Medical Cannabis for Adult Attention Deficit Hyperactivity Disorder: Sociological Patient Case Report of Cannabinoid Therapeutics in Finland

This paper presents a detailed patient case report of a male patient who was diagnosed in adulthood (aged 33) with attention deficit hyperactivity disorder (ADHD) and treated initially with immediate-release methylphenidate (Ritalin® 10 mg twice daily). After experiencing adverse effects from prolonged use of this medication and afterwards other medications that were prescribed as alternatives, the patient discovered that cannabinoid therapeutics (CT) had been experimented inside the EU area to treat patients with ADHD. Subsequently, he was evaluated by a physician in Germany (June 2010) who prescribed CT (Bedrocan®, Bediol®). A Finnish neurologist later confirmed the two prescribed medicines (Bedrocan®, October 2010; Bediol®, May 2011) in the patient’s own country of permanent residence (Finland). During a 5-year period of access, Bedrocan®, which mainly contains Δ9-tetrahydrocannabinol (Δ9-THC), was found to be helpful in alleviating the patient’s ADHD symptoms, in particular poor tolerance to frustration, outbursts of anger, boredom, and problems related to concentration. The second CT medication, Bediol®, which contains both Δ9-THC and the phytocannabinoid cannabidiol, was found to neutralize the excessive dronabinol effects of Bedrocan® as well as zo offer other medical benefits (e.g., improved sleep). In addition to the case report, this paper also offers a brief review of the literature surrounding the medical benefits of CT for AD(H)D, which includes observational studies, clinical case reports, and one randomized clinical experiment. This paper also briefly discusses the endocannabinoid system in relation to ADHD, although more preclinical and clinical research is warranted to establish the optimal levels of cannabinoids, terpenes, and dosing regimens, which vary between different ADHD patients.

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Treatment of attention deficit/hyperactivity disorder in children with CHD

Cardiology in the Young ◽

10.1017/s1047951120004965 ◽

2021 ◽

pp. 1-4

Author(s):

Alyson R. Pierick ◽

Melodie Lynn ◽

Courtney M. McCracken ◽

Matthew E. Oster ◽

Glen J. Iannucci

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

General Population ◽

Adverse Events ◽

Supraventricular Tachycardia ◽

Medical Therapy ◽

Attention Deficit ◽

Case Reports ◽

Single Centre ◽

Hyperactivity Disorder ◽

Increased Risk

Abstract Introduction: The prevalence of attention deficit/hyperactivity disorder in the general population is common and is now diagnosed in 4%–12% of children. Children with CHD have been shown to be at increased risk for attention deficit/hyperactivity disorder. Case reports have led to concern regarding the use of attention deficit/hyperactivity disorder medications in children with underlying CHD. We hypothesised that medical therapy for patients with CHD and attention deficit/hyperactivity disorder is safe. Methods: A single-centre, retrospective chart review was performed evaluating for adverse events in patients aged 4–21 years with CHD who received attention deficit/hyperactivity disorder therapy over a 5-year span. Inclusion criteria were a diagnosis of CHD and concomitant medical therapy with amphetamines, methylphenidate, or atomoxetine. Patients with trivial or spontaneously resolved CHD were excluded from analysis. Results: In 831 patients with CHD who received stimulants with a mean age of 12.9 years, there was only one adverse cardiovascular event identified. Using sensitivity analysis, our median follow-up time was 686 days and a prevalence rate of 0.21% of adverse events. This episode consisted of increased frequency of supraventricular tachycardia in a patient who had this condition prior to initiation of medical therapy; the condition improved with discontinuation of attention deficit/hyperactivity disorder therapy. Conclusion: The incidence of significant adverse cardiovascular events in our population was similar to the prevalence of supraventricular tachycardia in the general population. Our single-centre experience demonstrated no increased risk in adverse events related to medical therapy for children with attention deficit/hyperactivity disorder and underlying CHD. Further population-based studies are indicated to validate these findings.

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Review of literature of attention-deficit/hyperactivity disorder with comorbid eating disorders

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462008000400014 ◽

2008 ◽

Vol 30 (4) ◽

pp. 384-389 ◽

Cited By ~ 39

Author(s):

Bruno Palazzo Nazar ◽

Camilla Moreira de Sousa Pinna ◽

Gabriel Coutinho ◽

Daniel Segenreich ◽

Monica Duchesne ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Eating Disorders ◽

Bulimia Nervosa ◽

Attention Deficit ◽

Case Reports ◽

Small Sample ◽

Adult Women ◽

Case Control Studies ◽

Prevalence Studies ◽

Hyperactivity Disorder

OBJECTIVE: According to studies of prevalence, up to 70% of adults with attention deficit/hyperactivity disorder have at least one psychiatric comorbidity, which leads to diagnostic and therapeutic difficulties as well as more severe functional impairment. There is a paucity of data on the comorbidity of attention deficit/hyperactivity disorder and eating disorders. The objective of this study was to review the literature regarding the attention deficit/hyperactivity disorder/eating disorders comorbidity, performing a critical analysis of relevant data. METHOD: Articles in Medline, Lilacs, SciELO, ISI and PsycINFO databases from 1980 up to 2008, were searched. The references from the articles were used as additional sources of data. RESULTS: Fourteen articles were found: five prevalence studies, four case reports, three case-control studies, one symptom-assessment study of attention deficit/hyperactivity disorder and eating disorders, and one article regarding possible causes of the association between attention deficit/hyperactivity disorder and eating disorders. These articles suggested that adult women with attention deficit/hyperactivity disorder are at higher risk of developing eating disorders, especially bulimia nervosa. Bulimia Nervosa rates found in attention deficit/hyperactivity disorder groups ranged from 1% to 12%, versus 0% to 2% in control groups. CONCLUSIONS: Although there seems to be a relationship between attention deficit/hyperactivity disorder and eating disorders, the reduced number of studies available, with various methodologies, and small sample sizes limit the generalization of the findings.

