf. Accessed October 2020.
  9. Cannabis [Internet]. Stockton (CA): Therapeutic Research Center; 2020 [updated 2020 Oct 9; cited 2020 Oct 15]. Available from: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=947#interactionsWithDrugs
  10. Müller-Vahl KR, Kolbe H, Schneider U, Emrich HM. Cannabinoids: possible role in patho-physiology and therapy of Gilles de la Tourette syndrome. Acta Psychiatr Scand. 1998 Dec;98(6):502-6.
  11. Cooper RE, Williams E, Seegobin S, et al. Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial. Eur Neuropsychopharmacol. 2017;27(8):795-808.

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