Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder Omega-3/Omega-6 Fatty Acids for Attention Deficit Hyperactivity Disorder The effect of docosahexaenoic acid-containing food administration on symptoms of attention-deficit/hyperactivity disorder—a placebo-controlled double-blind study A randomized, double-blind, placebo-controlled trial of docosahexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder. Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder: the Multimodal Treatment Study of children with Attention-deficit/hyperactivity disorder. Common and unique therapeutic mechanisms of stimulant and nonstimulant treatments for attention-deficit/hyperactivity disorder. Group therapy for adolescents with attention-deficit/hyperactivity disorder: a randomized controlled trial. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Childhood hyperactivity and psychostimulants: a review of extended treatment studies. Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial. A Randomized, Double-Blind, Sham-Controlled Trial of Transcranial Direct Current Stimulation in Attention-Deficit/Hyperactivity Disorder A randomised controlled trial into the effects of food on ADHD Combined ω3 and ω6 Supplementation in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Refractory to Methylphenidate Treatment Parental Knowledge of Attention-Deficit Hyperactivity Disorder and Opinions of Treatment Options: Impact on Enrolment and Adherence to a 12-Month Treatment Trial Clinical evaluation of subjective and objective changes in motor activity and attention in children with attention-deficit/hyperactivity disorder in a double-blind methylphenidate trial. A double-blind placebo-controlled randomised trial of omega-3 supplementation in children with moderate ADHD symptoms Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial
Attention deficit/hyperactivity disorder ( ADHD ) is one of the most common child psychiatric disorders , and is often treated with stimulant medication . Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids , although their effectiveness remains to be shown conclusively . In this study , we investigated the effects of dietary omega-3 fatty acid supplementation on ADHD symptoms and cognitive control in young boys with and without ADHD . A total of 40 boys with ADHD , aged 8–14 years , and 39 matched , typically developing controls participated in a 16-week double-blind r and omized placebo-controlled trial . Participants consumed 10 g of margarine daily , enriched with either 650 mg of eicosapentaenoic acid (EPA)/docosahexaenoic acid ( DHA ) each or placebo . Baseline and follow-up assessment s addressed ADHD symptoms , fMRI of cognitive control , urine homovanillic acid , and cheek cell phospholipid sampling . EPA/DHA supplementation improved parent-rated attention in both children with ADHD and typically developing children . Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo . There was no effect of EPA/DHA supplementation on cognitive control or on fMRI measures of brain activity . This study shows that dietary supplementation with omega-3 fatty acids  reduces symptoms of ADHD , both for individuals with ADHD and typically developing children . This effect does not appear to be mediated by cognitive control systems in the brain , as no effect of supplementation was found here . Nonetheless , this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD ( NCT01554462 : The Effects of EPA/DHA Supplementation on Cognitive Control in Children with ADHD ; http:// clinical trials.gov/show/NCT01554462 ) 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 r and omized , 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 . 2009 ; 12(5 ) 394 - 401 OBJECTIVES To investigate whether docosahexaenoic acid ( DHA ) supplementation was able to ameliorate attention-deficit/hyperactivity disorder(AD/HD ) symptoms in AD/HD children . DESIGN AND SUBJECTS A placebo-controlled double-blind study with 40 AD/HD ( including eight AD/HD-suspected ) children of 6 - 12 y of age who were mostly without medication . Subjects of a DHA group ( n=20 ) took active foods containing fish oil ( fermented soybean milk , bread rolls and steamed bread ; 3.6 g DHA/week from these foods ) for 2 months , whereas those of a control group ( n=20 ) took indistinguishable control foods without fish oil . The following items were measured at the start and end of the study : ( 1 ) attention deficit , hyperactivity and impulsivity ( AD/HD-related symptoms according to DSM-IV criteria ) ; ( 2 ) aggression assessed by both parents and teachers ; ( 3 ) visual perception ( finding symbols out of a table ) ; ( 4 ) visual and auditory short-term memory ; ( 5 ) development of visual-motor integration ; ( 6 ) continuous performance ; ( 7 ) impatience . RESULTS Changes in tests 1 , 2 , 3 , 5 and 7 over time did not significantly differ between the two groups . However , visual short-term memory and errors of commission ( continuous performance ) significantly improved in the control group compared with the changes over time in the DHA group ( P=0.02 and 0.001 , respectively ) . Recalculation without AD/HD-suspected subjects ( n=4 each group ) showed similar P-values with regard to both measures . CONCLUSION DHA supplementation did not improve AD/HD-related symptoms . Treatment of ADHD with fatty acids deserves further investigation , but careful attention should be paid as to which fatty acid(s ) is used OBJECTIVE To determine whether docosahexaenoic acid ( DHA ) supplementation for 4 months decreases the symptoms of  attention-deficit/hyperactivity disorder ( ADHD ) .  