If you have a child, sibling, or any other family member, with Attention Deficit Hyperactivity Disorder (ADHD), Adderall must have become a household name for you.
Adderall is the brand name of a combination drug (Dextroamphetamine and Amphetamine), which is often prescribed by doctors to treat certain symptoms, like hyperactivity and impulse control, associated with ADHD and Narcolepsy, a sleep disorder marked by excessive daytime sleepiness.
This class of drugs, categorized as central nervous system stimulants or psychostimulants, is usually preferred over non-stimulant alternatives by most medical practitioners to effectively treat ADHD, which affects around 6.1 million children in the US alone.
By changing the levels of certain natural substances in the brain, Adderall helps boost an individual’s memory, ability to focus, and remain attentive to an activity or task. It also helps control behavioral issues, like impulsiveness, and enhances one’s organizational abilities. It also helps cancer patients overcome fatigue, associated with the disease. That’s why these are also called neuroenhancers.
Notwithstanding these benefits, such neuroenhancers can hinder ADHD patients from leading a normal life.
Adderall’s typical side-effects (panic attacks, palpitation, and sweating) can lower a person’s self-esteem, negatively impact his/her behavior, and disrupt normal functioning, both at work and home. ADHD patients on Adderall can also suffer from prolonged insomnia and cardiovascular risk, besides other side effects.
So, if you’re tired of the side-effects of prolonged Adderall use (or is parent of a youngster struggling to cope with its effects), you must be looking for a more side-effect-free and an effective alternative.
Can CBD Be An Alternative Therapy for ADHD?
Cannabidiol (CBD) has gained much traction among a large portion of the American population. Its therapeutic and health-promoting properties have caught the attention of both the scientific fraternity and the masses.
As a cannabinoid, known to aid the endocannabinoid system (ECS) to promote health by establishing and maintaining homeostasis, CBD is a cannabis extract that, unlike its psychoactive cousin THC (tetrahydrocannabinol), has no hallucinatory or psychedelic effects.
Instead, it has been found to help people manage and overcome the symptoms of a variety of diseases and conditions, including ADHD.
Although the effects of CBD on ADHD patients are still being researched, there is some promising evidence that indicates CBD can indeed enable patients to transition from traditional treatment methods to cannabinoids. Additionally, CBD has a much safer profile than Adderall, even for children.
Can CBD combat ADHD?
While Adderall may not behave the same way or go through the same processes in our body as CBD does, the two do have some things in common.
- According to several studies, including a 2020 study, published in the Brazilian Journal of Psychiatry, CBD stimulates a rise in the dopamine level in your brain. Stimulant drugs, like Adderall, too, behave similarly on ADHD patients.
- CBD has been found to protect dopamine-releasing neurons and prevent the breakdown of dopamine in the brain by indirectly regulating our brain’s stress response. This means CBD can increase dopamine levels over time. This could be the reason why CBD seems to work as much as stimulant drugs. This was elaborated in a 2020 review, published in the Antioxidants by researchers of the Institute of Medical Biochemistry, University of Veterinary Medicine, Vienna.
Besides, CBD also seems to induce anandamide release. A happy and content person usually focuses better and feels less anxious or agitated. CBD helps regulate a person’s moods, pleasure, and pain response.
- According to a 2012 study, published in the Translational Psychiatry, CBD “enhances anandamide signaling…”. This is indicative of how far CBD can enable a person to remain grounded.
That’s not all. CBD can also prevent the break-down of anandamide by blocking the functions of an enzyme, known as FAAH (fatty acid amide hydrolase).
- According to a 2016 study, published in the Frontiers in Pharmacology, cannabinoids, like CBD, can elevate anandamide levels by targeting the FAAH and the Fatty Acid Binding Proteins (FABPs).
- Another 2011 study, published in the Advances in Protein Chemistry and Structural Biology, confirms the theory that CBD, among other cannabinoids, can block the oxidation of anandamide. That proves that CBD is a great alternative for people with mood disorders.
However, there’s little direct research to prove cannabidiol can help patients with ADHD.
