Complementary Medicine for Children and Young People Who Have Attention Deficit Hyperactivity Disorder

Norbert Skokauskas; Fiona McNicholas; Tawfik Masaud; Thomas Frodl

Disclosures

Curr Opin Psychiatry. 2011;24(4):291-300. 

In This Article

Abstract and Introduction

Abstract

Purpose of review Despite effectiveness of medication in treating children and young people who have attention deficit hyperactivity disorder (ADHD), concerns about the effects of medication on children's developing brains, adverse side-effects, possibility of long-term use, and compliance issues have all contributed to the continuing search for alternative therapies. This article reviews the latest scientific evidence of the effectiveness and safety of these treatments in ADHD.
Recent findings Although there is evidence from a large randomized controlled study that neurofeedback has positive effects on reducing children's symptoms of ADHD, most recent randomized controlled trials have generally yielded negative results. Some positive results exist from a pilot study of repetitive transcranial magnetic stimulation. However, the sample size was far too small to enable any conclusions to be drawn about the evidence. Findings from the recent randomized controlled trials of supplements of essential fatty acids in children who have ADHD clearly demonstrated lack of superiority compared with placebo.
Summary Notwithstanding efforts made to increase the scientific rigor of previous studies, more recent studies have generally been unsuccessful in demonstrating adequate treatment effects of complementary medicine on children who have ADHD. Currently, there is no proof that complementary medicine provides a better alternative for children who have ADHD than treatments that are currently available within multimodal therapy.

Introduction

Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioral disorder of childhood (3–8%).[1–3] Previous reports document trends of increasing prevalence during the past decade and increases in use of medication for ADHD.[1–3]

Previous studies firmly placed medication management as a cornerstone in treating children and young people who have ADHD. However, despite strong effect sizes, not all children respond to medication (15–30%), and some experience significant adverse effects, which limits the use of medication.[4,5] In addition, both society and parents may have attitudinal difficulties with regard to giving medication to children, or to the risk of drug diversion.[4,5] These limitations have encouraged researchers, clinicians and families to search for additional treatment options.

Complementary medicine is a group of diverse medical and healthcare systems, practices and products that are not generally considered part of conventional medicine.[6] Complementary medicine is an increasing feature of healthcare practice, but considerable confusion remains about its effectiveness and what positions the disciplines included under this term should hold in relation to conventional medicine.[6]

The frequency of use of complementary medicines in children who have ADHD ranges between 12 and 64%.[7] However, there has been controversy about the effectiveness and safety of use of this group of interventions. Moreover, some philosophy-based complementary treatments do not lend themselves well to conventional evaluation, as the belief system associated with each is such an important component of the therapy.

This article reviews the latest studies (from January 2008 through to early 2011) on the use of complementary medicines in ADHD and examines their efficacy and safety profile.

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