What Kids, Teens and Parents Should Know About CBD Oil for Mental Health

Written by: Timothy Culbert, MD, IFMCP

By now you've probably heard of the potential health benefits of the natural plant-based remedy, CBD oil. Understandably, there's a lot of confusion about the differences between CBD oil and cannabis products that can get you high. 

It can all be confusing. Let’s sort it out... 

Possible Benefits of CBD Oil for Kids and Teens

CBD Oil has specific benefits for certain conditions in kids and teens and has a desirable safety profile when compared to THC. Unfortunately, the limited number of scientific studies on CBD oil lack quality. The World Health Organization's Comprehensive Report on CBD (2018) concluded that “CBD is generally well tolerated with a good safety profile.” The WHO report found no evidence that CBD has the potential for abuse or dependence. The experts were optimistic that that preliminary evidence suggests that it may be a “useful  treatment for a variety of medical conditions.” Some claims for use of CBD oil with children include benefits such as improved focus, better memory, higher daytime alertness, less agitation, and boosted immune function.

Promising Applications of CBD Oil for Children and Adolescents

Anxiety: Applications here include social anxiety, generalized anxiety and PTSD.

Autism: A study in Israel found that 80% of kids with Autism Spectrum Disorder given CBD Oil showed some improvements in problematic symptoms and 50% showed gains in communication. 

Sleep Problems: Problems with sleep onset, sleep maintenance, and nighttime fears.

Chronic Pain: Specifically inflammatory pain conditions.

Epilepsy: Promising results for kids with seizure disorders who don't respond to usual treatments.

Nausea and Appetite Suppression: May be helpful for either.

CBD Side Effects 

As noted, CBD is generally considered well-tolerated. However, CBD can cause side effects. These side effects can be more confusing given the unreliability of the purity and dosage of CBD in products (which is why purchasing a high-quality product is essential). 

Side effects of CBD may inlude:

• Drowsiness
• Dizziness and lightheadedness
• Dry Mouth
• Diarrhea
• Increased Appetite 
• Lowered blood pressure

 

CBD Interactions

Research suggests many side effects that occur with CBD use are likely the result of drug-to-drug interactions between CBD and other medications an individual may be taking. That's why it's so important to speak with your doctor before starting any supplement, and this is particularly true with CBD.

Here's how these interactions occur: CBD is broken down by the body via the same pathway as many prescription drugs. If multiple compounds are competing in this pathway (e.g., CBD and a prescription drug), then something called "altered concentration" can occur. This means that too little or too much of the drug is left in the body. When too little remains, a drug may no longer work as intended. When too much remains, side effects may increase.

This altered concentration should be considered when taking CBD with any other prescription, supplement, or over-the-counter product that causes sleepiness. These include (but are not limited to):

• Antidepressants
• Antipsychotics
• Benzodiazepines
• Opioids
• Antihistamines
• Herbal products to support sleep
• Alcohol

Additionally, there are other medication interactions with CBD that can be serious. Penn State College of Medicine has a really handy list of medications that may be impacted by altered concentration due to a combination with cannabinoids. Unfortunately, this list does not make any distinctions between CBD or THC, but it provides some guidance. Bring this list to your doctor before starting any CBD product.  

Penn State also found potentially serious interactions between prescription CBD and THC products and the following products:

• Warfarin and other blood thinners
• Amiodarone (heart medication)
• Levothyroxine (thyroid medication)
• Seizure medications (clobazam, lamotrigine, valproate)

Summary of Concerns About CBD Oil

• Products can be unreliable in delivering the amount of CBD stated on the label. Be sure to purchase from a reputable source.
• Little is known about how much CBD is absorbed and then delivered to the brain in various forms including topical, vaping, or ingested forms.
• Poor quality CBD products could contain harmful contaminants.
• Dosing for kids is uncertain due to a lack of research.
• CBD Oil can interact with medications (e.g., SSRIs) and affect efficacy or the development of side effects. 

How To Dose CBD Oil for Kids and Teens

There are no proven guidelines for dosing CBD oil in kids and teens. A doctor will usually suggest the method I use: START LOW, GO SLOW.  

High-quality CBD gummies and the unflavored isolate forms of CBD oil mixed in a beverage or food may be the easiest way to give it to kids. These options are generally palatable for kids and are easy to cut in quarters or halves (gummies) or just start with a tiny bit (oil).

The table below is NOT a treatment recommendation but the general guidelines that many doctors use. If a doctor suggests a higher dose, show them this table and ask if lower may be better at the start. If they suggest lower, great! Many people recommend much higher dose ranges but I prefer to err on the side of caution:

Weight		Starting Dose Range		High Dose Range
30 Lbs		1 MG-2.5 MG		7.5 MG
40 Lbs		2.5 MG- 3.5 MG		10 MG
50 Lbs		2.5 MG-5 MG		15 MG
75 Lbs		5 MG-7.5 MG		20 MG
100 Lbs		5 MG-10 MG		30 MG
125+ Lbs		5 MG-10 MG		30 MG-40 MG

 

Choosing the Best CBD Oil Products

CBD is available as a liquid, capsule, topical lotions and creams, vaping liquid, and in food/drink products. 

You can purchase CBD oil in a “broad-spectrum” form which contains many of the whole plant materials/compounds from the hemp plant which may have additive healing benefits. The only downside for kids may be that this iteration of hemp oil has a stronger, earthy taste which some may find unpleasant. By law, these must contain less than 0.3% THC, a negligible amount. Alternatively, CBD isolates are available in a liquid form that is colorless, odorless, and devoid of any THC at all, therefore it may be easier to add this to beverages or food so kids can take it without being put off. 

