Omega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: A randomized, double-blind, placebo-controlled study (original) (raw)
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Neuropsychopharmacology, 2017
The role of omega-3 polyunsaturated fatty acids (omega-3 or n-3 PUFAs) in the pathogenesis and treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD) is unclear. A systematic review followed by meta-analysis was conducted on: (1) randomized controlled trials (RCTs) assessing the effects of n-3 PUFAs on clinical symptoms and cognition in children and adolescent with ADHD; and (2) case-control studies assessing the levels of n-3 PUFAs in blood and buccal tissues of children and adolescents with ADHD. In seven RCTs, totalling n = 534 randomized youth with ADHD, n-3 PUFAs supplementation improves ADHD clinical symptom scores (g = 0.38, po0.0001); and in three RCTs, totalling n = 214 randomized youth with ADHD, n-3 PUFAs supplementation improves cognitive measures associated with attention (g = 1.09, p = 0.001). Moreover, children and adolescents with ADHD have lower levels of DHA (seven studies, n = 412, g = − 0.76, p = 0.0002), EPA (seven studies, n = 468, g = − 0.38, p = 0.0008), and total n-3 PUFAs (six studies, n = 396, g = − 0.58, p = 0.0001). In summary, there is evidence that n-3 PUFAs supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD, and that these youth have a deficiency in n-3 PUFAs levels. Our findings provide further support to the rationale for using n-3 PUFAs as a treatment option for ADHD.
Nutrition and Health
While pharmacotherapy and psychosocial interventions are recommended as the primary frontline treatment for attention deficit hyperactivity disorder (ADHD), alternative approaches to managing ADHD are becoming increasingly popular among patients and their families. Supplementation with polyunsaturated fatty acids (PUFAs) is an example of this. PUFA supplementation is not recommended by guidelines for managing ADHD; however, patients may still decide to use it. To provide direction to healthcare professionals (HCPs) managing ADHD, eight international experts in the field of adult and child ADHD came together for the Continuum Education Board: Omega Supplements in ADHD meeting. This commentary summarises the panel's consensus that current evidence suggests PUFA supplementation has a small beneficial effect on behaviour in children with ADHD, and that further high-quality research is needed to clearly evaluate and define its role in the management of ADHD of children, adolescents a...
Polyunsaturated fatty acids in the treatment of attention deficit hyperactivity disorder
Background: Attention deficit/hyperactivity disorder (ADHD) is one of the most common behavioral disorders in children. Insufficient dietary intake of long-chain polyunsaturated fatty acids (LC-PUFAs) has been suggested to have an impact on the development of symptoms of ADHD in children. Individuals with ADHD have been demonstrated to have significantly reduced blood concentrations of PUFAs and, in particular, reduced levels of omega-3 (n-3) PUFAs. These findings suggest that PUFA supplementation may reduce the attention and behavior problems associated with ADHD. Objective: To provide an overview of the efficacy of dietary LC-PUFA supplementation in the treatment of ADHD. Methods: Literature published up until December 2013 on the effects of n-3 PUFA supplementation on ADHD symptoms was obtained using a PubMed search and critically reviewed. Results: Dietary PUFA supplementation appears to have beneficial effects on ADHD symptoms although these effects are small. The clinical relevance of these observations remains to be determined. Conclusion: There is only limited support for the efficacy of PUFA supplementation for the core symptoms of ADHD. Given the small effect sizes regarding PUFA supplementation, it may not be a sufficient therapy for a majority of patients with ADHD.
Attention Deficit Hyperactivity Disorder and Omega-3 Fatty Acid Supplementation: A Systematic Review
Yeni symposium psikiyatri ve nörolojik bilimler dergisi, 2018
Objective: Attention deficit hyperactivity disorder (ADHD) is a chronic multifactorial disorder mainly affecting school-aged children and resulting in inattention, hyperactivity and impulsivity symptoms. While exact underlying cause remains unknown, observations regarding the low plasma levels of omega-3 fatty acids in ADHD patients leads to a new treatment approach, omega-3 fatty acid supplementation. Method: Literature search is performed about the relation between omega-3 fatty acid supplementation and ADHD treatment by using 3 databases. Nineteen studies met the inclusion criteria and further analyzed. Results: Studies performed with higher number of participants and for longer trial period demonstrate beneficial effects of omega-3 fatty acids in ADHD treatment while no significant additional adverse effects are recorded compared to regular treatment options. Discussion: Omega-3 fatty acid supplementation approach in ADHD treatment is one of the highly investigated issues while there is a lack of comprehensive literature review regarding that issue. In this literature review, we conclude beneficial effects of omega-3 fatty acids in ADHD treatment while it is important to emphasize the need for additional and more comprehensive clinical trials about this issue.
