Attention Deficit Hyperactivity Disorder and Omega-3 Fatty Acid Supplementation: A Systematic Review
01 Jan 2018-pp 1
TL;DR: Beneficial effects of omega-3 fatty acids in ADHD treatment are concluded while it is important to emphasize the need for additional and more comprehensive clinical trials about this issue.
Abstract: Date of accept: 02 October 2018 ABSTRACT 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.
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TL;DR: A 4-month period of DHA supplementation (345 mg/d) does not decrease symptoms of ADHD and there was no statistically significant improvement in any objective or subjective measure of ADHD symptoms.
328 citations
TL;DR: Many symptoms commonly attributed to stimulant medication are actually preexisting characteristics of children with ADHD and improve with stimulant treatment.
Abstract: Objective. To compare the side effect profiles of methylphenidate (MPH) and dexamphetamine (DEX) in children with attention deficit hyperactivity disorder (ADHD), as well as to determine which symptoms are genuine adverse effects of stimulant medication, as opposed to aspects of the child's underlying behavioral phenotype.
Design. Double-blind, crossover study.
Setting. Pediatric teaching hospital ambulatory behavior clinic.
Subjects. A total of 125 children with ADHD with a mean age of 104.8 months.
Interventions. Subjects received DEX (0.15 mg/kg/dose) and MPH (0.3 mg/kg/dose) twice a day for 2 weeks each in a randomized order.
Outcome Measures. The Barkley Side Effects Rating Scale (17 symptoms; 0 = absent, severity rated from 1 to 9) was completed by parents at baseline and at the completion of each trial fortnight.
Results. Subjects' parents reported a significantly greater mean number (8.19) and mean severity (4.08) of “side effects” before commencing the trial than during the MPH period (number 7.19; severity 3.24), but not the DEX period (number 7.64, severity 3.73). The mean severity (but not mean number) was greater on DEX than on MPH. DEX caused more severe insomnia and appetite suppression compared with the baseline rating. Appetite suppression was the only item rated more severe on MPH than at baseline. Six side effects were significantly more severe on DEX than MPH: insomnia, irritability, proneness to crying, anxiousness, sadness/unhappiness, and nightmares. None were more severe on MPH than DEX. Overall, both MPH and DEX were well tolerated by most subjects, with only four subjects discontinuing the trial period because of severe adverse effects (2 [1.6%] on each stimulant).
Conclusions. Many symptoms commonly attributed to stimulant medication are actually preexisting characteristics of children with ADHD and improve with stimulant treatment. At the doses investigated, both DEX and MPH caused appetite suppression, and DEX caused insomnia. Negative emotional symptoms were more severe on DEX than MPH.
290 citations
"Attention Deficit Hyperactivity Dis..." refers background or result in this paper
...Usage of dexamphetamine is related to similar side effects with methylphenidate.(3,4) Atomoxetine functions as selective noradrenaline (NE) reuptake inhibitor in order to increase its’ concentration in CNS that enhances and prolongs action of NE as neurotransmitter....
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...Methylphenidate is the most commonly used medication in the treatment of ADHD and licensed for use in children and teenagers.(3,4) However, methylphenidate utilization is associated with severe adverse effects including elevated blood pressure and heart rate, headache, mood swings, loss of appetite and sleep disorders....
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...Dexamphetamine is licensed for use in children over the age of 3 and not for adults.(4) Usage of dexamphetamine is related to similar side effects with methylphenidate....
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...It is important to note that methylphenidate treatment used commonly in case of ADHD is associated with headache, abdominal pain, sleeplessness, nervousness, growth retardation, reduced appetite, tachycardia, and changes in blood pressure.(3,4) Even though earlier studies with short trial phase are unable to show any beneficial effects compared to methylphenidate treatment alone, analysis of most studies with longer trial phase or higher number of participants demonstrates effectiveness of omega-3 fatty acid supplementation in the treatment of ADHD without significant additional side-effects....
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...However, methylphenidate utilization is associated with severe adverse effects including elevated blood pressure and heart rate, headache, mood swings, loss of appetite and sleep disorders.(3,4) Dexamphetamine is licensed for use in children over the age of 3 and not for adults....
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TL;DR: 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.
Abstract: 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-c...
201 citations
25 Apr 2012
TL;DR: In this article, the effects of supplements rich in eicosapentaenoic acid (EPA)-rich oil and a docosahexaenoic acids (DHA)rich oil versus an ω-6 polyunsaturated fatty acid-rich safflower oil (control) on literacy and behavior in children with attention-deficit/hyperactivity disorder (ADHD) in a randomized controlled trial were evaluated by linear mixed modeling.
Abstract: Objective: To determine the effects of an eicosapentaenoic acid (EPA)-rich oil and a docosahexaenoic acid (DHA)-rich oil versus an ω-6 polyunsaturated fatty acid-rich safflower oil (control) on literacy and behavior in children with attention-deficit/hyperactivity disorder (ADHD) in a randomized controlled trial. Methods: Supplements rich in EPA, DHA, or safflower oil were randomly allocated for 4 mo to 90 Australian children 7 to 12 y old with ADHD symptoms higher than the 90th percentile on the Conners Rating Scales. The effect of supplementation on cognition, literacy, and parent-rated behavior was assessed by linear mixed modeling. Pearson correlations determined associations between the changes in outcome measurements and the erythrocyte fatty acid content (percentage of total) from baseline to 4 mo. Results: There were no significant differences between the supplement groups in the primary outcomes after 4 mo. However, the erythrocyte fatty acid profiles indicated that an increased proportion of DHA was associated with improved word reading (r = 0.394) and lower parent ratings of oppositional behavior (r = 0.392). These effects were more evident in a subgroup of 17 children with learning difficulties: an increased erythrocyte DHA was associated with improved word reading (r = 0.683), improved spelling (r = 0.556), an improved ability to divide attention (r = 0.676), and lower parent ratings of oppositional behavior (r = 0.777), hyperactivity (r = 0.702), restlessness (r = 0.705), and overall ADHD symptoms (r = 0.665). Conclusion: Increases in erythrocyte ω-3 polyunsaturated fatty acids, specifically DHA, may improve literacy and behavior in children with ADHD. The greatest benefit may be observed in children who have comorbid learning difficulties.
111 citations
TL;DR: The objective is to measure efficacy of eicosapentaenoic acid in children with attention deficit hyperactivity disorder (ADHD) and to establish an experimental protocol for this study.
Abstract: Aim: Measure efficacy of eicosapentaenoic acid (EPA) in children with attention deficit hyperactivity disorder (ADHD). Methods: Randomized controlled trial (RCT) of 0.5 g EPA or placebo (15 weeks) ...
104 citations