From the Guidelines
The evidence for using medicinal marijuana to treat ADHD is currently insufficient to recommend it as a treatment option. While some individuals with ADHD report that cannabis helps reduce their symptoms like hyperactivity and impulsivity, there are no well-designed clinical trials that conclusively demonstrate its effectiveness or safety for ADHD 1. Traditional FDA-approved medications like stimulants (methylphenidate/Ritalin, amphetamine/Adderall) and non-stimulants (atomoxetine/Strattera, guanfacine/Intuniv) remain the standard treatments with established efficacy.
Some key points to consider:
- The most recent and highest quality studies do not support the use of medicinal marijuana for ADHD treatment 1.
- Stimulant medications are typically the first choice to treat ADHD because they work for 70% to 80% of people with ADHD and have been shown to be more effective than nonstimulant medications 1.
- Non-stimulant options include bupropion, atomoxetine, guanfacine, clonidine, and viloxazine, which may be considered for patients who cannot tolerate stimulants or have certain comorbidities 1.
- Medication adherence is a common problem in ADHD treatment, and regular assessment and open discussion of potential issues can help improve adherence 1.
Overall, traditional FDA-approved medications and behavioral therapies remain the most effective and safe treatment options for ADHD, and patients should consult with their healthcare provider to determine the best course of treatment for their individual needs.
From the Research
Effectiveness of Medicinal Marijuana for ADHD
- The current evidence on the effectiveness of medicinal marijuana for treating Attention Deficit Hyperactivity Disorder (ADHD) is limited and inconclusive 2, 3, 4.
- A scoping review of 39 studies found that most of the literature consists of cross-sectional studies that evaluate the association between ADHD severity and cannabis use, and that the concentration and amount of THC and CBD used were not well measured in most of the studies 2.
- Some studies indicated that cannabis improved ADHD symptoms, while most studies indicated it worsened or had no effect on ADHD symptoms 2.
- A systematic review of 20 research articles found that cannabis use is associated with lower cognitive performance and symptoms of ADHD, but the existing literature is relatively inconsistent 4.
- A randomized-controlled trial found that a cannabinoid medication, Sativex Oromucosal Spray, was associated with a nominally significant improvement in hyperactivity/impulsivity and a cognitive measure of inhibition, but the results did not meet significance following adjustment for multiple testing 5.
Risks and Limitations
- The use of cannabis for ADHD is not recommended due to the lack of objective measurements for cannabis exposure and ADHD symptoms, heterogenous definitions, oversampling, and small sample sizes 2.
- Cannabis use has been linked to increased risk of cognitive impairments, particularly in young adults 6.
- The long-term effects of cannabis use on ADHD symptoms and cognitive function are not well understood and require further research 3, 4.
Future Research Directions
- Further studies are needed to fully understand the potential effects of cannabis on ADHD symptoms and pathophysiology 2, 3, 4.
- Research should focus on objective measurements of cannabis exposure and ADHD symptoms, as well as the use of standardized protocols for assessing cannabis use and ADHD symptoms 2.
- The development of randomized-controlled trials with larger sample sizes and longer follow-up periods is necessary to determine the efficacy and safety of cannabis for ADHD treatment 5.