Complementary and Alternative Therapies for Pediatric Attention Deficit Hyperactivity Disorder: A Descriptive Review

Abstract

Attention deficit hyperactivity disorder (AD/HD), characterized by impulsivity, distractibility, and inattention, has an estimated pediatric population prevalence of 6–8%. Family physicians and pediatricians evaluate and treat the majority of children with this condition. The evidence-based treatment of choice for ADHD, stimulant medication, continues to be a source of public controversy. Surveys suggest that among parents of children with ADHD, there is considerable interest in complementary and alternative medicine (CAM). These therapies include herbal preparations, mineral supplements, sugar restriction, and polyunsaturated fatty acids. Other AD/HD therapies include neuro-feedback, cognitive training, mindfulness meditation, and exposure to “green space.” In order to assist physicians and mental health professionals in responding to patient and parent queries, this paper briefly describes these CAM therapies and current research regarding their effectiveness. While investigations in this area are hampered by research design issues such as sample size and the absence of double-blind placebo-controlled trials, there is some evidence that omega three fatty acids, zinc supplements, and neuro-feedback may have some efficacy.

Updates on the Use of Natural Treatments for Attention-Deficit Hyperactivity Disorder (ADHD)

“…This is conducted in a group setting where a therapist or a teacher demonstrates appropriate social behaviors and then encourages patients to repeat and practice those behaviors [16,17]. Other potential approaches include memory training through the use of computer software (Cogmed), electroencephalography biofeedback or neurofeedback, exercise, yoga, meditation, acupuncture, and green space [12,18,19]. As these therapies are not widely available, only a few patients can benefit from the effects of behavioral therapy.…”

“…Common culprits include sugar, dairy products, junk foods, food additives, preservative, and others [18,21]. Another dietary regimen that has been gaining support is the "oligoantigenic" or "few foods" diet, which entails strict removal of nearly all foods, except a limited number that have been proven to cause no problems or are deemed "hypoallergenic" [18,19,21]. However, due to inadequate research on the efficacy of these regimens, employing dietary modifications to treat ADHD is still controversial.…”

“…In view of the safety and efficacy issues of current pharmacological interventions, and the desire for safer yet effective ADHD treatments, there has been a growing interest in natural health products (e.g., botanical/herbal medicines, vitamins, and minerals) and other complementary and alternative medicines for ADHD [12,18,19]. It has been estimated that more than 50% of parents of children with ADHD treat their child using one or more of these products [22][23][24][25].…”

“…The potent antioxidant properties of Pycnogenol® are thought to be beneficial to ADHD given the presumed role of oxidative stress in the etiology of this disorder [28]. Pycnogenol® was also shown to normalize urinary catecholamine concentration of children with ADHD [29] and is believed to act as a vasodilator improving cerebral blood flow to brain regions involved in ADHD [19]. Contrastingly, Tenenbaum et al [30] reported that Pycnogenol® failed to produce treatment effects in adults (24-53 years old) with ADHD over a period of 3 weeks.…”

Attention-deficit hyperactivity disorder and exposure to nature in college students

“…The effectiveness of many alternative treatments for ADHD has been evaluated over the past few decades by several researchers conducting meta-analyses (e.g., Rojas & Chan, 2005;Searight, Robertson, Smith, Perkins, & Searight, 2012). Some of the more controversial treatments include sugar reduction diets, homeopathy, biofeedback, and computer-based training, all of which have been criticized for various reasons.…”