Pharmacological approaches of ADHD
Abstract Body Adults with ADHD describe self-medicating with cannabis. A small number of psychiatrists in the US prescribe cannabis medication for ADHD, despite there being no evidence from trials. The EMA-C trial (Experimental Medicine in ADHD-Cannabinoids) was a pilot randomised placebo-controll...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821002273/type/journal_article |
| _version_ | 1797616265307619328 |
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| author | R. Cooper E. Williams S. Seegobin C. Tye J. Kuntsi P. Asherson |
| author_facet | R. Cooper E. Williams S. Seegobin C. Tye J. Kuntsi P. Asherson |
| author_sort | R. Cooper |
| collection | DOAJ |
| description |
Abstract Body
Adults with ADHD describe self-medicating with cannabis. A small number of psychiatrists in the US prescribe cannabis medication for ADHD, despite there being no evidence from trials. The EMA-C trial (Experimental Medicine in ADHD-Cannabinoids) was a pilot randomised placebo-controlled experimental study of a cannabinoid medication, Sativex Oromucosal Spray, in 30 adults with ADHD. The primary outcome was cognitive performance and activity level using the QbTest. Secondary outcomes included ADHD and emotional lability (EL) symptoms. From 17.07.14-18.06.15, 30 participants were randomly assigned to the active (n=15) or placebo (n=15) group. For the primary outcome, no significant difference was found in the intent-to-treat analysis although the overall pattern of scores was such that the active group usually had scores that were better than the placebo group (Est=-0.17,95%CI-0.40-0.07, p=0.16, n=15/11 active/placebo). For secondary outcomes Sativex was associated with a nominally significant improvement in hyperactivity/impulsivity (p=0.03) and a cognitive measure of inhibition (p=0.05), and a trend towards improvement for inattention (p=0.10) and EL (p=0.11). Per-protocol effects were higher. Results did not meet significance following adjustment for multiple testing. One serious (muscular seizures/spasms) and three mild adverse events occurred in the active group and one serious (cardiovascular problems) adverse event in the placebo group. Adults with ADHD may represent a subgroup of individuals who experience a reduction of symptoms and no cognitive impairments following cannabinoid use. While not definitive, this study provides preliminary evidence supporting the self-medication theory of cannabis use in ADHD and the need for further studies of the endocannabinoid system in ADHD.
Disclosure
During this work-RC was a Ph.D. student funded by a grant to PA from Vifor Pharma. PA received funds (consultancy/sponsored talks/research/education) from Shire, Lilly, Novartis, Janssen, PCMScientific, Vifor Pharma, QBTech. Sativex was free from GW Pharm
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| first_indexed | 2024-03-11T07:38:40Z |
| format | Article |
| id | doaj.art-fdcaff672234480f927404ff5e95bb33 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:38:40Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-fdcaff672234480f927404ff5e95bb332023-11-17T05:09:07ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S73S7310.1192/j.eurpsy.2021.227Pharmacological approaches of ADHDR. Cooper0E. Williams1S. Seegobin2C. Tye3J. Kuntsi4P. Asherson5Unit For Social And Community Psychiatry, East London NHS Foundation Trust/Queen Mary University of London, London, United KingdomSocial, Genetic And Developmental Psychiatry Centre, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomDepartment Of Medical And Molecular Genetics, King’s College London, London, United KingdomSocial, Genetic And Developmental Psychiatry Centre, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomSocial, Genetic And Developmental Psychiatry Centre, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomSocial, Genetic And Developmental Psychiatry Centre, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom Abstract Body Adults with ADHD describe self-medicating with cannabis. A small number of psychiatrists in the US prescribe cannabis medication for ADHD, despite there being no evidence from trials. The EMA-C trial (Experimental Medicine in ADHD-Cannabinoids) was a pilot randomised placebo-controlled experimental study of a cannabinoid medication, Sativex Oromucosal Spray, in 30 adults with ADHD. The primary outcome was cognitive performance and activity level using the QbTest. Secondary outcomes included ADHD and emotional lability (EL) symptoms. From 17.07.14-18.06.15, 30 participants were randomly assigned to the active (n=15) or placebo (n=15) group. For the primary outcome, no significant difference was found in the intent-to-treat analysis although the overall pattern of scores was such that the active group usually had scores that were better than the placebo group (Est=-0.17,95%CI-0.40-0.07, p=0.16, n=15/11 active/placebo). For secondary outcomes Sativex was associated with a nominally significant improvement in hyperactivity/impulsivity (p=0.03) and a cognitive measure of inhibition (p=0.05), and a trend towards improvement for inattention (p=0.10) and EL (p=0.11). Per-protocol effects were higher. Results did not meet significance following adjustment for multiple testing. One serious (muscular seizures/spasms) and three mild adverse events occurred in the active group and one serious (cardiovascular problems) adverse event in the placebo group. Adults with ADHD may represent a subgroup of individuals who experience a reduction of symptoms and no cognitive impairments following cannabinoid use. While not definitive, this study provides preliminary evidence supporting the self-medication theory of cannabis use in ADHD and the need for further studies of the endocannabinoid system in ADHD. Disclosure During this work-RC was a Ph.D. student funded by a grant to PA from Vifor Pharma. PA received funds (consultancy/sponsored talks/research/education) from Shire, Lilly, Novartis, Janssen, PCMScientific, Vifor Pharma, QBTech. Sativex was free from GW Pharm https://www.cambridge.org/core/product/identifier/S0924933821002273/type/journal_article |
| spellingShingle | R. Cooper E. Williams S. Seegobin C. Tye J. Kuntsi P. Asherson Pharmacological approaches of ADHD European Psychiatry |
| title | Pharmacological approaches of ADHD |
| title_full | Pharmacological approaches of ADHD |
| title_fullStr | Pharmacological approaches of ADHD |
| title_full_unstemmed | Pharmacological approaches of ADHD |
| title_short | Pharmacological approaches of ADHD |
| title_sort | pharmacological approaches of adhd |
| url | https://www.cambridge.org/core/product/identifier/S0924933821002273/type/journal_article |
| work_keys_str_mv | AT rcooper pharmacologicalapproachesofadhd AT ewilliams pharmacologicalapproachesofadhd AT sseegobin pharmacologicalapproachesofadhd AT ctye pharmacologicalapproachesofadhd AT jkuntsi pharmacologicalapproachesofadhd AT pasherson pharmacologicalapproachesofadhd |