STUDY DESIGN Sixty-three 6- to-12-year-old children with ADHD , all receiving effective maintenance therapy with stimulant medication , were assigned r and omly , in a double-blind fashion , to receive DHA supplementation ( 345 mg/d ) or placebo for 4 months . Outcome variables included plasma phospholipid fatty acid patterns , scores on laboratory measures of inattention and impulsivity ( Test of Variables of Attention , Children 's Color Trails test ) while not taking stimulant medication , and scores on parental behavioral rating scales ( Child Behavior Checklist , Conners ' Rating Scale ) . Differences between groups after 4 months of DHA supplementation or placebo administration were determined by analysis of variance , controlling for age , baseline value of each outcome variable , ethnicity , and ADHD subtype . RESULTS Plasma phospholipid DHA content of the DHA-supplemented group was 2.6-fold higher at the end of the study than that of the placebo group ( 4.85 + /- 1.35 vs 1.86 + /- 0.87 mol % of total fatty acids ; P < .001 ) . Despite this , there was no statistically significant improvement in any objective or subjective measure of ADHD symptoms . CONCLUSION A 4-month period of DHA supplementation ( 345 mg/d ) does not decrease symptoms of ADHD BACKGROUND Intent-to-treat analyses of the study revealed that medication management , alone or combined with intensive behavioral treatment , was superior to behavioral treatment and community care in reducing attention-deficit/hyperactivity disorder ( ADHD ) symptoms ; but only combined treatment showed consistently greater benefit than community care across other outcome domains ( disruptive and internalizing symptoms , achievement , parent-child relations , and social skills ) . We examine response patterns in subgroups defined by baseline variables ( moderators ) or variables related to treatment implementation ( mediators ) . METHODS We reconducted r and om-effects regression ( RR ) analyses , adding factors defined by moderators ( sex ,  prior medication use  ,  comorbid disruptive or anxiety disorder  , and public assistance ) and a mediator ( treatment acceptance/attendance ) . RESULTS Study outcomes ( N = 579 ) were upheld in most moderator subgroups ( boys and girls , children with and without prior medication , children with and without comorbid disruptive disorders ) . Comorbid anxiety disorder did moderate outcome ; in participants without anxiety , results paralleled intent-to-treat findings . For those with anxiety disorders , however , behavioral treatment yielded significantly better outcomes than community care ( and was no longer statistically different from medication management and combined treatment ) regarding ADHD-related and internalizing symptoms . In families receiving public assistance , medication management yielded decreased closeness in parent-child interactions , and combined treatment yielded relatively greater benefits for teacher-reported social skills . In families with high treatment acceptance/attendance , intent-to-treat results were upheld . Acceptance/attendance was particularly important for medication treatments . Finally , two thirds of children given community care received stimulants . Behavioral treatment did not significantly differ from , but medication management was superior to , this subgroup . CONCLUSIONS Exploratory analyses revealed that our study ( the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder [ MTA ] ) results were confirmed across most baseline variables and treatment acceptance/attendance . In children with ADHD plus anxiety , behavioral treatment surpassed community care and approached medication-based treatments regarding parent-reported ADHD symptoms CONTEXT Attention-deficit/hyperactivity disorder ( ADHD ) is a highly prevalent and impairing psychiatric disorder that affects both children and adults . There are Food and Drug Administration-approved stimulant and nonstimulant medications for treating ADHD ; however , little is known about the mechanisms by which these different treatments exert their therapeutic effects . OBJECTIVE To contrast changes in brain activation related to symptomatic improvement with use of the stimulant methylpheni date hydrochloride vs the nonstimulant atomoxetine hydrochloride . DESIGN Functional magnetic resonance imaging before and after 6 to 8 weeks of treatment with methylpheni date ( n = 18 ) or atomoxetine ( n = 18 ) using a parallel-groups design . SETTING Specialized ADHD clinical research program at Mount Sinai School of Medicine , New York , New York . PARTICIPANTS Thirty-six youth with ADHD ( mean [ SD ] age , 11.2 [ 