OVERVIEW OF ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD)
Attention-deficit hyperactivity disorder, also known as ADHD, is a commonly misunderstood behavioral disorder. ADHD affects the brain and is typically seen when children and adults contend with behavioral challenges such as the inability to listen, inability to pay attention, forgetfulness, fidgeting, and poor time management. These are just a few of the many different symptoms seen in someone who has ADHD.
Symptoms can vary depending on whether the individual is a child, adolescent, or an adult. Diagnosis of ADHD can occur at any age but often it goes undiagnosed as an adult. Therefore, it is essential to seek medical attention if any abnormal behavioral symptoms appear. ADHD is often a chronic diagnosis in which symptoms can commonly follow an individual from childhood into adulthood.
Studies have shown that ADHD can be linked to additional cognitive disorders such as mood disorders, depression, anxiety, and even substance abuse in adulthood. Research has suggested that ADHD symptoms can persist and have a significant impact on social relationships, careers, and even an individual’s personal safety. Therefore, receiving the proper treatment is essential in order to minimize the potential negative effects that ADHD poses.
Although ADHD is often misunderstood, it is important that individuals who believe they are affected by this disorder receive the appropriate treatment. There are many drug and non-drug treatment options that can resolve the symptoms of ADHD. Some individuals will require trial-and-error with a variety of medications to find out which option is best for them and tolerable. ADHD is no longer a limiting factor to daily life in childhood or adulthood. In fact, once an appropriate therapy has been established, most individuals reach their full potential and continue to live symptom free.
Is There a Cure for ADHD?
Although there is no cure for ADHD, it is a disorder that can be managed with the appropriate drug and non-drug therapy. For some, medication alone is not sufficient enough to improve behavioral deficits such as organization or time management. These areas of deficits can be managed with non-drug therapy and natural remedies for attention deficit disorder. On the other hand, deficits such as impulsivity and poor attention-span typically require management via medications and are not often managed by natural remedies for attention deficit disorder. Nevertheless, in many cases, management of ADHD with medication is the most effective treatment strategy. But regardless of which option an individual chooses, it is important to understand the various therapies that may be available, whether it be drug or non-drug therapy, or a combination of both. It is important to note, there is no approved vitamins for attention deficit disorder that are effective for treatment.
Cognitive Behavioral Therapy
Initially, when diagnosed with ADHD, it is common for physicians to recommend a natural treatment for attention deficit disorder called cognitive behavioral therapy (CBT). These programs are used to assist with various cognitive disorders including obsessive compulsive disorder, depression, post-traumatic stress disorder, and many more. CBT falls under the umbrella of natural remedies for attention deficit disorder because it does not involve drug therapy. Some CBT programs are specifically designed for individuals that have ADHD. CBT programs give individuals the ability to identify exercises that can negate behavioral deficits. These exercises are done at the CBT session and at home in order to gradually find ways to cope with triggering situations. CBT is an individualized way to help develop and rehearse skills that allow people to manage circumstances that activate these behavioral challenges.
Specifically, CBT programs help individuals overcome everyday difficulties such as managing time and organization skills by identifying the areas of improvement and providing exercises to help cope with those deficiency areas. Secondly, CBT programs will help identify short-term and long-term methods to use for managing behavioral symptoms. Lastly, by finding healthy ways to manage symptoms of ADHD, individuals can prevent co-existing cognitive disorders. In fact, studies have shown that CBT programs for individuals with ADHD can decrease the likelihood of developing disorders such as anxiety and depression.
Starting ADHD therapy with a CBT program is a natural treatment for attention deficit disorder and is a great way to begin managing symptoms with or without the additional use of medication as well. CBT is an extremely effective way to increase the habits and skills that individuals need to self-manage their symptoms and is one of the natural remedies for attention deficit disorder that can be used. This can also help improve emotional and interpersonal self-regulation.
Drug and Non-Drug Therapies
There are two classes of medications that are used for managing the symptoms associated with ADHD: stimulants and non-stimulants. Both classes of medications have evidence that demonstrate effectiveness in treating the behavioral symptoms associated with ADHD. It is important to remember that medication will not cure ADHD, but rather it can help to ease the impulsive symptoms of ADHD. The function of these medications is to help regulate certain neurotransmitters in the brain, which are not working properly in individuals that have ADHD.
