Psychiatric Times.
CLINICAL Q&A
Alternative Medicine Therapies for ADHD
By James Lake, MD |
September 13, 2012
Dr Lake is in private practice in Monterey, Calif. He chairs the International Network of Integrative Mental Health (
http://www.inimh.org/) and is the author of the
Textbook of Integrative Mental Health Care (New York: Thieme Medical Publishers, Inc; 2007) and
Integrative Mental Health: A Therapist’s Handbook (New York: WW Norton and Company; 2009).
Answer: B (DHEA has not been shown to alleviate ADHD symptoms)
Discussion
There is emerging evidence that the herbals Bacopa (A), Pycnogenol (C), and zinc (D) supplementation may lessen symptoms of ADHD.
Bacopa monnieri is an Ayurvedic medicinal herbal widely used as a tonic and memory enhancer. In a small 12-week double-blind RCT, 36 children with ADHD randomized to receive Bacopa, 50 mg BID, showed significant improvement over placebo in tests of sentence repetition, logical memory, and pair-associative learning.1
A standardized extract of the bark from the French maritime pine (Pinus pinaster) may also help reduce symptoms of ADHD. A total of 61 children and adolescents randomized to a standardized extract of French maritime pine bark (Pycnogenol™), 1 mg/kg/d, for 1 month, experienced significant improvements in hyperactivity, inattention, and visual-motor coordination compared with placebo recipients; symptoms returned to pre-treatment baseline levels after a 1-month washout.2
There is also promising evidence that zinc supplementation may mitigate ADHD symptoms. In a large 12-week double-blind placebo controlled trial (N = 400), children and adolescents randomized to a high dose of zinc, 150 mg/d, experienced significant improvement in hyperactivity and impulsivity but not inattention over placebo.3 In an augmentation study, the addition of zinc to methylphenidate(Drug information on methylphenidate) resulted in greater improvement than methylphenidate alone.4
References:
1. Nathan PJ, Tanner S, Lloyd J, et al. Effects of a combined extract of Ginkgo biloba and Bacopa monniera on cognitive function in healthy humans. Hum Psychopharmacol. 2004;19:91-96.
2. Trebatická J, Kopasová S, Hradecná Z, et al. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur Child Adolesc Psychiatry. 2006;15:329-335. Epub 2006 May 13.
3. Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention-deficit/hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2004;28:181-190.
4. Akhondzadeh S, Mohammadi M-R, Khademi M. Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial. BMC Psychiatry. 2004,4:9. http://www.biomedcentral.com/1471-244X/4/9. Accessed September 13, 2012.
5. Lake J. Integrative management of ADHD: what the evidence suggests. 2010;27(7). Psychiatr Times. http://www.psychiatrictimes.com/adhd/content/article/10168/1603662.
