Should Your Kid Take Cannabis Instead of Pharma for Anxiety?
Kids, up until the end of adolescence, have more CB1 receptors in their brain than adults, suggesting dosing would be lower for kids.
In Canada and United States, anxiety ranks among the top five conditions for which individuals seek medical cannabis treatment. Although many anecdotal reports describe the anxiolytic (anti-anxiety) effects of cannabis, we still need more rigorous clinical studies. Especially on kids and Cannabis.
Nevertheless, there are some reports with good evidence. They suggest that indeed, both THC and CBD are anxiolytic molecules. THC uniquely exhibits a biphasic dose-dependent effect on anxiety, whereby at low doses (1.25mg on the lower end) it reduces anxiety and at higher doses (10mg on the lower end) it stimulates it in healthy adults.
On the other hand, CBD consistently demonstrates anxiolytic properties. In fact, it can successfully reverse the anxiety-inducing impact of THC. A dose of 300mg of CBD induces the same anxiolytic effect as a single dose of serotonin receptor inhibitor. Doctors typically prescribe those as antidepressants. However, all of these data come from adults. The question then remains whether the same anxiolytic effects exist for the pediatric and adolescent populations?
We Don’t Know Enough About Kids and Cannabis
We don’t know enough about the effects of cannabinoids on anxiety in kids. This is due to the lack of data in the literature. Only one case report describes the effectiveness of cannabidiol oil in treating anxiety and sleep issues. In this case, in a 10-year-old female with post traumatic stress disorder (PTSD).
Doctors administered 12-25mg dose of CBD oil in pill form at the beginning of the protocol. Later, they added sublingual spray to the regimen. They initiated treatment in March. By August, the patient improved significantly on both the anxiety and sleep scales. Her behavior improved, and she was sleeping well and attending school regularly by the end of the protocol. She also reported no side effects.
THC and CBD signaling comes through their interactions with CB1 and CB2 receptors. This begs a question. Is there a difference in cannabinoid receptor abundance, distribution, or even function, between pediatric and adult humans?
CB1 receptors are highly expressed in neural tissue at locales in the brain nvolved in emotional processing, motivation, and motor activation; all areas that affect anxiety levels and perception. In fact, CB1 receptors, as well as endocannabinoids, can be detected in the human brain during early development.
Interestingly, during the perinatal period, an unusual pattern of CB1 receptor expression is observed where they appear abundantly in regions of the brain that are devoid of CB1 receptors in the adult human brain. In animal models, CB1 receptors have been shown to mature slowly with maximal level of expression during adolescence, then drop off to adult levels.
THC and CBD Response Might Be Different During This Time
Peak levels of CB1 receptors express during development from childhood to adolescence. This means that during this time period, the effects of THC and CBD are different. This is in comparison to those in adults. Particularly when you take into consideration the anxiogenic (anxiety causing) effect of THC at high doses. Perhaps the appropriate staring doses should be lower in pediatric populations. The anxiolytic effects of 25mg/day dose of CBD in the pediatric case above support this idea.
Theoretically, higher abundance of CB1 receptors and/or levels of endocannabinoids in human pediatric populations would suggest that the therapeutic doses of THC and CBD for anxiety are lower than those for adults. Practically, we do not know that with great certainty, as studies are lacking in this area of research.
Animals studies will likely preclude those in humans, and we need them crucially. They’re all the more important because by human adolescence many psychiatric illnesses (like anxiety and mood disorders) increase in incidence. Healthcare is in need of therapies that are maximally beneficial with minimal side effects.