Attention Deficit Disorder

Related Terms

AADD; ADD; ADHD; Adult Attention Deficit Disorder; Attention Deficit and Hyperactivity Disorder; Hyperkinetic Syndrome

Attention deficit disorder (ADD) can cause hyperactivity, impulsive behavior, and/or problems paying attention. It affects people of all ages. It can impact school and work and cause problems with relationships.

Treatment is aimed at improving function at school and work as well as maintaining healthy relationships. Standard treatments include therapy and medications, such as stimulants and antidepressants. Some people add alternative treatments to further control symptoms; however, none has been conclusively shown to be helpful.

Natural Therapies

These therapies are likely to manage symptoms:

Likely Effective

  • Cognitive training focuses on tasks that help cognitive functions like attention.C1-C4
  • Dietary restriction of synthetic food colors A1-A4
  • Exercise F1
  • Massage therapy D1

May Be Effective

These therapies may manage symptoms:

  • Bacopa monnieri is a creeping herb.B18
  • 2-Dimethylaminoethanol (DMAE) is a compound thought to help with brain function. ( Note : DMAE should not be used in people who have a history of epilepsy. It may make the condition worse.)B1
  • Carnitine is a compound that helps the body make energy.B5
  • Omega-3 and Omega-6 fatty acids are used by the body for energy.B9, B11, B12, B13, B19, B20, B23, A3, A4,
  • Zinc is an essential mineral found in foods and taken as a supplement. ( Note : High doses of zinc may result in side effects that range from nausea and vomiting to reduced immune function or reduced iron function.)B3, B6, B21

May Not Be Effective

These therapies may not be effective in managing symptoms:

Unlikely to Be Effective

  • Acupuncture uses thin needles on specific parts of the body to ease symptoms.G4

Not Enough Data to Assess

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any alternative therapy you are taking to make sure it does not interfere with your treatment plan. Some supplement discussed here have certain concerns such as:

  • 2-Dimethylaminoethanol (DMAE) should not be used in people who have a history of epilepsy. It may make the condition worse.
  • St. John’s wort interacts with many medications and could make standard medications for ADD less effective.
  • Zinc in high doses may result in side effects that range from nausea and vomiting to reduced immune function or reduced iron function.

References►

Dietary Changes

A1. Nigg JT, Lewis K, et al. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):86-97.

A2. Sonuga-Barke EJ, Brandeis D, et al. Nonpharmacological interventions for ADHD: systemic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013 Mar;170(3):275-289.

A3. Pelsser LM, Frankena K, et al. Diet and ADHD, Reviewing the Evidence: A Systematic Review of Meta-Analyses of Double-Blind Placebo-Controlled Trials Evaluating the Efficacy of Diet Interventions on the Behavior of Children with ADHD. PLoS One. 2017 Jan 25;12(1):e0169277.

A4. Heilskov Rytter MJ, Andersen LB, et al. Diet in the treatment of ADHD in children - a systematic review of the literature. Nord J Psychiatry. 2015 Jan;69(1):1-18.

Herbs and Supplements

B1. Re' O. 2-Dimethylaminoethanol (deanol): a brief review of its clinical efficacy and postulated mechanism of action. Curr Ther Res Clin Exp. 1974;16:1238-1242.

B2. Kleijnen J, Knipschild P. Niacin and vitamin B 6 in mental functioning: a review of controlled trials in humans. Biol Psychiatry. 1991;29:931-941.

B3. Arnold LE, Pinkham SM, Votolato N. Does zinc moderate essential fatty acid and amphetamine treatment of attention-deficit/hyperactivity disorder? J Child Adolesc Psychopharmacol. 2000;10:111-117

B4. Lyon MR, Cline JC, Totosy de Zepetnek J, et al. Effect of the herbal extract combination Panax quinquefolium and Ginkgo biloba on attention-deficit hyperactivity disorder: a pilot study. J Psychiatry Neurosci. 2001;26:221-228.

B5. Van Oudheusden L, Scholte H. Efficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids. 2002;67:33.

B6. 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.

B7. Weber W, Vander Stoep A, McCarty RL, et al. Hypericum perforatum (St John's wort) for attention-deficit/hyperactivity disorder in children and adolescents: a randomized controlled trial. JAMA. 2008;299:2633-2641.

B8. Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res. 2018 Jul;32(7):1147-1162.

B9. Johnson M, Ostlund S, Fransson G, Kadesjö B, Gillberg C. Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder: a randomized placebo-controlled trial in children and adolescents. J Atten Disord. 2009;12:394-401.

B10. Salehi B, Imani R, et al. Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry. 2010 Feb 1;34(1):76-80.

B11. Bloch MH, Qawasmi A. Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2011;50(10):991-1000.

B12. Chang JP, Su KP, et al. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology. 2018 Feb;43(3):534-545.

B13. Gillies D, Sinn JKh, et al. Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev. 2012 Jul 11;(7).

B14. Sonuga-Barke EJ, Brandeis D, et al. Nonpharmacological interventions for ADHD: systemic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013 Mar;170(3):275-289.

