An experimental comparison of Pycnogenol® and methylphenidate in adults with Attention-Deficit/ Hyperactivity Disorder (ADHD)

Tenenbaum, Shay; Paull, J.C.; Sparrow, Elizabeth P.; Dodd, Deonna; Green, L.

doi:10.1177/108705470200600201

Cited by 54 publications

(40 citation statements)

References 25 publications

(23 reference statements)

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“…In a randomised, double-blind placebo controlled study, Pinus marinus was more effective than a placebo in reducing hyperactivity, and improving attention and visual-motor coordination in children with ADHD (Dvořáková et al 2007;Trebaticka et al 2006). In another study on adults with ADHD, Pinus marinus was as effective as methylphenidate, although neither was more effective than the placebo (Tenenbaum et al 2002).…”

Section: The Potential For Antioxidant-related Therapies In Adhdmentioning

confidence: 98%

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Lopresti

2015

ADHD Atten Def Hyp Disord

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Attention deficit hyperactivity disorder (ADHD) has a complex etiology although theories associated with disturbances in dopaminergic and noradrenergic activity are most commonly cited.The importance of these catecholamines in ADHD is supported by its effective treatment utilising stimulant and non-stimulant medications that modify their activity. Recently there has been interest in oxidative and nitrosative stress (O&NS) in ADHD and its potential to contribute to this condition. In this article, research investigating O&NS in ADHD is reviewed and its impact on catecholaminergic activity and neurological structure is discussed. Lifestyle, environmental, ADHD is most commonly treated with stimulant medications such as methylphenidate and amphetamines, non-stimulants such as atomoxetine, and alpha2-adrenergic agonists such as clonidine and guanfacine. Through their effects on dopamine and noradrenaline transporters, stimulants inhibit the reuptake of dopamine and noradrenaline, thereby increasing the extracellular levels of these neurotransmitters. These stimulants also inhibit monoamine oxidase, the enzyme that metabolises these catecholamines (Wilens et al. 2011). Atomoxetine works as a selective reuptake inhibitor of noradrenaline leading to its increased extracellular concentration (Garnock- Jones and Keating 2009).While effective, these medications are associated with several adverse effects. These include loss of appetite, growth delay and sleep disturbances (Cortese et al. 2013). It is important to note that despite their widely accepted short-term efficacy, the long-term effectiveness of pharmacological treatments on social, educational and occupational functioning in people with ADHD continues to be debated (Huang and Tsai 2011;Langberg and Becker 2012;Nijmeijer et al. 2008). On a positive note, recent analyses using the Swedish national registrar suggests that long-term stimulant use in people with ADHD is associated with reduced rates of substance use, criminality, and serious traffic accidents (Chang et al. 2014a;Chang et al. 2014b;Lichtenstein et al. 2012).Despite wide appreciation of catecholaminergic theories associated with ADHD, there has been increased research into other biological mechanisms associated with ADHD. For example, in psychiatry there has been interest in immune-inflammatory pathways and oxidative and nitrosative stress (O&NS). In particular, it has been confirmed through recent meta-analyses that depression is Increased O&NS has also been found in bipolar disorder (Andreazza et al. 2008;Brown et al. 2014),

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Section: The Potential For Antioxidant-related Therapies In Adhdmentioning

confidence: 98%

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Lopresti

2015

ADHD Atten Def Hyp Disord

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“…Impaired oxidative status has also been reported for ADHD, and a randomized, controlled trial of Pycnogenol, a pine bark extract with potent antioxidant properties, in children diagnosed with ADHD (n=61) has found symptomatic and biochemical improvements (Chovanova et al, 2006;Dvorakova et al, 2006;Trebaticka et al, 2006). On the other hand, a small (n=24) study comparing Pycnogenol and methylphenidate in adult ADHD has failed to show any advantage of either treatment over placebo (Tenenbaum et al, 2002).…”

Section: Other Conditionsmentioning

confidence: 99%

Oxidative stress in psychiatric disorders: evidence base and therapeutic implications

Berk

Dean

et al. 2008

Int. J. Neuropsychopharm.

864

569

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Oxidative stress has been implicated in the pathogenesis of diverse disease states, and may be a common pathogenic mechanism underlying many major psychiatric disorders, as the brain has comparatively greater vulnerability to oxidative damage. This review aims to examine the current evidence for the role of oxidative stress in psychiatric disorders, and its academic and clinical implications. A literature search was conducted using the Medline, Pubmed, PsycINFO, CINAHL PLUS, BIOSIS Previews, and Cochrane databases, with a time-frame extending to September 2007. The broadest data for oxidative stress mechanisms have been derived from studies conducted in schizophrenia, where evidence is available from different areas of oxidative research, including oxidative marker assays, psychopharmacology studies, and clinical trials of antioxidants. For bipolar disorder and depression, a solid foundation for oxidative stress hypotheses has been provided by biochemical, genetic, pharmacological, preclinical therapeutic studies and one clinical trial. Oxidative pathophysiology in anxiety disorders is strongly supported by animal models, and also by human biochemical data. Pilot studies have suggested efficacy of N-acetylcysteine in cocaine dependence, while early evidence is accumulating for oxidative mechanisms in autism and attention deficit hyperactivity disorder. In conclusion, multi-dimensional data support the role of oxidative stress in diverse psychiatric disorders. These data not only suggest that oxidative mechanisms may form unifying common pathogenic pathways in psychiatric disorders, but also introduce new targets for the development of therapeutic interventions.

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“…A randomised controlled trial of Pycnogenol (containing phenolic acids, catechin, taxifolin and procyanidins) supplementation reported improved symptoms in children with ADHD [95], accompanied by increased glutathione levels and total antioxidant status [96]. In adults with ADHD a crossover trial comparing Pycnogenol, methylphenidate and placebo over 3 weeks did not show improved symptoms in the treatment groups compared with placebo which may be attributed to methodological limitations with dosage, duration and crossover effects [97].…”

Section: Research Linking Antioxidants and Cognition/mental Healthmentioning

confidence: 99%

Nutritional modulation of cognitive function and mental health

Parletta

Milte

Meyer

2013

The Journal of Nutritional Biochemistry

239

187

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The important role of diet in cardiometabolic health is generally well recognised; for mental health, it is not so well understood. However, lifestyle risk factors for poor physical health are the same risk factors for mental illness, including poor diet. This is reflected by the high level of poor physical health in people with mental illness. Mediterranean, whole food diets have been associated with reduced risk for chronic disease, but very little research has investigated their mental health benefits. We provide a model for the pathways by which food components provided by a Mediterranean-style diet can facilitate healthy brain function. We then review evidence for the role of selected nutrients/food components -antioxidants, omega-3 fatty acids and B vitamins -in the brain and, hence, modulation of cognitive function and mental health. Converging evidence indicates multiple pathways by which these nutrients can assist in brain function, drawing from studies investigating them in isolation. There is very little work done on synergistic actions of nutrients and whole diets, highlighting a need for human intervention studies investigating benefits of Mediterranean-style diets for mental, as well as cardiometabolic health. ABSTRACTDietary risk factors for cardiometabolic health are generally well recognised; for mental

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An experimental comparison of Pycnogenol® and methylphenidate in adults with Attention-Deficit/ Hyperactivity Disorder (ADHD)

Cited by 54 publications

References 25 publications

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Oxidative stress in psychiatric disorders: evidence base and therapeutic implications

Nutritional modulation of cognitive function and mental health

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