In order to determine the appropriate medication regiment for an individual, physicians require the use of trialing different options. Physicians will trial one medication, observe whether or not there is improvement for the individual, and either increase the dose or change the medication altogether. Physicians will also watch out for any side effects that the individual may experience. This process will continue until the individual taking the medication feels benefits of the medication and is tolerating the medication well.
Stimulants
One class of medications is referred to as stimulants. Some of the different families of stimulants include methylphenidate, dextroamphetamine, dexmethylphenidate, and amphetamine salts. The stimulant category is one in which the commonly known drug, Adderall, an amphetamine stimulant, fits into. Stimulants are very commonly prescribed as therapy for children and adults with ADHD.
Stimulants come in various formulations that include those of the short-acting variety (or immediate release), intermediate-acting variety (or sustained release) and long-acting variety (or extended release). These definitions indicate how long the medication’s duration of action will last. Short-acting formulations can have a duration of anywhere from 3 to 6 hours. Intermediate-acting formulations will have a duration of action of anywhere from 6 to 10 hours. Long-acting formulations will have a duration of action of up to 12 hours a day. The varying duration of actions will partially depend on which stimulant class has been selected for treatment. The duration of action of these medications also depends on the individual that is trying the stimulant. Every individual will respond differently to each medication, therefore, some duration of actions for these medications may be longer or shorter than what is anticipated.
Depending on the needs of the individual that has ADHD, different formulations will be trialed. For example, if a child has ADHD and needs symptom control to focus during a school day, intermediate-acting formulations can be given in the morning before the child goes to school. This will give the child anywhere from 6 to 10 hours of symptom control, depending on which stimulant class is chosen. Intermediate-acting formulations in this situation can give the child the ability to focus throughout the school day. Long-acting formulations, however, have become the standard for many individuals with ADHD.
Taking a formulation that will provide symptom control for up to 12 hours a day is very appealing for more individuals. This is because there are less “ups and downs” throughout the day and there is less need to take additional doses of medication during school or at work. Hundreds of controlled studies have been done to test the efficacy and safety of stimulants in the treatment of ADHD. Stimulants can be an appropriate and fairly well-tolerated management strategy for individuals that cannot overcome their symptoms with CBT alone.
Safety of Stimulants
Stimulant medications are overall well-tolerated and safe. However, with any medication, there are commonly seen side effects that some individuals may experience. Side effects with stimulants are dose dependent. This means that as the dose increases, the likelihood of experiencing side effects will increase as well. Additionally, if any side effect becomes unbearable, it can likely be resolved by simply decreasing the dose or changing the time at which the medication is given.
Studies have shown the most common side effects when using a stimulant for ADHD management include insomnia, nausea, loss of appetite, anorexia, weight loss, increased blood pressure, increased heart rate, and mood lability. The cardiovascular effects (i.e. increased blood pressure and heart rate) are typically minimal and clinically insignificant. However, for an adult that has borderline hypertension or some type of cardiovascular disease, it is important to consider the benefits and risks of starting a stimulant for ADHD management.
Irritability is also a side effect that can sometimes occur later in the day when an individual is experiencing the rebound phenomenon. A rebound phenomenon is when an individual’s dose is wearing off causing symptoms to reappear. This can often be fixed by administering a short-acting stimulant about an hour or two prior to when the expected rebound might occur.
Non-Stimulant Medications
Some non-stimulant medications used to manage ADHD symptoms include atomoxetine, guanfacine, clonidine, bupropion and some anti-depressants such as imipramine and nortriptyline. Physicians will consider non-stimulant medications for ADHD management when stimulants do not work, or when the side effects of stimulants become unbearable. Non-stimulant medications work by different mechanisms to help control the symptoms of ADHD. Therefore, if a stimulant cannot be used to manage symptoms, non-stimulants are a great alternative.
One downside of non-stimulants is that they work slower than stimulants to take full effect. Although this can vary from person to person, it is important to understand that these drugs will take at least a few weeks for individuals to see the benefits. Once a physician starts someone on any of the non-stimulants listed above, the dose will gradually be increased until the individual sees a proper reduction in ADHD symptoms.
