Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents

Gillies, Donna; Sinn, John; Lad, Sagar; Leach, Matthew; Ross, Melissa J

doi:10.1002/14651858.cd007986.pub2

Cited by 123 publications

(154 citation statements)

References 75 publications

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“…19 Several stimulant (eg, methylphenidate, amphetamine salts) and nonstimulant medications (eg, guanfacine, atomoxetine) are approved by the US Food and Drug Administration for ADHD management, with large effect sizes (Cohen d 5 0.9) reported for stimulant medications. 20 Likewise, although with smaller effect sizes (Cohen d 5 0.3), dietary interventions, including single nutrient supplements, 21 multinutrient supplements, 22,23 and supplementation with omega-3 fatty acids, [24][25][26][27] have received more empirical attention in the past 10 years and are now used more in ADHD management. Nonetheless, these biological interventions are not be considered in this review.…”

Section: Front-line Interventions For Attention-deficit/hyperactivitymentioning

confidence: 99%

Psychosocial Interventions in Attention-Deficit/Hyperactivity Disorder

Antshel¹

2015

Child and Adolescent Psychiatric Clinics of North America

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Attention-deficit/hyperactivity disorder (ADHD) is the most common reason for referral to child and adolescent psychiatry clinics. Although stimulant medications represent an evidence-based approach to managing ADHD, psychosocial interventions for child/adolescent ADHD target functional impairments as the intervention goal, and rely heavily on behavioral therapy techniques and operant conditioning principles. Evidence-based psychosocial interventions for managing pediatric ADHD include behavioral parent training, school-based interventions relying on behavioral modification, teaching skills, and operant conditioning principles, and intensive summer treatment programs. The use of conjoint psychosocial treatments with ADHD medications may enable lower doses of each form of treatment.

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Section: Front-line Interventions For Attention-deficit/hyperactivitymentioning

confidence: 99%

Psychosocial Interventions in Attention-Deficit/Hyperactivity Disorder

Antshel¹

2015

Child and Adolescent Psychiatric Clinics of North America

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“…We found two systematic reviews (search date 2011; [20] and 2013 [21] ), which evaluated polyunsaturated fatty acids in general versus placebo. The first review [20] included one RCT of sufficient quality, while the second review [21] included the same RCT and one further RCT, published subsequent to the first review (see Comment, p 4 ).…”

Section: Omega-3 Versus Placebomentioning

confidence: 99%

“…The first review [20] included one RCT of sufficient quality, while the second review [21] included the same RCT and one further RCT, published subsequent to the first review (see Comment, p 4 ). The first RCT (40 children) [22] compared omega-3 (docosahexaenoic acid [DHA] plus eicosapentaenoic acid [EPA]) with placebo (non-enriched food with olive oil) for 8 weeks.…”

Section: Omega-3 Versus Placebomentioning

confidence: 99%

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Attention Deficit Hyperactivity Disorder in Children and Adolescents

Banerjee¹

2013

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INTRODUCTION: Prevalence estimates of attention deficit hyperactivity disorder (ADHD) vary according to the diagnostic criteria used and the population sampled. DSM-5 prevalence estimate among school children in the US is 5%, but other estimates vary from 2% to 16%. No objective test exists to confirm the diagnosis of ADHD, which remains a clinical diagnosis. Other conditions frequently co-exist with ADHD. METHODS AND OUTCOMES: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of nutritional supplements in children and adolescents with ADHD? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2014 (BMJ Clinical Evidence overviews are updated periodically, please check our website for the most upto-date version of this overview). RESULTS: At this update, searching of electronic databases retrieved 157 studies. After deduplication and removal of conference abstracts, 91 records were screened for inclusion in the review. Appraisal of titles and abstracts led to the exclusion of 29 studies and the further review of 62 full publications. Of the 62 full articles evaluated, four additional systematic reviews were included at this update. We performed a GRADE evaluation for two PICO combinations. CONCLUSIONS: In this systematic overview, we categorised the efficacy for three interventions, based on information relating to the effectiveness and safety of iron supplements, omega-3 polyunsaturated fatty acids, and zinc supplements. QUESTIONSWhat are the effects of nutritional supplements in children and adolescents with attention deficit hyperactivity disorder ( Key points• Core symptoms of attention deficit hyperactivity disorder (ADHD) are inattention, hyperactivity, and impulsiveness, although other conditions frequently co-exist with ADHD, including developmental disorders (especially motor, language, autism spectrum disorder, and specific learning disabilities) and psychiatric disorders (especially oppositional defiant and conduct disorder, anxiety, and depressive disorders).DSM-5 criteria state that symptoms must be present for at least 6 months, are generally observed in children before the age of 12 years, and cause clinically important impairment in social, academic, or occupational functioning that must be evident in more than one setting.Formal diagnostic criteria are most applicable to boys aged 6 to 12 years, and most research data relate to this group. Pre-school children, adolescents, adults, and females may present less typical features, but similar levels of impairment.The global prevalence estimates of ADHD are 5.3% for children and adolescents and 4.4% in adulthood, although there is significant variability in the prevalence estimates worldwide, largely explained by methodological procedures.• We searched for evidence from RCTs and systematic reviews of RCTs on the effectiveness of nutritional supplements (omega-3, iron, or zinc) in children and adolescents with ADHD.We found few RCTs that met our i...

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“…The efficacy of nonpharmacological interventions such as food additives [18] or behavioral interventions [19] remains uncertain [20]. Treatments with stimulants represent the main therapy [5,21] due to their well-documented effect sizes [22,23].…”

Section: Introductionmentioning

confidence: 99%

Assessment of potential cardiovascular risks of methylphenidate in comparison with sibutramine: do we need a SCOUT (trial)?

Antel

Albayrak

Heusch³

et al. 2014

Eur Arch Psychiatry Clin Neurosci

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With the recent approval of methylphenidate (MPH) for treating attention-deficit/hyperactivity disorder (ADHD) in adults, the number of patients exposed will increase tremendously. The ongoing debate on the cardiovascular safety of MPH has triggered two large retrospective cohort studies in children and adolescents as well as in young to middle-aged adults. These studies looked into serious cardiovascular events (sudden cardiac death, acute myocardial infarction and stroke) as primary endpoints and concluded that MPH was safe after a mean duration of 2.1 years of follow-up in children and adolescents and mean duration of 0.33 years of current use in adults. The results are encouraging with respect to the short- and medium-term use of MPH. Without the inherent limitations of retrospective cohort studies, a prospective randomized, double-blind, placebo-controlled, multicenter trial in individuals stratified for cardiovascular risk factors would allow for an optimized risk assessment. With many millions of patients treated per year and drawing parallels to the lately discovered risks of sibutramine, another sympathomimetic with an overlapping mode of action and similar side effects on heart rate and blood pressure, we hypothesize that such a trial might be a dedicated risk mitigation strategy for public health. A critical assessment of cardiovascular side effects of MPH appears particularly warranted, because ADHD is associated with obesity, smoking and poor health in general. We summarize recent findings with the focus on cardiovascular risks of MPH in humans; we additionally analyze the limited number of rodent studies that have addressed cardiovascular risks of MPH.

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Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents

Abstract: Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents.

Cited by 123 publications

References 75 publications

Psychosocial Interventions in Attention-Deficit/Hyperactivity Disorder

Psychosocial Interventions in Attention-Deficit/Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder in Children and Adolescents

Assessment of potential cardiovascular risks of methylphenidate in comparison with sibutramine: do we need a SCOUT (trial)?

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