2.7 ] years ; 27 boys ) recruited from r and omized clinical trials . MAIN OUTCOME MEASURES Changes in brain activation during a go/no-go test of response inhibition and investigator-completed ratings on the ADHD Rating Scale-IV-Parent Version . RESULTS Treatment with methylpheni date vs atomoxetine was associated with comparable improvements in both response inhibition on the go/no-go test and mean ( SD ) improvements in ratings of ADHD symptoms ( 55 % [ 30 % ] vs 57 % [ 25 % ] ) . Improvement in ADHD symptoms was associated with common reductions in bilateral motor cortex activation for both treatments . Symptomatic improvement was also differentially related to gains in task-related activation for atomoxetine and reductions in activation for methylpheni date in the right inferior frontal gyrus , left anterior cingulate/supplementary motor area , and bilateral posterior cingulate cortex . These findings were not attributable to baseline differences in activation . CONCLUSIONS Treatment with methylpheni date and atomoxetine produces symptomatic improvement via both common and divergent neurophysiologic actions in frontoparietal regions that have been implicated in the pathophysiology of ADHD . These results represent a first step in delineating the neurobiological basis of differential response to stimulant and nonstimulant medications for ADHD OBJECTIVE To determine the efficacy of group cognitive-behavioral therapy ( CBT ) on adolescents with attention-deficit/hyperactivity disorder ( ADHD ) who were in pharmacological treatment but still had persistent symptoms . METHOD We conducted a multicenter , r and omized , rater-blinded , controlled trial between April 2012 and May 2014 in a cohort of 119 adolescents ( 15 - 21 years of age ) . Participants were r and omly assigned to 12 manualized group CBT sessions ( n = 45 ) or a waiting list control group ( n = 44 ) . Primary outcomes were assessed by a blinded evaluator ( ADHD Rating Scale [ ADHD-RS ] , Clinical Global Impression Scale for Severity [ CGI-S ] , Global Assessment of Functioning [ GAF ] ) before and after treatment , as well as by self-report and parent informant ratings . RESULTS Of the initial 119 participants enrolled , 89 completed treatment . A mixed-effects model analysis revealed that participants who were assigned to the group CBT sessions experienced significantly reduced ADHD symptoms compared to the control group ( ADHD-RS Adolescent : -7.46 , 95 % CI = -9.56 to -5.36 , p < .001 , d = 7.5 ; ADHD-RS Parents : -9.11 , 95 % CI = -11.48 to -6.75 , p < .001 , d = 8.38 ; CGI-S Self-Report : -0.68 , 95 % CI = -0.98 to -0.39 , p < .001 , d = 3.75 ; CGI-S Clinician : -0.79 , 95 % CI = -0.95 to -0.62 , p < .001 ; d = 7.71 ) . Functional impairment decreased significantly in the CBT group according to parents ( Weiss Functional Impairment Scale -4.02 , 95 % CI = -7.76 to -0.29 , p < .05 , d = 2.29 ) and according to the blinded evaluator ( GAF : -7.58 , 95 % CI = -9.1 to -6.05 , p < .001 , d = 7.51 ) . CONCLUSION Group CBT associated with pharmacological treatment is an efficacious intervention for reducing ADHD symptoms and functional impairment in adolescents . Clinical trial registration information-CBT Group for Adolescents With ADHD : a R and omized Controlled Trial ; http:// clinical trials.gov/ ; NCT02172183 BACKGROUND Previous studies have demonstrated the short-term efficacy of pharmacotherapy and behavior therapy for attention-deficit/hyperactivity disorder ( ADHD ) , but no longer-term ( i.e. , > 4 months ) investigations have compared these 2 treatments or their combination . METHODS A group of 579 children with ADHD Combined Type , aged 7 to 9.9 years , were assigned to 14 months of medication management ( titration followed by monthly visits ) ; intensive behavioral treatment ( parent , school , and child components , with therapist involvement gradually reduced over time ) ; the two combined ; or st and ard community care ( treatments by community providers ) . Outcomes were assessed in multiple domains before and during treatment and at treatment end point ( with the combined treatment and medication management groups continuing medication at all assessment points ) . Data were analyzed through intent-to-treat r and om-effects regression procedures . RESULTS All 4 groups showed sizable reductions in symptoms over time , with significant differences among them in degrees of change . For most ADHD symptoms , children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care . Combined and medication management treatments did not differ significantly on any direct comparisons , but in several instances ( oppositional/aggressive symptoms , internalizing symptoms , teacher-rated social skills , parent-child relations , and reading achievement )  combined treatment proved superior to intensive behavioral treatment and /or community care while medication management did not . Study medication strategies were superior to community care treatments , despite the fact that two thirds of community-treated subjects received medication during the study period . CONCLUSIONS For ADHD symptoms , our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication . Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms , but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes ABSTRACT Clinical trials with a treatment duration of at least 3 months were review ed to determine the effect of psychostimulants on the core symptoms of attention-deficit hyperactivity disorder ( ADHD ) and on its commonly associated features . Eighteen studies were identified : 17 were studies of  methylpheni date  , 1 was a study of dextroamphetamine , and none involved  pemoline  or  slow-release stimulants . Eleven of these studies were r and omized controlled trials , whereas seven employed quasi-experimental design s without r and omization . The results of r and omized controlled trials showed that psychostimulants provided greater benefit than did the nonr and omized trials , suggesting that the efficacy of extended treatment may have been underestimated because more seriously disturbed children were assigned to medication treatment than to control treatments in nonr and omized trials . Evidence from the more definitive r and omized controlled trials indicates that stimulants are more effective in ameliorating the core behavioral symptoms of ADHD ( restlessness , inattentiveness , impulsiveness ) than placebos , nonpharmacological therapies , or no treatment-at least in 3 - 7-month trials . During extended psychostimulant treatment , few children become symptom-free , clinical effects may diminish with time , and improvement dissipates rapidly upon discontinuation of medication . There is minimal evidence that extended stimulant treatment improves cognitive deficits or associated problems such as conduct disturbance , low self-esteem , poor peer relationships , or academic underachievement . The belief that stimulants do not improve the long-term prognosis of  children with ADHD  may be based on weakly design ed studies that focus on associated rather than core symptoms . A failure to assign patients of similar clinical severity to different treatment conditions may also have contributed to obscuring the efficacy of extended psychostimulant treatments BACKGROUND The role of nutrition in the treatment of  attention-deficit hyperactivity disorder ( ADHD )  is gaining international attention ; however , treatments have generally focused only on diet restriction or supplementing with one nutrient at a time . AIMS To investigate the efficacy and safety of a broad-based micronutrient formula consisting mainly of vitamins and minerals , without omega fatty acids , in the treatment of ADHD in adults . METHOD This double-blind r and omised controlled trial assigned 80 adults with ADHD in a 1:1 ratio to either micronutrients  ( n = 42 ) or  placebo ( n = 38 ) for 8 weeks ( trial registered with the Australian New Zeal and Clinical Trials Registry : ACTRN12609000308291 ) . RESULTS Intent-to-treat analyses showed significant between-group differences favouring active treatment on self- and observer- but not clinician-ADHD rating scales . However , clinicians rated those receiving micronutrients as more improved than those on placebo both globally and on ADHD symptoms . Post hoc analyses showed that for those with moderate/severe depression  at baseline , there was a greater change in mood favouring active treatment over placebo . There were no group differences in adverse events . CONCLUSIONS This study provides preliminary evidence of efficacy for micronutrients in the treatment of  ADHD symptoms in adults , with a reassuring safety profile Background Current st and ardized treatments for cognitive impairment in attention-deficit/hyperactivity disorder remain limited and their efficacy restricted . Transcranial direct current stimulation ( tDCS ) is a promising tool for enhancing cognitive performance in several neuropsychiatric disorders . Nevertheless , the effects of tDCS in reducing cognitive impairment in patients with attention-deficit/hyperactivity disorder ( ADHD ) have not yet been investigated . Methods A parallel , r and omized , double-blind , sham-controlled trial was conducted to examine the efficacy of tDCS on the modulation of inhibitory control in adults with ADHD . Thirty patients were r and omly allocated to each group and performed a go/no-go task before and after a single session of either anodal stimulation ( 1 mA ) over the left dorsolateral prefrontal cortex or sham stimulation . Results A nonparametric two- sample Wilcoxon rank-sum ( Mann-Whitney ) test revealed no significant differences between the two groups of individuals with ADHD ( tDCS vs. sham ) in regard to behavioral performance in the go/no go tasks . Furthermore , the effect sizes of group differences after treatment for the primary outcome measures —correct responses , impulsivity and omission errors — were small . No adverse events result ing from stimulation were reported . Conclusion According to these findings , there is no evidence in support of the use of anodal stimulation over the left dorsolateral prefrontal cortex as an approach for improving inhibitory control in ADHD patients . To the