Is magnesium bisglycinate effective for treating Attention Deficit Hyperactivity Disorder (ADHD)?

Magnesium Bisglycinate for ADHD: Effectiveness Assessment

Magnesium bisglycinate is not recommended for treating ADHD as there is insufficient evidence supporting its efficacy, and it is not included in any major clinical guidelines as an approved treatment for ADHD. 1, 2

Evidence-Based Treatment Recommendations

The American Academy of Pediatrics (AAP) clinical practice guidelines clearly establish that the first-line treatments for ADHD should be:

1. FDA-approved medications - particularly stimulants which have an effect size of approximately 1.0 1
2. Behavioral therapy - particularly parent training in behavior management (PTBM) 1

These treatments have robust evidence demonstrating their effectiveness in reducing ADHD symptoms and improving function, with the benefits outweighing the risks 1.

Evaluation of Magnesium for ADHD

The evidence regarding magnesium supplementation for ADHD is:

• Limited and low quality - There is no well-controlled clinical trial investigating the efficacy and safety of magnesium for treating ADHD 3
• Inconclusive - Available studies show mixed results and at best marginal beneficial effects 4
• Methodologically flawed - Existing studies lack proper control groups or randomization 3

A systematic review from 2013 concluded that "until further strong evidences for its efficacy and safety are provided, magnesium is not recommended for treating ADHD" 3. A more recent review in 2017 found that magnesium supplementation may only potentially reduce ADHD symptoms in children with or at high risk of deficiencies in this mineral, but "convincing evidence in this regard is lacking" 4.

Established Treatment Options

According to current guidelines, clinicians should prioritize:

For Medication Management:

• Stimulants (methylphenidate, amphetamine derivatives) as first-line pharmacological treatment 1, 2
• Non-stimulants as alternatives:
  • Atomoxetine (Strattera): 0.5 mg/kg/day starting, 1.2 mg/kg/day target 2
  • Extended-release guanfacine (Intuniv): 0.1 mg/kg once daily 2
  • Extended-release clonidine 1
  • Bupropion: 100-150 mg daily (sustained-release) 2

For Non-Pharmacological Approaches:

• Behavioral parent and classroom training - well-established for preadolescent children 1
• Cognitive Behavioral Therapy (CBT) - particularly effective for older adolescents and adults 2

Important Clinical Considerations

• The effect size for FDA-approved medications (1.0 for stimulants, 0.7 for non-stimulants) far exceeds any potential benefits reported from nutritional supplements like magnesium 1, 4
• Some non-medication treatments for ADHD-related problems "have either too little evidence to recommend them or have been found to have little or no benefit" 1
• A combined approach using medication and behavioral interventions offers the best chance for symptom improvement and functional gains 2

Caveat

If a patient has a documented magnesium deficiency, correcting this deficiency may be warranted for general health, but should not be considered a primary treatment for ADHD. Any supplementation should be monitored by a healthcare provider and not replace evidence-based ADHD treatments.