Referenzen

Medical cannabis may be beneficial in treating patients with attention-deficit/hyperactivity disorder (ADHD).

A British team of the Institute of Psychiatry, Psychology and Neuroscience, King’s College London conducted a randomized placebo controlled experimental trial of Sativex, a cannabinoid medication, to investigate the efficacy of medical cannbis in 30 adults with ADHD. Sativex is an Oromucosal spray containing delta-9-tetrahydrocannabinol and cannabidiol (ratio 1:1). Participants were assigned in a 1:1 ratio to the active Sativex or placebo groups (placebo controlled experimental trial). Both investigators and participants were blind to treatment allocation (double blind). The placebo and active treatments were identical in appearance and method of administration and were flavored with peppermint. Patients were randomly assigned to the active Sativex or placebo groups (randomized trial). The effect of medical cannabis on cognitive performance, activity levels, behavioral symptoms of ADHD and emotional dysregulation was investigated after 6 weeks.

The team led by Ruth Cooper showed that treatment with Sativex was associated with a significant improvement in hyperactivity/impulsivity. There was a trend towards improvement for inattention and emotional liability with medical cannabis, though the difference between groups was not statistically significant. There was no significant difference in cognitive performance between groups.

This study provides preliminary evidence that adults with ADHD may represent a subgroup of individuals who experience a reduction of symptoms and no cognitive impairments following cannabinoid use.

All participants of the study underwent a two-week titration period. The maximum dose for the study was 14 sprays per day (on average 5 sprays per day). Mild adverse events were experienced by 3 participants in the active group, including feeling light-headed after taking 2 sprays at once.

In conclusion, this experimental study provides an initial evaluation of the potential effects of Sativex on cognitive impairment and behavioral symptoms in adults with ADHD.

Cannabinoids in attention-deficit/hyperactivity disorder: A randomized-controlled trial

Klinische Studie zur Wirksamkeit von Cannabinoiden bei ADHS

Cannabinoids in attention-deficit/hyperactivity disorder

Reference

The medical use of cannabis is permitted in Canada since 2001. In a recently published Canadian study, researchers from the University of British Columbia in Vancouver evaluated patient reported safety and efficacy of cannabis from a survey of medical cannabis patients in Canada. 

Data was collected from 214 patients with various disorders via self-completed web-based surveys. The most frequently reported medical conditions were recurrent pain, post-traumatic stress disorder, anxiety, sleep disorders (including restless leg syndrome), and arthritis and other rheumatic disorders. Patients were asked to complete the survey before beginning medical cannabis treatment, and at one follow up 6 weeks after beginning medical cannabis treatment. To assess changes in reported medical conditions and quality of life measures, both validated questionnaires and self-reported changes in health outcomes were utilized.

Overall, over 60% of patients self-reported improvements in their medical conditions. More specifically, patients who reported they had recurrent pain experienced an improvement in their pain and overall quality of life after 6 weeks of medical cannabis treatment. Of those who rated cannabis as being helpful, 31% selected high THC products while 33% selected high CBD products.

In patients who reported anxiety as their primary medical condition, quality of life significantly improved from the intake survey to the 6-week follow-up survey, indicating that overall quality of life improved after 6 weeks of medical cannabis treatment for patients with anxiety. Patients also provided self-reported changes in their anxiety after 6 weeks of medical cannabis treatment, with 85% reporting some improvement in their anxiety. There was also a significant improvement in symptoms and quality of life in patients who reported post-traumatic stress disorder as their primary medical condition. After 6 weeks of medical cannabis treatment, patients with arthritis or another rheumatic disorder reported improvements specifically in pain and global activity, but not in their overall condition. 93% of the patients with sleep disorder reported some improvement in their sleep disorder.

Patients were also asked if they experienced any side effects – 20% reported mild side effects after 6 weeks of medical cannabis treatment, such as dry mouth, sleepiness, restlessness, and decreased memory.

With the use of validated surveys, researchers found significant improvements in recurrent pain, post-traumatic stress disorder, and sleep disorders after 6 weeks of medical cannabis treatment. Patients who stated anxiety as their main medical condition did not experience significant changes in their anxiety after 6 weeks of cannabis treatment, though there were improvements in quality of life. Findings from patients who reported arthritis and other rheumatic disorders are complex, showing improvements in pain and global activity sub-scores, but not overall changes in validated survey scores. No evidence for serious side effects was found.

When asked about how long patients found it took medical cannabis to affect their overall condition, 26% reported the effects of medical cannabis on their condition were experienced immediately.

Overall, the evaluation of patient reported efficacy of medical cannabis may inform future clinical research as well as healthcare practitioner practices around authorizing medical cannabis.

Patient reported safety and efficacy of medical cannabis

Wirksamkeit von medizinischem Cannabis bei einer Vielzahl an Erkrankungen

Cannabinoids have been proposed as a potential new therapeutic alternative for treating chronic insomnia.

The aim of the world-first randomized double-blind placebo-controlled crossover trial led by Jennifer Walsh from the University of Western Australia, Centre for Sleep Science was to evaluate the safety and efficacy of medical cannabis for treating insomnia symptoms. Patients with chronic insomnia disorder were characterized by difficulty initiating or maintaining sleep at least 3 nights per week for at least 3 months.

In this study, patients were either treated with medical cannabis or placebo. Patients were randomly allocated to medical cannabis or placebo for 2 weeks (randomization). Both participants and investigators were blind to whether medical cannabis or placebo was administered (double-blind study design), which is in accordance with clinical-scientific standards.

They found that two weeks of medical cannabis significantly decreased insomnia symptoms relative to placebo. Patients perceived that they went to sleep faster, slept for longer, had improved sleep quality, and felt more rested/refreshed on waking.

The researchers also found that no serious adverse events were reported during medical cannabis dosing. All adverse events, such as dry mouth or dizziness, were classified as mild and had either resolved overnight or soon after waking.

Two weeks of nightly sublingual administration of a cannabinoid extract was well tolerated and improved insomnia symptoms and sleep quality in individuals with chronic insomnia symptoms. No serious adverse events were reported.

The significant improvements in self-reported measures of sleep were also seen in objective measures, such as actigraphy.

Following a single dose of the cannabinoid extract, peak plasma levels of the major constituents were reached at approximately 4-6 hours. Data suggest that for patients with sleep onset insomnia dosing 2-4 hours before desired bedtime might be optimal, while those with sleep maintenance insomnia should dose 1 hour before desired bedtime.

Evidence for the treatment with medical cannabis

Cannabinoids in attention-deficit/hyperactivity disorder: A randomized-controlled trial

Patient reported safety and efficacy of medical cannabis

Medical cannabis as treatment for insomnia symptoms