Higher Learning LV Staff
May 5, 20236 min
Welcome to homework assignment CAS 1.4 in the Cannabis for Anxiety seminar from Higher Learning LV. This assignment focuses on the therapeutic application of cannabis for anxiety and other mental disorders in children. This assignment includes a summary of a recently published academic study about the topic of cannabis for anxiety and other disorders in children.
After you complete this assignment, use the button at the bottom to return to the Cannabis for Anxiety seminar master page.
A 2023 article entitled "Medicinal Cannabis for Pediatric Developmental, Behavioral, and Mental Health Disorders" that was published in the journal Environmental Research and Public Health reviewed the evidence base for medical cannabis for pediatric developmental, behavioural, and mental health conditions."
The study reported that interest has increased in the potential use of medicinal cannabis (MC) for the treatment of disorders associated with pediatric development, behavior, and mental health. It noted that a variety of conventional medications are commonly employed to treat these conditions, including antidepressants, psychostimulants, and antipsychotics. However, the scientists reported that these medications carry a "high risk of adverse effects, including sedation, changes in mood, appetite and cognition, metabolic syndrome, and extrapyramidal effects."
These potential negative side effects and adverse events have motivated parents of sick children and medical professionals to seek out better therapies and solutions that may feature a superior safety profile. Medical cannabis is one of the focuses of this industry-wide investigation.
The study reported that the human endocannabinoid system (ECS) "appears to play an important role in neurodevelopment and behavior" and that there is research supporting a physiological mechanism involving medical cannabis for the treatment of neurodevelopmental disorders.
"The study noted that signalling in the ECS is altered in children suffering autism, Fragile X syndrome, and Tourette syndrome."
An an example, the study noted that signalling within the ECS is altered in children suffering autism spectrum disorder (ASD), commonly referred to as simply autism. This is also the case for Fragile X and Tourette syndrome. Dysfunction of the immune system and neuroinflammation are believed to be mechanisms that lead to ASD. Medical cannabis seems to help based on a number of biochemical influences, including antioxidant, anti-inflammatory, and neuroprotective characteristics.
The study explained that anxiety is a common and debilitating symptom among patients with a variety of neurodevelopmental disorders. Studies conducted on animals indicate that medical cannabis may act as an anxiolytic (anxiety reduction agent) and that the CB1 receptor in the ECS may play a role in this mechanism.
Due to these reasons, the study's authors proclaimed that "there is biological plausibility for medical cannabis as a potential treatment for childhood developmental and mental health disorders."
"CBD has proven benefits for seizure control in children with epilepsy, including Dravet syndrome and Lennox Gastaut syndrome."
The study noted that a number of chemical components of the cannabis plant have shown efficacy for many childhood disease states and conditions. For example, cannabidiol (CBD) has shown "proven benefits" for seizure control in children who have various forms of epilepsy, including Dravet syndrome and Lennox Gastaut syndrome. One-third of children with epilepsy who were treated with CBD experienced improvements in alertness and behavior.
The research noted that thousands of anecdotal testimonies from the parents of sick children indicate that children with conditions such as ASD have experienced "reductions in anxiety, agitation, and aggression and in some cases have resulted in the ability to reduce or cease other psychotropic medications, thereby reducing the risk of adverse effects."
The study noted that a number of other scientific investigations have observed that medical cannabis, in a variety of forms and via a range of consumption avenues, has shown a pattern of reducing anxiety. This has been true for several different conditions, including ASD, intellectual disabilities, neurodevelopmental syndromes, attention deficit hyperactivity disorder (ADHD), Tourette syndrome, and a number of mental health disorders.
"Medical cannabis, in a variety of forms and via a range of consumption avenues, has shown a pattern of reducing anxiety."
The study reported that ASD is a developmental disorder that affects roughly one percent of children and that patients typically also exhibit anxiety disorders, including obsessive-compulsive disorder. These anxiety disorders may lead to irritability, aggression, and self-injury. "These behaviours can pose a risk to self and others and have a major impact on the individual's daily functioning, capacity for participation, and quality of life," reported the study's authors.
The research reported that children with ASD are typically treated with psychotropic pharmaceutical drugs, but that in recent years medical cannabis has gained the attention of researchers and caregivers as an alternative treatment to these conventional drugs and their litany of potential and common negative side effects.
