From the Guidelines
Neurofeedback therapy should not be relied upon to reduce medication needs in patients, as the current evidence supporting its efficacy in treating ADHD is sparse and does not approach the robust strength of evidence documented for established medication and behavioral treatments. When considering the use of neurofeedback or neurotherapy to help train self-regulation, it is essential to prioritize the most recent and highest quality studies. According to the 2019 clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents 1, some nonmedication treatments for ADHD-related problems have either too little evidence to recommend them or have been found to have little or no benefit, including EEG biofeedback. The American Academy of Pediatrics recommends prescribing FDA-approved medications for ADHD with the adolescent’s assent, as well as evidence-based training interventions and/or behavioral interventions as treatment of ADHD, if available 1. Key points to consider include:
- The current evidence supporting treatment of ADHD with neurofeedback is sparse and does not approach the robust strength of evidence documented for established medication and behavioral treatments 1.
- Medication adjustments should only occur under close medical supervision, and patients interested in neurofeedback should continue their prescribed medications while beginning neurofeedback sessions.
- Neurofeedback is best viewed as a complementary approach rather than a replacement therapy, and any medication changes should be gradually implemented with a physician's guidance based on symptom monitoring and clinical assessment.
- The therapy works by helping patients learn to self-regulate their brain activity through real-time feedback of EEG patterns, but individual responses vary significantly. In summary, while neurofeedback may be a useful complementary therapy for some patients, it should not be relied upon as a primary means of reducing medication needs, and medication adjustments should only be made under close medical supervision.
From the Research
Neurofeedback and Medication Therapy
- Neurofeedback (NF) has been found to be a useful treatment for attention-deficit/hyperactivity disorder (ADHD) and can help patients control their brain waves consciously 2.
- Studies have compared the efficacy of NF with medication, such as methylphenidate, in treating ADHD, with some findings suggesting that NF can be an independent or combined intervention tool for children with ADHD 2, 3.
- Research has shown that NF can reduce the need for medication therapy in patients with ADHD, with one study finding that NF was able to decrease medication dosages and maintain the results at 6-month follow-up 4.
Comparison of Neurofeedback and Medication
- A study comparing NF with Ritalin in treating children with ADHD found that the combination of NF and Ritalin was more efficient than NF alone 3.
- Another study found that methylphenidate had a large effect size for treating ADHD symptoms, while NF had a moderate effect size 5.
- A systematic review of randomized controlled trials found that NF was not supported as a standalone treatment for children or adolescents with ADHD, but it may be considered a viable alternative to stimulants for a specific group of patients 4.
Potential Benefits of Neurofeedback
- NF may be beneficial for patients who are low responders to medication, have intolerable side effects due to medication, or have higher baseline theta power spectra 4.
- NF may also be considered a viable alternative to stimulants for patients with no comorbid psychiatric disorders 4.
- A study found that NF was able to improve learning problems in children with ADHD, with NF being the most effective treatment for this symptom 2.