From the Guidelines
There is no single "best" supplement for ADHD, but omega-3 fatty acids (particularly EPA and DHA from fish oil) show the most promising evidence, although the provided evidence does not support the use of supplements as a primary treatment for ADHD. According to the evidence provided, the most effective treatment options for ADHD are stimulants, such as methylphenidate and lisdexamfetamine, and non-stimulants, such as atomoxetine 1. These medications have been shown to have large effect sizes for reducing ADHD core symptoms and are available in various formulations to allow for individualization of treatment. The evidence suggests that stimulants should be used as first-line therapy, with non-stimulants as second-line therapy 1.
When considering treatment options, it is essential to take into account the severity of symptoms, presence of comorbidities, and patient preferences 1. Medication adherence is also a crucial factor, and regular assessment and open discussion of potential issues can help increase adherence 1. The dosing regimen can also affect medication adherence, with once-daily dosing generally preferred over twice-daily dosing 1.
While some nonmedication treatments, such as behavioral therapy and lifestyle modifications, may be beneficial for ADHD-related problems, the evidence for supplements is limited, and they should not replace established treatments 1. In fact, the evidence suggests that some nonmedication treatments, such as mindfulness, cognitive training, and diet modification, have little or no benefit for ADHD 1.
In summary, the most effective treatment for ADHD is a combination of prescription medications, such as stimulants and non-stimulants, and behavioral therapy, with supplements playing a secondary role, if any, and only under the guidance of a healthcare provider. It is essential to consult with a healthcare provider before starting any treatment regimen, especially if you're taking prescription ADHD medications, as some supplements may interact with medications or have contraindications for certain health conditions.
From the Research
Supplements for ADHD
- Omega-3 fatty acids have been shown to have a positive effect on ADHD symptoms, with studies suggesting that they may be beneficial in reducing symptoms of inattention 2, 3
- The effectiveness of omega-3 fatty acid supplements in reducing medication dosage has been suggested, but needs to be confirmed 4
- Combined omega-3 and omega-6 supplementation has been shown to have a significantly higher likelihood of improvement in ADHD symptoms compared to placebo 5
- Other supplements such as zinc, iron, and magnesium may reduce ADHD symptoms in children with or at high risk of deficiencies in these minerals, but convincing evidence is lacking 4
Key Findings
- Omega-3 fatty acid supplements have been found to improve parent-rated attention in both children with ADHD and typically developing children 3
- Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo 3
- There is little evidence that PUFA supplementation provides any benefit for the symptoms of ADHD in children and adolescents, although some limited data shows an improvement with combined omega-3 and omega-6 supplementation 5
Considerations
- The majority of data shows no benefit of PUFA supplementation, but some studies suggest that it may be beneficial in reducing symptoms of ADHD 2, 4, 5
- Future research should address current weaknesses in this area, including small sample sizes, variability of selection criteria, and short follow-up times 5
- Clinicians can apply the SECS versus RUDE rule to guide patients, considering treatments that are Safe, Easy, Cheap, and Sensible (SECS) and those that are Risky, Unrealistic, Difficult, or Expensive (RUDE) 6