Alternative treatments of ADHD: A Concise Review

Many individuals diagnosed with ADHD use alternative therapies alone or adjunctively with conventional pharmacological treatments (Russing et al., 2002). Over half of parents of children diagnosed with ADHD treat their children’s symptoms using one or more CAM therapies including vitamins, dietary changes and expressive therapies but few disclose this to their child’s pediatrician (Chan et al. 2003). Most CAM therapies for ADHD are supported by limited evidence however when any herbal or other naturopathic therapy is used to treat ADHD it is regarded as the primary treatment over 80% of the time (Chan et al., 2003). Appropriate CAM and integrative treatment strategies for ADHD will depend on the sub-type of ADHD that is being addressed, symptom severity, previous treatment outcomes using conventional or CAM modalities, adverse effect issues, psychiatric or medical co-morbidities, patient preferences, and the availability of qualified CAM practitioners or access to reputable brands of specific supplements. Dietary modifications including reduced sugar and caffeine intake and specialized restrictive diets are reasonable first-line strategies in ADHD-diagnosed children who are predominantly hyperactive. There are no contra-indications to taking stimulant medications while following a restrictive diet however parents of ADHD children should first consult with their child’s pediatrician before initiating a strict dietary regimen, and ideally with a nutritionist who can provide them with expert guidance. Preliminary findings suggest that omega-3 essential fatty acids in doses up to 16 gm/day are effective adjuvants when combined with stimulants for both hyperactivity and inattention however more studies are needed to confirm this. Preliminary findings suggest that a standardized extract of the bark of the French maritime pine tree may be beneficial in some cases of ADHD however it is not clear whether this product has adjunctive benefits when combined with stimulants. Zinc supplementation may enhance the efficacy of prescription stimulants permitting reductions in stimulant doses in some cases, and preliminary findings suggest that acetyl-L-carnitine at doses up to 1500mg/day may significantly ameliorate symptoms of inattention but not hyperactivity. Other reasonable integrative treatment strategies for ADHD combine specific EEG biofeedback protocols with restrictive diets, the above supplements, and stimulants. When EEG biofeedback training is pursued on a regular basis effective doses of conventional stimulants can sometimes be reduced resulting in fewer adverse effects, improved treatment adherence and better outcomes. For a more complete discussion of alterrnative and integrative approaches to ADHD please go to http://www.psychiatrictimes.com/adhd/content/article/10168/1603662#

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