the recommended daily allowance of vitamins, minerals, and other necessary elements—became an increasingly popular alternative to stimulant medication, particularly among families who considered megavitamins the more “natural” approach.
Research has failed, however, to reveal significant positive results from megavitamin therapy for children with ADHD. While some early studies resulted in improved classroom attention ratings for subjects taking megavitamins, these studies were marred by the fact that the children, their parents, their teachers, and the researchers were all aware that a given subject was being given this new form of treatment. When the studies were repeated using the double-blind method discussed earlier, so that no one knew whether a particular child was taking a megavitamin or a placebo, no behavioral improvement was shown. In fact, it was discovered that disruptive behavior increased in a significant number of the children given the megavitamins.
Studies have also suggested certain abnormalities in the way the liver functions among children on megavitamin therapy, signaling possible toxic effects of this high level of vitamin intake—a strong reminder that “natural” substances are not always safe, especially in the highly “unnatural” doses prescribed here. As a result, experts have concluded that megavitamin therapy for ADHD is of little benefit for nearly all children with the condition—and potentially harmful. In 1976 the AAP Committee on Nutrition issued a formal statement to that effect. No subsequent studies have provided evidence that would change this opinion. This is not to say that children with ADHD should not take any vitamins, just that vitamins at normal doses and even megadoses are not in any way an effective treatment for ADHD.
Other Vitamin and Mineral Supplements
In the wake of the enthusiasm for megavitamin therapy, a number of specific nutritional elements have been studied regarding their possible role in the development of ADHD and their potential for treating the condition. These elements include iron, magnesium, pyridoxine (vitamin B6), and zinc.
All of these substances are known to be necessary for optimal brain development and function. However, no difference between children with or without ADHD has been shown for levels of zinc, iron, magnesium, or vitamin B6, and no links between these low levels and ADHD-type behavior have been established to date. No significant improvement in ADHD behaviors has been demonstrated when supplemental doses of these substances are provided. As with all children, any true nutritional deficiency should be corrected with a standard supplement or a change in daily diet. But supplementation should not exceed the daily recommended allowance because higher levels of some elements (zinc in particular) can prove toxic.
Additional Supplements to Improve Performance
A number of other dietary supplements have been proposed to replace the use of stimulants in treating ADHD. Principal among these are nootropics, antioxidants, and herbs. Nootropics, specifically a substance called piracetam, have been advocated as cognitive enhancers for children with Down syndrome, dyslexia, and ADHD. While there is no scientific proof of positive effects relating to Down syndrome, one convincing study did show improvement in reading ability and comprehension among children taking piracetam supplements. While there is a rational basis for theorizing that piracetam may also improve ADHD-type behaviors because it is believed to enhance the transmission of the same brain chemicals influenced by stimulant medication (dopamine and noradrenaline), no controlled studies have yet been published, so this treatment cannot be recommended.
Children with ADHD as well as people who eat a modern American diet may have low levels of certain EFAs (including EPA and DHA). In a study of nearly 100 boys, those with lower levels of omega-3 fatty acids had more learning and behavioral problems than boys with normal levels. Studies examining whether omega-3 fatty acids can help improve symptoms of