It's important to purchase CBD oil that is produced by C02 extraction methods and is from a manufacturer that submits to third-party testing to assure quality, potency, and purity. 

 

CBD Supplements at Natural Mental Health

• Sleep CBD is a blend of broad-spectrum CBD (30 mg per serving) combined with 5 mg of CBN (cannabinol) and 3 mg of melatonin. CBN is a form of phytocannabinoid shown to be more specifically helpful for sleep, and melatonin is nature’s internal timekeeper, helping set a more consistent bedtime. CBD Sleep may improve a variety of challenging sleep issues, and is especially helpful for those who have trouble falling asleep. 

• Calm CBD combines 30 mg of broad-spectrum CBD with 200 mg of l-theanine, an amino acid that can also help reduce anxiety and stabilize mood. Together, they may improve stress resilience and calm anxiety without sedation. Taken at bedtime, CBD Calm may also be helpful for those who tend to wake in the middle of the night.

 

• Restore CBD gummies are infused with the highest quality, all-natural, US-grown hemp. Each gummy offers a precise dose of broad-spectrum CBD to support your endocannabinoid system with naturally occurring, plant-based ingredients. This synergy of multiple cannabinoids work together for the greatest impact to restore your natural resilience. 

 

*Note: Some of the supplements discussed in this article can cause side effects, but many people tolerate them much better than prescription medications. They are generally considered safe, however, they should not be started without your doctor’s knowledge and supervision. If you are taking medication already, be sure to talk with your doctor before adding any of these items. If you are considering going off medication, remember never to stop your medication suddenly—always consult with your doctor about how to safely taper off any psychiatric medication. See terms.

**These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

 

 

---

RELATED ARTICLE

CBD and ADHD

A physician may recommend CBD oil as a preventative tool for ADD/ADHD. It may help to manage acute symptom flare ups, but the preventative maintenance is likely most important. Similar to a dietary supplement or medication, it may work best to establish a baseline concentration in the system. Read more.

 

Sources

1. Abrams, D. (2018). The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report. European journal of internal medicine, 49, 7-11.
2. Atakan, Z. (2012). Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic advances in psychopharmacology, 2(6), 241-54. doi:10.1177/2045125312457586
3. Atalay, S., Jarocka-Karpowicz, I., & Skrzydlewska, E. (2019). Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants, 9(1), 21. https://doi.org/10.3390/antiox9010021
4. Ballard, C. R., & Junior, M. R. M. (2019). Health benefits of flavonoids. In Bioactive compounds (pp. 185-201). Woodhead Publishing.
5. Bridgeman, M. B., & Daniel T. A. (2017). Medicinal cannabis: History, pharmacology, And implications for the acute care setting. P&T: A peer-reviewed journal for formulary management, 42(3), 180-188.
6. Cox-Georgian, D., Ramadoss, N., Dona, C., & Basu, C. (2019). Therapeutic and medicinal uses of terpenes. In Medicinal Plants (pp. 333-359). Springer, Cham.
7. García-Gutiérrez, M.S., Navarrete, F., Gasparyan, A., Austrich-Olivares, A., Sala, F., & Manzanares, J. (2020). Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders. Biomolecules, 10(11). https://doi.org/10.3390/biom10111575  
8. Kocis, P, T., & Vrana, K, E. (2020). Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions. Med Cannabis Cannabinoids, 3:61-73. doi: 10.1159/000507998
9. Lee, C. H., & Giuliani, F. (2019). The Role of Inflammation in Depression and Fatigue. Frontiers in immunology, 10, 1696. https://doi.org/10.3389/fimmu.2019.01696
10. Leonard, B. E. (2014). Impact of inflammation on neurotransmitter changes in major depression: An insight into the action of antidepressants, Progress in Neuro-Psychopharmacology and Biological Psychiatry, 48. 261-267. https://doi.org/10.1016/j.pnpbp.2013.10.018.
11. Morales, P. et al. (2017). Molecular targets of the phytocannabinoids: A complex picture. Progress in the chemistry of organic natural products, 103, 103-131. doi:10.1007/978-3-319-45541-9_4
12. Noreen N., Muhammad, F., Akhtar, B., Azam, F., & Anwar, M. I. (2018). Is cannabidiol a promising substance for new drug development? A review of its potential therapeutic applications. Crit Rev Eukaryot Gene Expr, 28(1), 73-86. doi: 10.1615/CritRevEukaryotGeneExpr.2018021528. 
13. Sales, A. J., Crestani, C. C., Guimarães, F. S., Joca, S. (2018). Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 86. 255-261. https://doi.org/10.1016/j.pnpbp.2018.06.002.
14. Sales, A. J., Fogaça, M. V., Sartim, A. G., et al. (2019). Cannabidiol induces rapid and sustained antidepressant-like effects through increased BDNH signaling and synaptogenesis in the prefrontal cortex. Mol Neurobiol, 56, 1070–1081. doi:10.1007/s12035-018-1143-4. 
15. Sarris, J. et al. (2020). Medicinal cannabis for psychiatric disorders: A clinically-focused systematic review. BMC Psychiatry, 20(1). doi:10.1186/s12888-019-2409-8
16. Wong, S. S., & Wilens, T. E. (2017). Medical cannabinoids in children and adolescents: a systematic review. Pediatrics, 140(5).