best of our knowledge , this is the first clinical study to assess the cognitive effects of tDCS in individuals with ADHD . Further research is needed to assess the clinical efficacy of tDCS in this population . Trial Registration Clinical Trials.gov The aim of this study is to assess the efficacy of a restricted elimination diet in reducing symptoms in an unselected group of children with Attention deficit/hyperactivity disorder ( ADHD ) . Dietary studies have already shown evidence of efficacy in selected subgroups . Twenty-seven children ( mean age 6.2 ) who all met the DSM-IV criteria for ADHD , were assigned r and omly to either an intervention group ( 15/27 ) or a waiting-list control group ( 12/27 ) . Primary endpoint was the clinical response , i.e. a decrease in the symptom scores by 50 % or more , at week 9 based on parent and teacher ratings on the abbreviated ten-item Conners Scale and the ADHD-DSM-IV Rating Scale . The intention-to-treat analysis showed that the number of clinical responders in the intervention group was significantly larger than that in the control group [ parent ratings 11/15 ( 73 % ) versus 0/12 ( 0 % ) ; teacher ratings , 7/10 ( 70 % ) versus 0/7 ( 0 % ) ] . The Number of ADHD criteria on the ADHD Rating Scale showed an effect size of 2.1 ( cohen ’s d ) and a scale reduction of 69.4 % . Comorbid symptoms of oppositional defiant disorder also showed a significantly greater decrease in the intervention group than it did in the control group ( cohens ’s d 1.1 , scale reduction 45.3 % ) . A strictly supervised elimination diet may be a valuable instrument in testing young children with ADHD on whether dietary factors may contribute to the manifestation of the disorder and may have a beneficial effect on the children ’s behaviour Children ( 6 - 12 years ) with attention-deficit hyperactivity disorder ( ADHD ) being treated with methylpheni date and st and ard behavior therapy for more than 6 months , whose parents reported no improvement in behavior and academic learning , were r and omly assigned to receive supplementation with a combined ω3 and ω6 preparation or a placebo . Outcome was measured at 3 and 6 months after treatment using a self- assessment checklist completed by the parents . Statistically significant improvement was found in the treatment group compared with the placebo group ( P < .01 ) in the following measures : restlessness , aggressiveness , completing work , and academic performance . Statistically significant improvement was not found at 3 months of treatment between groups but was evident at 6 months of treatment ( P < .05 ) with inattention , impulsiveness , and cooperation with parents and teachers . Distractibility failed to show improvement . Effect sizes ranged from 0.3 to 1.1 at 3 months and 0.2 to 1.4 at 6 months for individual symptom variables Objective : This study examines the relationship between parents ' knowledge of attention-deficit hyperactivity disorder ( ADHD ) and opinions of treatment and their impact on enrolment in and adherence to both pharmacological and nonpharmacological interventions for children with ADHD . Method : Participants in the study were the parents of 81 children who reached diagnostic criteria for ADHD and who were referred to a treatment study of ADHD involving stimulant medication and parent groups . The mothers completed a modified version of the ADHD Knowledge and Opinion Scale  ( AKOS ) prior to receiving diagnostic feedback and prior to the families ' decisions to participate in a 12-month r and omized trial ( medication [ methylpheni date or placebo ] and parent groups [ training or support ] ) . Treatment enrolment and adherence were monitored over the 12-month trial , and families who remained in the study at 12 months completed another modified AKOS . Results : A higher level of knowledge of ADHD was found to be related to more favourable opinions of parent groups but not of medication . Moreover , parents who were more knowledgeable about ADHD were more likely to enrol in both pharmacological and nonpharmacological treatments . Adherence to pharmacological and nonpharmacological treatments was not predicted by parental knowledge of ADHD or opinions of the treatment . Conclusion :  Parents ' knowledge of ADHD and opinions of treatments play a significant role in enrolment in treatments for their children with ADHD . Providing information to parents regarding ADHD prior to offering treatment modalities could have a favourable impact on treatment enrolment and hence treatment adherence The aim of this study was to determine drug-dependent effects on attention and motor activity in children with attention-deficit/hyperactivity disorder ( ADHD ) in a double-blind methylpheni date ( MPH ) trial using both subjective behavior ratings and objective measures of function . In particular , we were interested in the relationship between changes of those subjective and objective measures . A total of 44 ADHD children with the combined subtype completed a r and omized , double-blind , placebo-controlled , crossover trial with 2 doses of MPH ( 0.25 ; 0.5 mg/kg body weight ) and placebo . In each condition , computerized attention tasks were performed , teacher-behavior ratings were obtained , and actigraph data were collected in both clinical and naturalistic setting s. Trend tests revealed linear effects of MPH dose on actigraph data in the test session ( p = 0.02 ) and at school ( p = 0.001 ) , as well as on sustained attention ( p < 0.001 ) , while inhibitory control showed a quadratic dose-response curve ( p < 0.001 ) . Multivariate regression analyses revealed that changes of both , hyperactive-impulsive symptoms ( 28 % ) and inattentive symptoms ( 23 % ) could be explained by objective changes of motor activity . Thus , for clinical practice , it should be taken into account that behavior ratings of ADHD symptoms seemed to be predominantly influenced by changes of motor activity Objective Clinical trials and inconclusive meta-analyses have investigated the effects of omega-3 supplements in children with Attention-Deficit Hyperactivity Disorder ( ADHD ) . We performed a r and omised placebo-controlled trial to evaluate the efficacy of omega-3 fatty acids . Methods Children aged 6–15 years with established diagnosis of ADHD were r and omised 1:1 to receive either supplements containing docosahexaenoic acid ( DHA ) and eicosapentaenoic acid ( EPA ) or a placebo for 3 months . Psychotropic or omega-3-containing treatments were not authorised during the study . The primary outcome was the change in the Attention-Deficit Hyperactivity Disorder Rating Scale version 4 ( ADHD-RS-IV ) . Other outcomes included safety , lexical level ( Alouette test ) , attention ( Test of Attentional Performance for Children — KiTAP ) , anxiety ( 48-item Conners Parent Rating Scale-Revised — CPRS-R ) , and depression ( Children ’s Depression Inventory — CDI ) . Results Between 2009 and 2011 , 162 children were included in five French child psychiatry centres . The mean age was 9.90 ( SD 2.62 ) years and 78.4 % were boys . The inclusion ADHD-RS-IV at was 37.31 ( SD 8.40 ) . The total ADHD-RS-IV score reduction was greater in the placebo group than in the DHA – EPA group : −19 ( −26 , −12 ) % and −9.7 ( −16.6 , −2.9 ) % , respectively , p = 0.039 . The other components of the Conners score had a similar variation but the differences between groups were not significant . Two patients in the DHA – EPA group and none in the placebo group experienced a severe adverse event ( hospitalisation for worsening ADHD symptoms ) . Conclusion This study did not show any beneficial effect of omega-3 supplement in children with mild ADHD symptoms An increasing number of parents turn to homeopathy for treatment of their hyperactive child . Two publications , a r and omised , partially blinded trial and a clinical observation study , conclude that homeopathy has positive effects in patients with attention deficit hyperactivity disorder ( ADHD ) . The aim of this study was to obtain scientific evidence of the effectiveness of homeopathy in ADHD . A total of 83 children aged 6–16 years , with ADHD diagnosed using the Diagnostic and Statistical Manual of Mental Disorders-IV criteria , were recruited . Prior to the r and omised , double blind , placebo controlled crossover study , they were treated with individually prescribed homeopathic medications .  62 patients , who achieved an improvement of 50 % in the Conners ’ Global Index ( CGI )  , participated in the trial . Thirteen patients did not fulfill this eligibility criterion ( CGI ) . The responders were split into two groups and received either verum for 6 weeks followed by placebo for 6 weeks ( arm A ) , or vice-versa ( arm B ) . At the beginning of the trial and after each crossover period , parents reported the CGI and patients underwent neuropsychological testing . The CGI rating was evaluated again at the end of each crossover period and twice in long-term follow-up . At entry to the crossover trial , cognitive performance such as visual global perception , impulsivity and divided attention , had improved significantly under open label treatment ( P<0.0001 ) . During the crossover trial , CGI parent – ratings were significantly lower under verum ( average 1.67 points ) than under placebo ( P = 0.0479 ) . Long-term CGI improvement reached 12 points ( 63 % , P < 0.0001 ) . Conclusion : The trial suggests scientific evidence of the effectiveness of homeopathy in the treatment of attention deficit hyperactivity disorder , particularly in the areas of behavioural and cognitive functions
Free fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessment s , although the clinical significance of these effects remains to be determined .
Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities .
OBJECTIVE Nonpharmacological treatments are available for attention deficit hyperactivity disorder ( ADHD ) , although their efficacy remains uncertain .
The authors undertook meta-analyses of the efficacy of dietary ( restricted elimination diets , artificial food color exclusions , and free fatty acid supplementation ) and psychological ( cognitive training , neurofeedback , and behavioral interventions ) ADHD treatments .