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ADHD is the most frequent neurodevelopmental disorder in childhood. Symptoms often appear in preschool years, and most children (65-80%) continue to experience some ADHD-associated symptoms into adolescence and adulthood. The disorder is marked by age-inappropriate inattention, hyperactivity, and impulsivity. Drug treatments for ADHD include stimulants containing methylphenidate (like Ritalin and Concerta) or amphetamines (like Vyvanse). However, 30-35% of the patients do not respond well to these treatments, and stimulants may result with various side effects.
The use of medical cannabis increases; applied for expending medical conditions, with growing evidence for its beneficial effects. A study on ADHD adults treated by cannabinoids demonstrated improvements in hyperactivity and impulsivity.
The current study is aimed to examine the safety and efficacy of treating children diagnosed with ADHD with a CBD oil (devoid of THC), enriched with terpenes. Participants will be randomly assigned to receive either the enriched CBD oil or a placebo, for 5 weeks (Treatment, Stage I).
At the end of the treatment stage (I), an open-label stage will follow (II), wherein, all participants will receive the investigational product for an additional 5 weeks.
The investigators hypothesize that children treated with the enriched CBD oil (Treatment, Stage I) will show significantly higher improvement in hyperactivity and inattention scores, as compared with the placebo group.
Screening phase:
Parents who are interested to take part in study, will contact the study team. Parents will be asked to provide documents attesting their child's medical status and forms required to process a medical cannabis prescription.
Visit 1 - Baseline:
Treatment using the study drug (Stage I) will be initiated following Visit 1, according to a schedule set by the study team.
Follow-up 1:
The study team will contact the parents via a phone call two weeks (±2 days) after initiation of stage I. Parents will answer questions regarding general health and side effects.
Visit 2 -at the end of Stage I:
Follow-up 2:
• The study team will contact the parents via a phone call two weeks (±2 days) after initiation of Stage II. Parents will answer questions regarding general health and side effects.
Visit 3 - at the end of Stage II:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CBD oil enriched with terpenes | Active Comparator | 24% CBD, terpenes, MCT oil. |
|
| Placebo oil | Placebo Comparator | fragrances and flavors, MCT oil. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Oral CBD oil enriched with terpenes | Drug | Stage I dosing, increasing titration: days 1-2: 2.5 mg/kg BW/day; days 3-4: 5 mg/kg BW/day; day 5-7: 7.5 mg/kg BW/day; days 8-35: 10 mg/kg BW/day. Stage II dosing, increasing titration: days 36-37: 2.5 mg/kg BW/day; days 38-39: 5 mg/kg BW/day; day 40-42: 7.5 mg/kg BW/day; days 43-70:10 mg/kg BW/day. |
| Measure | Description | Time Frame |
|---|---|---|
| Improvement in hyperactivity sub-score of the Conners' Parent Questionnaire, as compared with baseline. | Conners' Parent Rating Scale | 5 weeks (Visit 1 to Visit 2) |
| Improvement in inattentiveness sub-score of the Conners' Parent Questionnaire, as compared with baseline. | Conners' Parent Rating Scale | 5 weeks (Visit 1 to Visit 2) |
| Measure | Description | Time Frame |
|---|---|---|
| Improvement in Conners' Parent Questionnaire - Total score, as compared with baseline. | Conners' Parent Rating Scale | 5 weeks (Visit 1 to Visit 2) |
| Improvement in hyperactivity sub-score of the TOVA test, as compared with baseline. |
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Inclusion Criteria:
Exclusion Criteria:
Criteria for early termination:
Criteria for exchange:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ariela Hazan | Contact | +972-89778465 | arielah@shamir.gov.il | |
| Elkana Kohn, PhD | Contact | +972-89542181 | elkanak@shamir.gov.il |
| Name | Affiliation | Role |
|---|---|---|
| Matitiahu Berkovitch, MD | Shamir Medical Center, Zerifin, Israel | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shamir Medical Center | Recruiting | Ẕerifin | Israel |
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| ID | Term |
|---|---|
| D001289 | Attention Deficit Disorder with Hyperactivity |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D013729 | Terpenes |
| ID | Term |
|---|---|
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
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Each participant will be randomly assigned to receive either the terpene-enriched CBD oil or a placebo for 5 weeks.
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All blinded except dispensing pharmacist.
|
| Oral Placebo | Drug | Oral placebo oil that is similar in appearance and taste to the CBD oil. Titration and dosing identical to those described for the CBD oil. |
|
Computerized visual T.O.V.A
| 5 weeks (Visit 1 to Visit 2) |
| Improvement in inattentiveness sub-score of the TOVA test, as compared with baseline. | Computerized visual T.O.V.A | 5 weeks (Visit 1 to Visit 2) |
| Improvement in TOVA test - Total score, as compared with baseline. | Computerized visual T.O.V.A | 5 weeks (Visit 1 to Visit 2) |
| Improvement in hyperactivity sub-score of the Conners' Teacher Questionnaire, as compared with baseline. | Conners' Teacher Rating Scale | 5 weeks (Visit 1 to Visit 2) |
| Improvement in inattentiveness sub-score of the Conners' Teacher Questionnaire, as compared with baseline | Conners' Teacher Rating Scale | 5 weeks (Visit 1 to Visit 2) |
| Improvement in Conners' Teacher Questionnaire - Total score, as compared with baseline. | Conners' Teacher Rating Scale | 5 weeks (Visit 1 to Visit 2) |
| Improvement in the scores of CBCL questionnaire, as compared with baseline. | Child Behavior Checklist (CBCL) | 5 weeks (Visit 1 to Visit 2) |
| Side effects are tolerable and transient. | Side effect questionnaire | 5 weeks (Visit 1 to Visit 2) |
| The rate of drop-out will be similar in both groups. | Drop-outs will be recorded by the study stuff. | 5 weeks (Visit 1 to Visit 2) |