Biochemical and Psychological Effects of Omega-3/6 Supplements in Male Adolescents with Attention-Deficit/Hyperactivity Disorder: A Randomized, Placebo-Controlled, Clinical Trial

Abstract

Background: An abnormality in long chain-polyunsaturated fatty acid (LC-PUFA) levels has been implicated in attention-deficit/ hyperactivity disorder (ADHD). Studies evaluating LC-PUFA supplementation for therapeutic efficacy in ADHD have shown mixed and, therefore, inconclusive results. Methods: Seventy-six male adolescents (age 12-16 years, mean = 13.7) with ADHD were assessed for the effects of 12 weeks omega-3 and omega-6 supplements on biochemical and psychological outcomes in a randomized, placebo-controlled, clinical trial. The primary outcome measure was change in the Conners' Teacher Rating Scales (CTRS) following 12 weeks of supplementation of LC-PUFA or placebo. At baseline, the placebo and treatment groups had comparable levels of LC-PUFA as measured by red blood cell phosphatidylcholine. In the treatment group, supplementation enhanced eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and total omega-3 fatty acid levels. Results: No superiority of LC-PUFAs to placebo was observed on the primary outcome. Further, there were no reliable treatment effects on aggression, impulsivity, depression, and anxiety. Conclusions: Future studies should use larger sample sizes and longer supplementation period to detect small-modest effects for clinical recommendations in ADHD.

Do Omega-3/6 Fatty Acids Have a Therapeutic Role in Children and Young People with ADHD?

“…A 12-week RCT comprised of 76 male adolescents with ADHD using a similar dose of fatty acids found that supplementation improved blood levels of EPA, DHA, and total omega-3 fatty acids, though no effects on aggression, impulsivity, or anxiety were seen, possibly due to the smaller study sample size and shorter study length of this trial [ 32 ]. Two other trials have been undertaken using a similar 9 : 3 : 1 ratio of EPA, DHA, and GLA, respectively [ 33 , 34 ].…”

“…Three studies concluded that there were limited associations between omega-3/6 fatty acid supplementation and ADHD outcomes. In one study, Conners' Parent and Teacher Rating Scale was not regarded as being sensitive enough to detect small improvements in the behaviour of male adolescents [ 32 ]. Another work found that a supplement providing 480 mg of linoleic acid and 120 mg of α -linolenic acid ameliorated some ADHD symptoms amongst 7–13-year-olds, although no significant differences were found, possibly because children were unmedicated [ 30 ].…”

Antioxidants as a Potential Target against Inflammation and Oxidative Stress in Attention-Deficit/Hyperactivity Disorder

“…On the other hand, in one study, EPA and DHA supplementation in children with ADHD demonstrated no significant improvements in outcome [89]. Furthermore, no beneficial results were observed in a randomized placebo-controlled clinical trial with EPA and DHA supplementation in children with ADHD [90]. There were increased EPA and DHA concentrations in erythrocyte membranes and improved working memory function on supplementation with a mix of omega-3 FAs [93].…”

International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder

“…Five RCTs have been conducted to study the effect of complementary treatments in adolescents with ADHD but without SUD: cognitive training [26, 34], neurofeedback [35], dietary supplementation with omega-3/6 fatty acids [36], and physical exercise [37]. None yielded robust evidence that these complementary interventions reduce ADHD symptoms in these patients.…”