Deborah Malka MD, PhD: Attention Deficit Disorder

Här följer Deborah Malkas åsikt om adhd, och cannabis effekt på det. Hon är familjeläkare i Kalifornien sedan 18 år och deltog nyligen i The International Association for Cannabinoid Medicines för MediCann Incs räkning. MediCann är Kaliforniens största förskrivare av de intyg som krävs för att få medicinsk cannabis.

Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) is the name given to a set of symptoms usually first experienced and diagnosed in childhood. These include difficulty concentrating, impulsivity, distractibility, and in the case of ADHD – hyperactivity, or difficulty staying still, sitting in one place, etc. This disorder has been linked to a dysfunction of the neurotransmitter dopamine. It is estimated that up to 50-70% of those diagnosed with childhood ADD/ADHD can continue to have these symptoms into adulthood.

Standard medical treatments for ADD/ADHD include
Pharmacological stimulants – such as Ritalin, Dexedrine. Desoxyn, Adderall , Cylert, or Concerta. Another treatment used to treat ADHD in kids is the nonstimulant medication, Strattera. Various other medications including antidepressants, antianxiety drugs and/or mood stabilizers are also tried.

Some of the side effects of these medications are problematic, especially when used in children or young adults whose nervous systems are still developing. The use of these medications has not been in practice long enough to adequately assess the long term impact on adults who have used them throughout their childhood. Significant unwelcome effects include difficulty in sleeping and low appetite. This is no surprise as the primary medications used are stimulants which have a history of use as “diet pills”.

Supportive and alternative treatments also include
* Counseling – Educational interventions and other behavioral therapies
* Behavioral therapies include – adjusting the environment to promote more successful social interactions, such as creating more structure, encouraging routines, and clearly defining expectations.
* Somatic therapies – Movement therapies, sensory integration therapy
* EEG biofeedback- A therapy that allows the patient to monitor and adjust his/her own brainwaves
* Detoxification – To reduce contaminants such as heavy metals, food dye or environmental pollutants.
* Nutritional recommendations – These run the gamut from a diet free of chemicals, free of sugars, free of foods one may be sensitive to, to the replacement of nutritional deficiencies such as minerals, vitamins and amino acids.
* Other alternative treatments include the use of herbs, homeopathy or flower essences.

ADD/ADHD and Cannabis
The use of marijuana to treat this disorder in young people has to include a consideration of the risk/benefit ratio of the effects of cannabis on youth. The efficacy of marijuana to help ADD/ADHD has mixed reviews. There are many factors that are involved in causing an individual’s symptoms beyond whether hyperactivity is or is not part of the picture. For example, if hyperactivity is present, then a calming effect may be helpful, yet for simple ADD a stimulant effect may be more appropriate.

Further, there is often the complication of a patient currently taking pharmaceutical medication, or having to adjust to recently stopping his/her medication. In addition, there are many variable effects of marijuana depending on the strain used and preparation method. No wonder it’s hard to know whether marijuana can help in an individual case.

If you can understand your own physiology and what your body needs to be balanced then you may know how to choose an appropriate cannabis product to help. Finally, there is always caution in recommending cannabis to youth. This is a personal decision, but it may be fair to say that cannabis would be recommended more to treat adult ADD/ADHD than for a childhood diagnosis.

Nevertheless, when faced with the effects of a stimulant versus the effects of marijuana, a more prudent choice may be the herbal compound. One California physician was quoted on Fox news in 2004 as saying, ”Cannabinoids are a very viable alternative to treating adolescents with ADD and ADHD. I have a lot of adult patients who swear by it.”

Deborah Malka MD, PhD

(Published with kind permission from Medicinal cannabis for ADHD (mcforadhd.free.fr))