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Improvement in refractory psychosis after initiating management for underlying ADHD

University of Western Ontario Medical Journal ◽

10.5206/uwomj.v84is1.4254 ◽

2015 ◽

Vol 84 (S1) ◽

pp. 6-8

Author(s):

Michael Blaszak ◽

Danica Brister ◽

Jordon Charlebois ◽

Erica Hoe ◽

Maggie Siu

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Case Report ◽

Clinical Practice ◽

Attention Deficit ◽

Clinical Case ◽

Psychotic Symptoms ◽

Visual Hallucinations ◽

Hyperactivity Disorder ◽

Stimulant Medications ◽

Pathophysiologic Mechanisms

We report on a unique clinical case of psychosis precipitated by Attention Deficit Hyperactivity Disorder (ADHD) and explore its implications for clinical practice as well as our understanding of these conditions. We describe a clinical case of a 46-year-old male presenting with auditory, olfactory, tactile, and visual hallucinations. We reviewed the literature on reported cases in which psychotic symptoms were treated with stimulant medications for ADHD comorbidity. This case report reveals the potential for properly selected patients to benefit from a consideration of ADHD comorbidity and a trial of treatment with that focus. In addition, the literature reveals a pathophysiologic association between psychosis and ADHD supported by neurobiological data. However, far more research is required to fully understand these conditions and their relationship. We conclude that ADHD and psychosis have some related pathophysiologic mechanisms but their connection has not been adequately explored. This case adds support to literature suggesting that in refractory psychosis, clinicians should re-evaluate the diagnosis and one of the considerations should be ADHD. In certain cases, the presence of psychotic symptoms with ADHD should not exclude the use of stimulants.

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Adolescent attention deficit hyperactivity disorder and susceptibility to psychosis in adulthood: a review of the literature and a phenomenological case report

Early Intervention in Psychiatry ◽

10.1111/j.1751-7893.2011.00293.x ◽

2011 ◽

Vol 6 (1) ◽

pp. 11-20 ◽

Cited By ~ 4

Author(s):

Martin Jandl ◽

Jürgen Steyer ◽

Wolfgang P. Kaschka

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Case Report ◽

Attention Deficit ◽

Review Of The Literature ◽

Hyperactivity Disorder

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Effectiveness and Tolerability of Methylphenidate in Children and Adolescents with Attention Deficit Hyperactivity Disorder

Clinical Medicine Insights Therapeutics ◽

10.4137/cmt.s6615 ◽

2011 ◽

Vol 3 ◽

pp. CMT.S6615

Author(s):

Caroline Bodey

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Side Effects ◽

Children And Adolescents ◽

Attention Deficit ◽

Treatment Plan ◽

Immediate Release ◽

Height Velocity ◽

Comprehensive Treatment ◽

Hyperactivity Disorder ◽

Cardiovascular Side Effects

Attention deficit hyperactivity disorder (ADHD) is a common condition and important for the affected individual, their family and society. It manifests with pervasive symptoms of hyperactivity, impulsivity and inattention. In many children with ADHD these symptoms persist into adolescence and adulthood. Drug treatment with psychostimulants, including methylphenidate, is an important part of a comprehensive treatment plan for children with severe ADHD that includes psychosocial, behavioural and educational advice and interventions. Methylphenidate is a central nervous system stimulant, whose mechanism of action is thought to be due to an increase in catecholamines in areas of the brain concerned with motivation and reward. Methylphendiate is available in short acting (immediate release) and longer acting (modified release) forms. Pharmacotherapy for ADHD is in three stages: initiation, maintenance and termination. The efficacy of methylphenidate in terms of reducing core symptoms is 70% as compared to placebo. This efficacy is maintained for at least 24 months. Methylphenidate generally has a favourable side effect profile. The most significant side effects include appetite suppression with an initial deceleration in height velocity, cardiovascular side effects that are not clinically significant in children with no adverse cardiac history, and tics. Methylphenidate is generally well tolerated and liked by children and adolescents with ADHD, who appreciate the benefits that medication has on their behaviour.

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Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd013011 ◽

2018 ◽

Author(s):

Raissa Carolina F Cândido ◽

Su Golder ◽

Cristiane A Menezes de Padua ◽

Edson Perini ◽

Daniela R Junqueira

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Immediate Release ◽

Hyperactivity Disorder

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Chromosome 15 Duplication and Attention-Deficit Hyperactivity Disorder

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_316_17 ◽

2017 ◽

Vol 08 (04) ◽

pp. 660-661

Author(s):

Sundar Gnanavel

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Case Report ◽

Attention Deficit ◽

Management Strategies ◽

Behavioral Phenotype ◽

Chromosome 15 ◽

Diagnosis And Management ◽

Psychiatric Illnesses ◽

Hyperactivity Disorder

ABSTRACTChromosome 15 duplication has been associated with a number of psychiatric illnesses including psychosis and autism. However, literature on association with attention-deficit hyperactivity disorder (ADHD) is scant. This case report describes a patient with chromosome 15 duplication diagnosed with ADHD in our neurodevelopmental clinic. The possible biological underpinnings are discussed along with possible challenges in diagnosis and management. The need for better understanding ADHD as a behavioral phenotype in such cases along with need for tailored management strategies is emphasized.

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