Journal of Attention Disorders, 2012
Objective: We aimed to investigate the efficacy of polyunsaturated fatty acids (PUFAs) as an adjuvant treatment in patients with ADHD receiving methylphenidate as well as its side effects. Method: This randomized clinical trial was conducted on 40 ADHD patients aged between 6 and 12 years. Both treatment and placebo groups received methylphenidate. Treatment arm also received omega-6 once daily. The Parent ADHD Rating Scale was used to evaluate disease improvement. Results: The Parent ADHD Rating Scale scores of the two groups were similar at baseline. Although total score and scores of three categories decreased significantly in both groups, total score and scores of inattention, hyperactivity, and impulsivity were not significantly different between the groups. Conclusion: The results did not support the efficacy of PUFA in the treatment of ADHD, and adding PUFAs to the therapeutic regimen of ADHD is not recommended at the moment. (J. of Att. Dis. 2012; XX(X) 1-XX)
Omega-3 Fatty Acid Supplementation Improves Attention Deficit Hyperactivity Disorder Symptoms in Children, 2022
Background: Attention Deficit-Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders in children. Increasing evidence suggests an association between omega-3 fatty acid and ADHD. We aimed to investigate the effects of 6-month omega-3 fatty acid supplementation on the fatty-acid profile of erythrocytes and on the clinical severity of ADHD symptoms in children. Methods: Recruitment included 32 children aged 6-14 years diagnosed with ADHD at the Child and Adolescent Psychiatry Department at Ziv Medical Center, Israel. Intervention included refrigerated omega-3 fatty acid supplementation normalized to body weight. Blood samples were taken at baseline, 3 and 6 months after intervention for quantification of fatty acids from erythrocyte membranes. ADHD symptoms were assessed by parents and teachers according to the ADHD Rating-Scale and the Strengths and Difficulties Questionnaire. ADHD severity was additionally assessed by a psychiatrist according to the Clinical Global Impressions Scale. Results: Supplementation of omega-3 fatty acid in children with ADHD raised their omega-3 index statistically significantly from an average of 4.4% omega-3 index at baseline to 11.6% after 6 months and had beneficial effects on ADHD symptoms, as measured by validated questionnaires and in accordance with a pediatric psychiatrist examination. Conclusion: Our pilot study showed that dietary supplementation of omega-3 fatty acid increased the blood omega-3 index levels and improved ADHD symptoms even at the midpoint of 3 months.
Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment
Neuropsychiatric Disease and Treatment
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. The classical treatment of ADHD where stimulant medication is used has revealed severe side effects and intolerance. Consequently, the demand to search for alternative treatment has increased rapidly. When comparing levels of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in ADHD patients with those in age-matching controls, lower levels are found in ADHD patients' blood. ω-3 PUFAs are essential nutrients and necessary for a proper brain function and development. Additionally, there are strong indications that ω-3 PUFA supplements could have beneficial effects on ADHD. However, the results of ω-3 PUFA supplementation studies show a high variability. Therefore, we reviewed recent studies published between 2000 and 2015 to identify effective treatment combinations, the quality of design, and safety and tolerability of ω-3-containing food supplements. We searched the databases MEDLINE, PubMed, and Web of Science with keywords such as "ADHD" and "ω-3/6 PUFA" and identified 25 studies that met the inclusion and exclusion criteria. The results of these ω-3 PUFA studies are contradictory but, overall, show evidence for a successful treatment of ADHD symptoms. Tolerability of the given supplements was high, and only mild side effects were reported. In conclusion, there is evidence that a ω-3 PUFA treatment has a positive effect on ADHD. It should be added that treatment could be more effective in patients with mild forms of ADHD. Moreover, the dosage of stimulant medication could be reduced when used in combination with ω-3 PUFA supplements. Further studies are necessary to investigate underlying mechanisms that can lead to a reduction of ADHD symptoms due to ω-3 PUFA treatments and also to determine the optimal concentrations of ω-3 PUFAs, whether used as single treatment or in combination with other medication.
Since attention deficit/hyperactivity disorder (ADHD) presents high prevalence among children, science has been researching alternative forms of treatment that do not involve medication. Objective: To evaluate the effects of polyunsaturated fatty acids (PUFAs) on attention deficit/hyperactivity disorder. Methods: We reviewed the articles published between 1980 and 2012 indexed in the databases PubMed, APA psychNET, Scopus and Web of Knowledge. Results: Initially 231 articles were selected, out of which 12 met the inclusion criteria. The articles selected reported a modest cognitive and behavioral improvement of the patients after treatment with low doses of PUFAs. Those results might be associated with the evaluation methodology, the doses of PUFAs administered or the duration of treatment.
Journal of Attention Disorders, 2009
Objective: The aim of the study was to assess omega 3/6 fatty acids (eye q) in attention deficit hyperactivity disorder (ADHD). Method: The study included a randomized, 3-month, omega 3/6 placebo-controlled, one-way crossover trial with 75 children and adolescents (8-18 years), followed by 3 months with omega 3/6 for all. Investigator-rated ADHD Rating Scale-IV and Clinical Global Impression (CGI) scale were outcome measures. Results: A majority did not respond to omega 3/6 treatment. However, a subgroup of 26% responded with more than 25% reduction of ADHD symptoms and a drop of CGI scores to the near-normal range. After 6 months, 47% of all showed such improvement. Responders tended to have ADHD inattentive subtype and comorbid neurodevelopmental disorders. Conclusion: A subgroup of children and adolescents with ADHD, characterized by inattention and associated neurodevelopmental disorders, treated with omega 3/6 fatty acids for 6 months responded with meaningful reduction of ADHD symptoms. (J. of Att. Dis. 2008; XX(X) xx-xx)