Alternative treatments for attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder, also known as ADHD, is a behaviour problem. Children with ADHD:

• Have problems paying attention.

• Have problems finishing their work.

• Are impulsive and may act without thinking.

• Are easily distracted.

These are known as the ‘core’ symptoms of ADHD. They are different for each child. These symptoms usually lead to other problems in school, with relationships (friends, family members) and with self-esteem.

Treating ADHD can involve:

• Training for parents.

• Strategies to change your child’s behaviour.

• Educational programs to help your child in school.

• Medication.

The most common drugs used to treat ADHD are called stimulants. The Canadian Paediatric Society has a handout on how these drugs work. It’s available at www.caringforkids.cps.ca/behaviour/ADHD.htm.

What about alternative therapies?

You may have seen advertisements for alternative therapies in magazines, on the Internet and in stores. The advertisements claim that these treatments will help your child’s ADHD. Sometimes they claim that alternative treatments are safer or more effective than medication.

The problem with alternative therapies is that they have not had the same kind of scientific review or testing as the medications that doctors use to treat ADHD, like for example, methylphenidate (Ritalin [Novartis Pharmaceuticals Canada Inc, Dorval]).

So how do doctors make decisions about which therapies to recommend? Doctors read and review scientific studies on a regular basis. Studies published in medical journals have to meet certain standards before doctors will use them to make decisions.

The claims that producers of alternative therapies make don’t meet these standards and there is no guarantee that these therapies are safer than drugs.

What do we know about alternative therapies?

There is some scientific evidence on alternative therapies and most of it suggests that parents should be careful and well informed before they try these treatments. Many can cause side effects, and some can be dangerous. Talk to your doctor before trying any alternative therapy for your child’s ADHD.

Here’s what we do know about the many therapies that have been promoted as alternatives to drugs:

• Diet: Changes in diet may help a small group of children who have allergy symptoms or migraine headaches. However, there is no evidence that a diet without sugar or additives will help the symptoms of ADHD.

• Vitamin supplements: If a child lacks a certain vitamin or mineral (such as iron, magnesium or zinc), a supplement may help. Talk to your doctor, however, about what amount is right for your child. Megavitamins may harm the liver.

• Fatty acids: Essential fatty acids such as fish oil and primrose oil, as well as nootropics (also known as ‘smart drugs’) such as deanol, have not been shown to help children with ADHD.

• Herbs: Herbs can help calm a person, and they may play a role in memory and thinking. However, because herb products are not regulated, be sure to ask your pharmacist about the purity (how strong is it?), safety, and toxicity (can it cause harm?) of any product. Valerian, which is used to help with sleep problems and anxiety, can cause headaches. Blue-green algae can cause stomach upset, weakness, numbness and tingling. Ginko biloba, which is said to help brain function, can cause headaches, dizziness, palpitations, stomach upset and skin rashes. It should not be used in children with clotting problems. In 2002, Health Canada issued a recall on all products containing kava, because it can cause liver problems.

• Antioxidants: Also known as anti-aging remedies, antioxidants protect nerve cells. But there is no direct effect on ADHD. There is no evidence that pycnogenol is effective, and it should not be used in children with clotting problems. Melatonin can help with sleep problems, but it can cause headaches, fatigue, irritability and sleepiness. It can also trigger convulsions (seizures) and possibly suppress puberty.

• Homeopathy: Homeopathy uses combinations of plant, animal or mineral extracts. No studies have shown that homeopathy is effective in treating ADHD. It should still be considered to be ‘experimental.’

• Biofeedback: Biofeedback is supposed to help people control their own responses. It involves a big commitment from your whole family. Studies on its effectiveness were done with very small groups of children and were not clear. It is still considered to be an experimental treatment.

• Hypnotherapy: Hypnotherapy might be helpful for certain symptoms of ADHD, such as sleep problems or tics.

• Vision therapy, oculovestibular treatment, sound training: There is no evidence to support any of these treatments.

For more information about ADHD

• www.ldac-taac.ca: Learning Disabilities Association of Canada

• www.addofoundation.org: Attention Deficit Disorder Canada

• www.aqeta.qc.ca/index.html: Learning Disabilities Association of Quebec

• www.aap.org: American Academy of Pediatrics

For more information about alternative therapies

Talk to your doctor and/or visit one of these Web sites:

• www.consumerlab.com: an independent evaluation of various products

• www.hc-sc.gc.ca/english/protection/natural.html: Health Canada’s Office of Natural Health Products

• http://dietary-supplements.info.nih.gov: National Institutes of Health, Office of Dietary Supplements (United States)

• http://nccam.nih.gov: National Center for Complementary and Alternative Medicine (United States)

• www.quackwatch.com: Provides an index of questionable treatments

• www.nutriwatch.org: “Your guide to sensible nutrition”

Source: This handout was based on a position statement developed by the Psychosocial Paediatrics Committee of the Canadian Paediatric Society, “The use of alternative therapies in treating children with attention deficit hyperactivity disorder” available at www.cps.ca and published in Paediatrics & Child Health in December 2002.