Nutritional supplements may not be the answer to treating ADHD, according to a new analysis from the Yale Child Study Center.
Michael Bloch, a professor at the Center, recently published a summary of existing studies on the efficacy of various alternate treatments for ADHD, such as omega-3 fatty acids, melatonin, zinc, iron and herbal supplements. Although there are many pharmaceutical medications available to treat ADHD — most commonly, stimulant medications such Ritalin and Adderall — some individuals choose to forego traditional pharmacotherapies because of the side effects or their doubts over these medications’ long-term efficacy. The analysis revealed that polyunsaturated fatty acids such as omega-3 fatty acids seemed to improve ADHD symptoms, and melatonin was effective in treating chronic insomnia, one of the symptoms commonly associated with ADHD. However, many of the other supplement treatments commonly used in the United States do not demonstrate significant benefits, and may even have harmful side effects.
“From my personal experience, I have found that people on nutritional supplements alone have fared worse on tested symptoms than people on both medication and nutritional supplements,” said Terry Dickson, a founder and director of the Behavioral Medicine Clinic for ADHD patients, who was not involved in the study.
For his analysis, Bloch reviewed previously published trials regarding the efficacy of these treatments. He then categorized each treatment based on its level of efficacy demonstrated in the trial and rigor of the trial: omega-3 fatty acids were level 1: beneficial, though less so than traditional psychostimulants. Melatonin was assigned level 2, and seemed to aid in associated ADHD symptoms like insomnia but not in core ADHD symptoms. Levels 3 and 4, which included zinc, iron, psycnogenol, ningdong and magnesium, were subject to bias based on the methods of the study. The rest of the treatments studied — St. John’s Wort, G. biloba and carnitine — seemed to be largely ineffective, with potentially harmful side effects.
Dickson, who is a practicing physician, said that while he does not discourage the use of nutritional supplements for the treatment of ADHD, in his clinic he has not found them to be as effective as traditional medication.
Some experts are more optimistic regarding the efficacy of nutritional supplements.
“If it works, it works,” said Linda Anderson, who specializes in coaching adults with ADHD and has served on the Attention Deficit Disorder Association board for 10 years. “One of my clients says that he swears when he takes omega-3 he thinks better.”
Both Anderson and Dickson said more research needs to be done in the area, and that there will be robust interest from patients in alternative approaches.
Ongoing studies are exploring the potential of the new approaches, Dickson said. For instance, one is analyzing a new drug, based on a vitamin derivative, called metadoxime that is showing promise in treating ADHD symptoms.
“We definitely need more research on nutritional supplements,” Dickson said. “Currently there are three non-stimulant drugs, and the rest are stimulants, but now we’re testing this drug [metadoxime].”
ADHD affects about 9 percent of American children ages 13-18 and about 4.1 percent of American adults, according to the National Institute of Mental Health.