When it comes to the safety profile of non-stimulant medications, the side effects vary because each medication works differently. Thus, each option should be thoroughly discussed with a physician to assess the risks and benefits of starting a non-stimulant medication.
ADHD and Cannabidiol (CBD)
Cannabidiol (CBD) is a compound extracted from cannabis plants and has become popular amongst millions of people looking to manage everything from anxiety and stress to joint pain and insomnia, including people looking for natural supplements for attention deficit disorder. To date, Epidiolex is the only cannabidiol product to be approved by the Food and Drug Administration (FDA). It’s used for the treatment of childhood seizure disorders called Lennox-Gastaut syndrome or Dravet syndrome.
Recently though there has been interest amongst researchers looking at CBD as another potential tool and natural supplement for attention deficit disorder. The interest stems from the “calming” effects that CBD can possibly have on individuals with ADHD. It is thought that these effects can help reduce the need of using certain medications to manage symptoms or in some circumstances when traditional therapies fail.
In a recent 2020 study, researchers looked at 59 adults who were licensed with a medical cannabis card and had a concurrent diagnosis of ADHD. This study utilized self-reporting questionnaires to evaluate monthly results from October 2019 through January 2020. The study determined that there was reduction in use of ADHD medications for those who were using CBD concurrently. Unfortunately, there were some flaws in this study. The sample size was very small, the results were bias due to the self-reporting questionnaire tool, and the study was not blinded or randomized. This means that the individuals who conducted the study knew who the people involved in the study were, which can lead to prejudice in favor of the results that the researchers want to see. Additionally, there was no standard dose of CBD for everyone to utilize throughout the 59 patients. This makes it difficult to assess if there is a possible benefit seen at one single dose for all of the patients. Therefore, the results of this study lack the requisite evidence of benefit.
Still, it is plausible that CBD may play a positive role for individuals with ADHD as well as individuals who use pharmaceutical stimulants to help them focus and perform at a higher level (such as when studying or taking tests). And for the many students who have access to and utilize such stimulants primarily to help them focus during intense periods of study, having a healthy, natural alternative with fewer side effects might be warmly welcomed.
Alas, with more studies and research, there will eventually be a clear answer on if and how CBD should be used clinically or as an option for home remedies for attention deficit disorder. Regardless, at this time more investigation is required to validate whether there is a benefit for ADHD patients to use CBD. As such and given the limited data on this information, the recommendation of CBD for ADHD symptom management is something that should be discussed with a healthcare provider. This way, individuals can assess the benefits and risks of trying to utilize CBD for additional symptom management.
Conclusion
For many years, ADHD was a disorder that was believed to be limited to childhood. However, over time it became apparent that ADHD is a disorder that affects both children and adults. Everyday activities can become limited when an individual lives with the symptoms of ADHD. Therefore, finding a proper treatment is essential for living a normal life.
With CBT, individuals can learn how to monitor their behaviors and change those behaviors appropriately. These individuals will find strategies to help manage situations that may trigger their ADHD symptoms. Interventions such as creating a daily schedule and organizing everyday items are only two of the many ways to overcome symptoms of ADHD. CBT can help identify various intervention strategies and as a result, can even help individuals avoid drug therapy altogether.
If CBT therapy as one of the natural remedies for attention deficit disorder is not enough for managing symptoms, individuals can move on to drug therapies as well. The appropriate drug therapy varies from person to person and will require trialing different options. If stimulant medications do not work, there are many non-stimulant medications that can be just as effective. Beyond these commonly used FDA-approved treatment strategies for ADHD (i.e. CBT, stimulants and non-stimulants), products such as CBD and vitamins for attention deficit disorder do not yet have enough evidence with regard to providing benefits for managing ADHD. But there is interest in the possibilities and so if CBD is an option you are considering, it is important to consult with your healthcare provider to discuss the possible benefits and risks associated with CBD use as an option for home remedies for attention deficit disorder.
It is, however, most important to understand that each individual who has ADHD will respond differently to different mediations and treatment strategies. Therefore, seeing a primary care physician in order to assess the benefits and risks of each option is essential in managing ADHD.
Resources
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