B15. Shakibae F, Radmanesh M, et al. Ginkgo biloba in the treatment of attention-deficit/hyperactivity disorder in children and adolescents. A randomized, placebo-controlled, trial. Complement Ther Clin Pract. 2015 May;21(2):61-67.

B16. Catalá-López F, Hutton B, et al. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials. PLoS One. 2017 Jul 12;12(7):e0180355.

B17. Anheyer D, Lauche R, et al. Herbal medicines in children with attention deficit hyperactivity disorder (ADHD): A systematic review. Complement Ther Med. 2017 Feb;30:14-23.

B18. Kean JD, Downey LA, et al. A systematic review of the Ayurvedic medicinal herb Bacopa monnieri in child and adolescent populations. Complement Ther Med. 2016 Dec;29:56-62.

B19. Cooper RE, Tye C, et al. The effect of omega-3 polyunsaturated fatty acid supplementation on emotional dysregulation, oppositional behaviour and conduct problems in ADHD: A systematic review and meta-analysis. J Affect Disord. 2016 Jan 15;190:474-482.

B20. Puri BK, Martins JG. Which polyunsaturated fatty acids are active in children with attention-deficit hyperactivity disorder receiving PUFA supplementation? A fatty acid validated meta-regression analysis of randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids. 2014 May;90(5):179-189.

B21. Ghanizadeh A, Berk M. Zinc for treating of children and adolescents with attention-deficit hyperactivity disorder: a systematic review of randomized controlled clinical trials. Eur J Clin Nutr. 2013 Jan;67(1):122-124.

B22. Schoonees A, Visser J, et al. Pycnogenol® (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane Database Syst Rev. 2012 Apr 18;(4):CD008294.

B23. Raz R, Gabis L. Essential fatty acids and attention-deficit-hyperactivity disorder: a systematic review. Dev Med Child Neurol. 2009 Aug;51(8):580-592.

Cognitive Training

C1. . Dovis S, Van der Oord S, et al. Improving executive functioning in children with ADHD: training multiple executive functions within the contest of a computer game. A randomized double-blind placebo controlled trial. PLoS One. 2015 Apr6;10(4).

C2. Sonuga-Barke EJ, Brandeis D, et al. Nonpharmacological interventions for ADHD: systemic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013 Mar;170(3):275-289.

C3. Steiner NJ, Frenette EC, et al. In-school neurofeedback training for ADHD: sustained improvements from a randomized control trial. Pediatrics. 2014 Mar;133(3):483-492.

C4. Lloyd A, Brett D, et al. Coherence training in children with attention-deficit hyperactivity disorder: cognitive functions and behavioral changes. Altern Ther Health Med. 2010 Jul-Aug;16(4):34-42.

Massage Therapy

D1. Chen SC, Yu BY, et al. Massage therapy for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and adolescents: A systematic review and meta-analysis. Complement Ther Med. 2019 Feb;42:389-399.

Meditation

E1. Zhang J, Díaz-Román A, et al. Meditation-based therapies for attention-deficit/hyperactivity disorder in children, adolescents and adults: a systematic review and meta-analysis. Evid Based Ment Health. 2018 Aug;21(3):87-94.

E2. Evans S, Ling M, et al. Systematic review of meditation-based interventions for children with ADHD. Eur Child Adolesc Psychiatry. 2018 Jan;27(1):9-27.

E3. Krisanaprakornkit T, Ngamjarus C, et al. Meditation therapies for attention-deficit/hyperactivity disorder (ADHD). Cochrane Database Syst Rev. 2010 Jun 16;(6):CD006507.

Exercise

F1. Cerrillo-Urbina AJ, García-Hermoso A, et al. The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials. Child Care Health Dev. 2015 Nov;41(6):779-788.

Other Therapies

G1. Goode AP, Coeytaux RR, et al. Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review. Pediatrics. 2018 Jun;141(6). pii: e20180094.

G2. Sarris J, Kean J, et al. Complementary medicines (herbal and nutritional products) in the treatment of Attention Deficit Hyperactivity Disorder (ADHD): a systematic review of the evidence. Complement Ther Med. 2011 Aug;19(4):216-227.

G3. Davidson JR, Crawford C, et al. Homeopathic treatments in psychiatry: a systematic review of randomized placebo-controlled studies. J Clin Psychiatry. 2011 Jun;72(6):795-805.

G4. Li S, Yu B, et al. Acupuncture for Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev. 2011 Apr 13;(4):CD007839.

G5. Lan Y, Zhang LL, et al. Attention deficit hyperactivity disorder in children: comparative efficacy of traditional Chinese medicine and methylphenidate. J Int Med Res. 2009 May-Jun;37(3):939-948.

G6. Coulter MK, Dean ME. Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005648.

G7. Altunç U, Pittler MH, et al. Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials. Mayo Clin Proc. 2007 Jan;82(1):69-75.

Last reviewed November 2019 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 5/19/2020

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