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Nervenheilkunde 2019; 38(09): 662-666
DOI: 10.1055/a-0957-6708
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

Endocannabinoidsystem und Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung im Erwachsenenalter

Aktuelle Studienlage und potenzielle therapeutische AnsatzpunkteEndocannabinoid system and attention deficit hyperactivity disorder in adults
Nathalie Brunkhorst-Kanaan
1   Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universitätsklinikum Frankfurt am Main, Goethe-Universität Frankfurt am Main
,
Sarah Kittel-Schneider∗
1   Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universitätsklinikum Frankfurt am Main, Goethe-Universität Frankfurt am Main
› Author Affiliations
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Publication History

Publication Date:
02 September 2019 (online)

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ZUSAMMENFASSUNG

ADHS ist eine entwicklungspsychiatrische Erkrankung, die im Erwachsenenalter häufig unerkannt und unbehandelt bleibt. Die Folgen für die Betroffenen sind neben häufigeren Arbeitsplatzverlusten, ein erhöhtes Unfallrisiko und Schwierigkeiten in der sozialen Interaktion. Häufig präsentiert sich die ADHS im Erwachsenenalter sehr heterogen und ist in ca. 80 % der Fälle mit psychiatrischen Komorbiditäten, wie Depressionen, bipolare Störung, Angststörung, Borderline- und dissoziale Persönlichkeitsstörung sowie Suchterkrankungen vergesellschaftet. Letztere führt zu der hohen Inzidenz von Cannabismissbrauch von Patienten mit ADHS. Auf der anderen Seite wird vermutet, dass Cannabis von den Betroffenen als leichtes Sedativum im Sinne einer Selbstmedikation gegen einige Symptome des ADHS wie innere Unruhe, Rastlosigkeit und Schlafstörungen eingesetzt wird. Seit den frühen 1990er-Jahren sind zahlreiche Studien erschienen, die den Zusammenhang zwischen einer Störung des physiologischen endogenen Cannabinoidsystems und der Genese psychiatrischer Erkrankungen wie Depressionen, Angststörungen, posttraumatischer Belastungsstörung (PTBS), Schizophrenie, Suchterkrankungen und Schlafstörungen beschreiben und im Endocannabinoidsystem eine potenzielle Möglichkeit neuer pharmakologischer Behandlungsmöglichkeiten, z. B. durch den Einsatz von synthetischen Cannabinoiden, sehen. In diesem Artikel sollen grundlegende Mechanismen des Endocannabinoidsystems erklärt und die Zusammenhänge mit der Genese des ADHS anhand der Studienlage beleuchtet werden. Zudem soll ein Ausblick auf mögliche Therapieoptionen mit Cannabinoiden gegeben werden.

ABSTRACT

ADHD is a developmental psychiatric disorder that often goes unnoticed and untreated in adulthood. The consequences for affected individuals include frequent school drop-outs, job losses, more frequent accidents, and difficulties in social interaction. ADHD presents in adult life in about 80 % of cases comorbid with other psychiatric disorders, like major depression, bipolar disorder, anxiety disorder, borderline personality disorder, antisocial disorder and substance abuse. Especially cannabis use, and misuse has a high incidence in patients with ADHD. They use cannabis as a light sedative in the sense of a self-medication for ADHD symptoms such as inner restlessness, motor restlessness and sleep disorders. Since the early 1990 s frequent studies investigated a potential role of the endocannabinoid system in the genesis of psychiatric disorders such as depression, anxiety disorders, post-traumatic stress disorder (PTSD), schizophrenia, and sleep disorders. In targeting the endocannabinoid system with synthetical cannabinoids new opportunities for treatment of these mental disorders are discussed. In this article mechanisms of the endocannabinoid system are explained and the connections with ADHD are mentioned. In addition, an outlook on possible treatment options with cannabinoids is given.

Schlüsselwörter

Endocannabinoide - ADHS - Dopamin - Cannabidiol

Key words

Endocannabinoids - adhd - dopamine - cannabidiol
 

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