- One such Randomized Controlled Trial studied the effects of cannabinoid medication, Sativex (THC-CBD) Oromucosal Spray, on 30 adults with ADHD. In this study, which was published in the European Neuropsychopharmacology in 2017, Sativex seemed to exhibit a “nominally significant improvement in hyperactivity/impulsivity” and a “cognitive measure of inhibition”, besides improving the attention span and emotional stability of the individuals. However, researchers added that this preliminary evidence only partially supports the idea of self-medicating oneself with medical cannabis for ADHD.
Interestingly, a small number of psychiatrists in the US do prescribe medical cannabis for ADHD, despite the lack of clear evidence to support this claim.
- Speaking of medical cannabis, a 2020 study, published in the Rambam Maimonides Medical Journal, shows that medical cannabis may lead to low ADHD symptom frequency and high ADHD medication-sparing effects.
While these studies do seem to shed some light on the potential of CBD and medical cannabis in treating ADHD symptoms and replace conventional ADHD medications, more studies are needed to establish a clear link between ADHD and CBD.
Can CBD be Taken With Adderall?
There is some anecdotal evidence suggesting that, if taken in low doses, CBD can be safely taken along with Adderall. Besides, there is no recorded interaction between the two products, as per Pharmotech SA and The Drugs.com Database.
This doesn’t, however, rule out the possibility that, when taken together, CBD can interact with Adderall.
Here are some of the basic understandings & findings:
- Most pharmaceutical medications require a group of liver enzymes, known as Cytochrome P450 or CYP450 to metabolize. Whatever portion of the medication remains after passing through the liver enters the systemic bloodstream and circulates through the body. This process, known as the first-pass effect, determines a substance/medication’s bioavailability, i.e. the strength, potency, and amount of the drug/substance that reaches the bloodstream.
- CBD, when consumed orally, as a capsule, an edible product, or a tincture (partially), inhibits the functioning of certain CYP450 enzymes, like CYP3A4 and CYP2D6, affecting the breakdown of the other medications. This is because CBD, too, requires certain subtypes of this group of enzymes, particularly, CYP3A4, to get metabolized. However, it is seen to hinder the function of several other CYP enzymes as well.
- This may cause the drug to remain in the system longer than originally intended, aggravating the side effects of those drugs.
Sometimes, when the drug remains in the body for too long, it can even lead to the patient overdosing on the pharmaceutical drug, even though both the drug and CBD were taken in the right doses.
Now, which enzyme plays a role in Adderall metabolism?
- Adderall (owing to the presence of the chemical compound amphetamine) requires CYP2D6, a subtype of CYP450 enzyme, to get metabolized. The fact that amphetamine requires CYP2D6 to break down is well-documented.
Interestingly, Adderall is a highly potent drug, with a bioavailability of 75%.
Then, what about CBD?
- A 2011 study, published in the Drug Metabolism and Disposition, established that CBD is a potent inhibitor of the CYP2D6 enzyme. The researchers found evidence of CBD causing potent direct CYP2D6 inhibition.
This means that CBD may interact with Adderall, if taken together.
Another interesting fact about CBD is that it can counter some of the side-effects of Adderall.
- According to a 2016 study, published in The Journal of Neuroscience, CBD can counteract the side effects of Adderall compound Amphetamine.
These studies prove that CBD:
- may interact with Adderall and cause adverse effects
- may be effective in helping people get off Adderall or at least could reduce the side effects of Adderall – if taken together
From all these studies, it seems that CBD could be taken along with Adderall, but only by lowering Adderall’s dose to a certain extent. This may help in countering Adderall’s side effects to a certain extent, as well as replace it with CBD by gradually decreasing Adderall’s dosage and increasing CBD’s dosage.
Adderall or CBD: WHAT TO DO?
While CBD may seem like a feasible alternative to Adderall, it’s best to consult your doctor before you decide anything.
Firstly, ADHD is a difficult-to-treat disorder.
Secondly, the side-effects of conventional ADHD medication are very troublesome – to say the least.
Thirdly, CBD, too, has a few side effects that one must consider.
Fourthly, suddenly quitting Adderall isn’t wise. It’s better to do so gradually and under your doctor’s supervision.
Fifthly, only your physician, who understands the inner workings of your body, is better equipped to guide you on:
- whether to replace Adderall with CBD
- whether you should replace it
- how you should go about it