L-theanine as a Supplement to Behavioral Therapy for ADHD Hyperactivity
L-theanine may be considered as a supplement to behavioral therapy for hyperactivity in children with ADHD, particularly when sleep disturbances are present, though it is not included in current clinical guidelines as a primary treatment option.
Evidence-Based Treatment Recommendations for ADHD
- The American Academy of Pediatrics strongly recommends FDA-approved medications combined with behavioral interventions as the most effective treatment for reducing core ADHD symptoms and improving functioning 1, 2
- For preschool children (4-5 years), evidence-based parent-administered behavior therapy should be prescribed as first-line treatment 2
- For elementary and middle school-aged children, a combination of FDA-approved medications (particularly stimulants) and behavioral interventions is strongly recommended 2
- Behavioral therapy represents a broad set of specific interventions that modify the physical and social environment to alter behavior, typically implemented by training parents in specific techniques 1
L-theanine Research for ADHD
- A small randomized controlled trial found that L-theanine-caffeine combination improved total cognition composite scores (p=0.041), sustained attention (p=0.033), and showed a trend toward improvement in inhibitory control (p=0.080) in boys with ADHD 3
- In a randomized, double-blind, placebo-controlled trial with 98 boys with ADHD, 400 mg daily of L-theanine significantly improved sleep percentage and sleep efficiency scores compared to placebo 4
- L-theanine was well tolerated with no significant adverse events at relatively high doses (400 mg daily) in children with ADHD 4
- L-theanine has shown some benefit for improving simple reaction times in healthy adults at doses of 100-200 mg, though effects on more complex attention tasks were limited 5
Considerations for Using L-theanine
- Current ADHD treatment guidelines do not include L-theanine among recommended treatments, focusing instead on FDA-approved medications and evidence-based behavioral interventions 1, 2
- The greatest evidence for reducing core ADHD symptoms exists for stimulant medications (effect size ~1.0) and non-stimulants like atomoxetine, extended-release guanfacine, and extended-release clonidine (effect size ~0.7) 1
- L-theanine may be particularly helpful for ADHD children with comorbid sleep problems, as disturbed sleep may be linked etiologically to ADHD 4
- A systematic review of drugs for behavioral insomnia in children with ADHD found that L-theanine showed improvements in sleep-onset latency and total sleep duration, though the quality of evidence was rated as moderate to low 6
Clinical Application
- If considering L-theanine as a supplement to behavioral therapy:
- Start with evidence-based treatments first (behavioral therapy and/or FDA-approved medications) 2
- Consider L-theanine particularly for children with comorbid sleep disturbances 4
- Dosing in studies ranged from 200-400 mg daily, with 400 mg daily (divided into two doses) showing benefits for sleep quality 4
- Monitor for improvements in both sleep parameters and ADHD symptoms 4
Important Caveats
- The evidence for L-theanine in ADHD management is limited to a few small studies, whereas FDA-approved medications and behavioral therapy have robust evidence supporting their efficacy 1, 2
- Many 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
- When using any supplement, parents should be advised to inform all healthcare providers to monitor for potential interactions with other treatments 7
- L-theanine should be considered an adjunctive therapy rather than a replacement for evidence-based treatments 2, 4