Kids with ADD May Benefit from Alternative Therapies
Scientific research is beginning to validate the use of certain unconventional treatments in children and adolescents with attention deficit/hyperactivity disorder (ADHD), according to a new review article in Alternative Therapies.1 With the incidence of ADHD on the rise and the concern over the long-term effects of prescription medications, many parents appear to be turning to natural therapies.2
The authors feel that neurofeedback may be beneficial for ADHD. Studies have demonstrated that some children with ADHD have different electrical patterns in the brain compared with healthy children. Neurofeedback is a specific type of biofeedback designed to help children exercise different neurological pathways, which results in impulse control, increased attention, and more efficient processing of information. Several small studies are cited that show that 20 to 40 sessions of neurofeedback is an effective therapy for ADHD, and one study found it to be as effective as prescription medication, with no known adverse effects.
Nutrition-oriented physicians often recommend dietary changes for children with ADHD but no food or food component has been clearly identified as a cause. The authors discuss the Feingold diet, which eliminates food additives and salicylates. While this diet is popular, the supporting scientific evidence is inconclusive. The mixed results in the studies may be due to different sensitivities to various food additives or preservatives, or to differences in the amount ingested in different studies. More research is necessary to clarify this issue. In addition, some evidence suggests that consumption of refined sugar may increase hyperactivity in particular children, but this has not been substantially proven.3 4
A few trials have shown that kids with ADHD are deficient in essential fatty acids (EFAs), which are important for proper brain functioning. The authors mention one small study that showed evening primrose oil had a minimal effect on attention and behavior. One recent study found that EFAs helped children with ADHD,5 while another found no benefit.6 As EFAs are safe, however, they may be worth trying, despite the lack of definitive data. Although the optimal EFA supplementation for children with ADHD is not known, the study that showed a beneficial effect used a daily supplement that contained 186 mg of eicosapentaenoic acid (EPA), 480 mg of docosahexaenoic acid (DHA), 96 mg of gamma-linolenic acid (GLA), and 864 mg of linoleic acid.
Other nutritional supplements that may be helpful include grapine and L-glutamine. The authors state that grapine is a powerful antioxidant commonly used in France to treat the symptoms of ADHD, but is new to the United States and has not yet been studied in clinical trials. Children with ADHD have been found to be deficient in the amino acid L-glutamine, a precursor for a chemical in the brain called GABA. GABA is a neurotransmitter that calms the mind and may play a role in hyperactivity. While taking a daily supplement of L-glutamine may improve symptoms of ADHD, the amount needed and length of treatment have not been established.
Iron deficiency, which is a fairly common nutritional problem, can cause a wide array of behavioral problems. In children with ADHD and iron deficiency, supplementation with iron may improve both behavior and performance in school. Even some children with ADHD who are not iron-deficient may benefit from iron supplementation, though the benefits seem to be less pronounced in those children.
Homeopathy has been shown to be a safe, effective treatment for ADHD. Remedies prescribed include stramonium for nervousness and terrors, cina for restlessness, and hyoscyamus for poor impulse control. Many of the children treated continued to show improvement in behavior two months following discontinuation of treatment. A new controlled study about to get underway at Yale University will look at the effectiveness of homeopathy in children with ADHD, but won’t be completed until 2003.
Current conventional treatment for ADHD includes taking stimulant medications such as methylphenidate (Ritalin®), pemoline (Cylert®) or dextroamphetamine (Dexedrine®, Adderall®) to improve concentration and help children focus in school. Since these medications often have unwanted side effects, such as nervousness, loss of appetite, and sleep disturbances, the authors suggest that established alternative therapies may be viable options in treating ADHD. However, they recommend using a proven alternative or conventional therapy over "trial-and-error" methods, to avoid delaying appropriate treatment.
1. Brue AW, Oakland TD. Alternative treatments for attention-deficit/hyperactivity disorder: Does evidence support their use? Altern Ther Health Med 2002;8:68–74.
2. Stubberfield TG, Parry TS. Utilization of alternative therapies in attention deficit hyperactivity disorder. J Pediatr Child Health 1999;35:450–3.
3. Prinz RJ, Roberts WA, Hantman E. Dietary correlates of hyperactive behavior in children. J Consult Clin Psychol 1980;48:760–9.
4. Wolraich ML, Lindgren SD, Stumbo PJ, et al. Effects of diets high in sucrose or aspartame on the behavior and cognitive performance of children. N Engl J Med 1994;330:301–7.
5. Richardson AJ, Puri BK. A randomized double-blind, placebo-controlled study on the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties. Prog Neuropsychopharmacol Biol Psychiatry 2002;26:233–9.
6. Voigt RG, Llorente AM, Jensen CL, et al. A randomized, double-blind, placebo-controlled trial of docosahexanoic acid supplementation in children with attention-deficit/hyperactivity disorder. J Pediatr 2001;139: 189–96.
Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of Garlic and Cholesterol: Everything You Need to Know (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice in Westport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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