In children with neurodevelopmental syndromes such as Fragile X (FXS), a transdermal CBD gel (250 mg) demonstrated a significant reduction in anxiety and other behavior symptoms. The study noted that a number of other ongoing studies involve the cannabinoids CBD and cannabidivarin (CBDV) for similar neurodevelopmental syndromes and associated symptoms or comorbid conditions such as anxiety.
Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder and exists in roughly five percent of children. Those with significant ADHD must be treated with medication, most commonly psychostimulants. These drugs, while often effective in reducing ADHD symptoms, also carry a range of potential adverse effects.
"There is a long history of complementary and alternative medicine use in ADHD and interest in medical cannabis as a treatment option," reported the scientists. Some researchers theorize that young people with ADHD may self-medicate with cannabis to treat the core symptoms of their disorder (hyperactivity and impulsivity) while also decreasing anxiety.
The study explained how conventional medications for Tourette syndrome carry many potential negative side effects and that their efficacy for reducing the symptoms of Tourettes is variable. It reported that medical cannabis "is one of a number of new agents being investigated as potential treatments for Tourette syndrome."
The adolescents received 300 mg of CBD per day and reported "significantly lower social anxiety symptoms."
The ECS has been found to play an important role in the pathology of Tourette syndrome, making medical cannabis a prime target for research projects. While most neurodevelopmental syndromes are treated with CBD, "THC has been proposed as the key therapeutic agent in treating Tourette syndrome." The ability of THC or CBD to reduce the anxiety associated with many cases of Tourette syndrome remains to be seen.
The study reported that medical cannabis is being investigated and used to treat a range of both adolescent and adult mental health disorders. It noted a recent double-blind placebo-controlled study involving adolescents who were 18 and 19 years old and who suffered social anxiety disorder and avoidant personality disorder. The adolescents received 300 mg of CBD per day and reported "significantly lower social anxiety symptoms relative to those who received placebo after four weeks of treatment."
Other research involved 31 subjects aged 12-25 who featured treatment-resistant anxiety. Participants were administered 200 mg of CBD per day. Those who did not show clinically meaningful improvement were given doses that increased by 200 mg per day, up to a maximum of 800 mg of CBD per day. Or the 31 participants, 19 up-titrated to the maximum dose, nine stopped at 600 mg of CBD per day, one stopped at 400 mg a day, and two participants withdrew.
"After 12 weeks of treatment, there was a significant decrease in anxiety," reported the study, adding that the participants experienced a mean reduction in anxiety of 43 percent. Subjects also experienced a reduction in depression and an increase in social and occupational functioning. On something called the Clinicians' Global Impressions Scale, 87 percent of study participants experienced improvement, while 53 percent "improved substantially."
"After 12 weeks of treatment, there was a significant decrease in anxiety," reported the study.
In this particular study, no serious adverse events were reported and the mild and moderate negative side effects involved fatigue, low mood, appetite change, drowsiness, nausea, diarrhea, dry mouth, insomnia, hot flashes, and cold chills.
In Australia, where doctors have been prescribing medical cannabis for nearly a decade, some practitioners—including pediatricians and child and adolescent psychiatrist—have begun using medical cannabis for children and adolescents with developmental and mental health disorders. In 2022, 1,783 applications to prescribe medical cannabis to patients under the age of 18 were approved by the Australian government. Most of these involved oils that are administered sublingually and were for the conditions ASD, anxiety, epilepsy, and ADHD.
The study reported that clinical trials are underway to test the therapeutic efficacy of cannabis and components such as CBD and THC for a number of conditions, including ASD, intellectual disabilities, Tourette syndrome, and anxiety.
"Future research must determine the optimal therapeutic dose range for cannabinoids such as CBD and THC for these childhood diseases."
The researchers explained that many issues remain unanswered and must be thoroughly investigated if medical cannabis is to be successfully employed in clinical settings for the treatment of childhood and adolescent developmental disorders and anxiety. It noted that future research must determine the optimal therapeutic dose range for cannabinoids such as CBD and THC for these childhood diseases. The study also noted that minor cannabinoids should be investigated as they may offer significant efficacy.
"Despite the lack of good evidence, prescribing of medical cannabis for these patients is increasing," concluded the research.
View the original study.