Phytotherapy for Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review and Meta-analysis

Abstract

Attention deficit hyperactivity disorder (ADHD) is commonly a neurodevelopmental behavioural disorder in children and adolescents. Mainly characterized by symptoms like lack of attention, hyperactivity, and impulsiveness, it can impact the overall mental development of the one affected. Several factors, both genetic and non-genetic, can be responsible for this disorder. Although several traditional treatment methods involve medication and other counselling techniques, they also come with different side effects. Hence, the choice is now shifting to alternative treatment techniques. Herbal treatments are considered one of the most popular complementary and alternative medicine (CAM) administered. However, issues related to the safety and efficacy of herbal remedies for the treatment of ADHD need to be investigated further. This study aims to find out the recent advancement in evidence-based use of herbal remedies for ADHD by a comprehensive and systematic review that depicts the results of the published works on herbal therapy for the disorder. The electronic databases and the references retrieved from the included studies present related randomized controlled trials (RCTs) and open-label studies. Seven RCTs involving children and adolescents diagnosed with ADHD met the inclusion criteria. There is a fair indication of the efficacy and safety of Melissa officinalis L., Bacopa monnieri (L.) Wettst., Matricaria chamomilla L., and Valeriana officinalis L. from the studies evaluated in this systematic review for the treatment of various symptoms of ADHD. Limited evidence was found for Ginkgo biloba L. and pine bark extract. However, various other preparations from other plants did not show significant efficacy. There is inadequate proof to strongly support and recommend the administration of herbal medicines for ADHD, but more research is needed in the relevant field to popularize the alternative treatment approach.

Complementary and Alternative Medicine (CAM) Practices: Elucidating the Impact on Healthcare Systems, Mechanisms, and Paediatric Applications.

“…In some RCTs conducted on children and adolescents with ADHD using herbs such as Gingko biloba and Valeriana officinalis, it was reported that such herbs might ameliorate ADHD symptoms [128,129]. However, systematic reviews and meta-analyses assessing the possible effects of herbs on children with ADHD have concluded that available evidence is inconclusive and insufficient to recommend herbs as an alternative treatment for ADHD [130][131][132][133].…”

“…Despite a number of clinical trials reporting positive effects for different herbs such as the aforementioned, it is fundamental to acknowledge that results should be interpreted with caution, given that their validity and generalizability to the paediatric population are commonly hampered by methodological heterogeneity, lack of long-term follow-ups, small sample sizes and absence of common clinical and objective measurements as concluded in available systematic reviews [130][131][132][133]143]. Further research is needed in this area to address knowledge gaps and establish the efficacy and safety profiles of herbal treatments, thus potentially providing alternative treatment approaches for consideration in clinical practice.…”

Ginkgo biloba leaf extract EGb 761® as a paragon of the product by process concept

“…In many review articles, specifically EGb 761 ® , rather than “Ginkgo extract” was examined, or the authors carefully distinguished between different extracts (for a few selected examples, see Gauthier and Schlaefke, 2014 ; Barth et al, 2021 ; DeFeudis, 1991 ; Spiegel et al, 2018 ; Tomino et al, 2021 ; Zhang et al, 2016 ; Riepe, 2020 ; Farzaei et al, 2017 ; Müller et al, 2019 ; Hashiguchi et al, 2015 ; Solfrizzi and Panza, 2014 ; Tan et al, 2015 ). In other studies, the distinction was less stringent or not implemented at all (for a few selected examples, see Al-Kuraishy et al, 2022 ; Dutta et al, 2022 ; Zhao et al, 2021 ; Hallak et al, 2021 ; Ibrahim et al, 2021 ). Thus, it may be misleading to generalize evidence gained for one specific extract to all products made from the same plant.…”

Construction of Meta-Thinking Educational Program Based on Mental-Brain Simulation (MTMBS) and Evaluating its Effectiveness on Executive Functions, Emotion Regulation, and Impulsivity in Children With ADHD: A Resting-State Functional MRI Study

“…The prevalence of this disorder is 6.76% in adults and 5% to 7% in children (Fuller-Thomson et al, 2022; Polanczyk et al, 2007; Song et al, 2021; Willcutt, 2012). About 50% of children and adolescents with this disorder maintain their symptoms during adulthood (Dutta et al, 2022; Faraone & Biederman, 2005; Pellow et al, 2011). Attention deficit-hyperactivity disorder (ADHD) is accompanied by numerous issues in personality, psychological and educational fields, including media and internet abuse, a tendency to use drugs, poor academic performance, high-risk sexual behaviors, poor quality sleep, risk of suicide attempts, impulsive and unplanned behaviors, disturbed relations with family and friends, criminal actions, sever anxiety and mood problems in childhood and adolescence (Jia et al, 2021; Thapar & Cooper, 2016).…”