Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents, with environmental and biological causal influences. Pharmacological medication is the first choice in ADHD treatment; recently, many studies have concentrated on dietary supplementation approaches to address nutritional deficiencies, to which part of non-responses to medications have been imputed. This review aims to evaluate the efficacy of non-pharmacological supplementations in children or adolescents with ADHD. We reviewed 42 randomized controlled trials comprised of the following supplementation categories: polyunsaturated fatty acids (PUFAs), peptides and amino acids derivatives, single micronutrients, micronutrients mix, plant extracts and herbal supplementations, and probiotics. The reviewed studies applied heterogeneous methodologies, thus making it arduous to depict a systematic overview. No clear effect on single cognitive, affective, or behavioral domain was found for any supplementation category. Studies on PUFAs and micronutrients found symptomatology improvements. Peptides and amino acids derivatives, plant extracts, herbal supplementation, and probiotics represent innovative research fields and preliminary results may be promising. In conclusion, such findings, if confirmed through future research, should represent evidence for the efficacy of dietary supplementation as a support to standard pharmacological and psychological therapies in children and adolescents with ADHD.
Highlights
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting about 5% of children and 2.5% of adults worldwide
Future investigations with homogeneous methodologies are needed to clarify the reason of non-significant results or could better specify the role of polyunsaturated fatty acids (PUFAs) supplementation on ADHD symptoms
Seven studies focused on plant or herbal extracts containing a mix of micronutrients, vitamins, and macronutrients (Table 1e)
Summary
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting about 5% of children and 2.5% of adults worldwide. It is characterized by dysregulated cognition and behaviors, resulting in inattention, excessive motor activity, and impulsivity [1]. Stimulants, the first choice for ADHD drug treatment, include methylphenidate that inhibits dopamine reuptake and amphetamines that inhibit dopamine and noradrenaline reuptake and increase dopamine release. At least 10–30% of children with ADHD may not benefit from these medications due to non-response or adverse effects [6,7] such as decreased appetite, insomnia, stomachache, headache, weight loss (potentially leading to growth retardation), tics, increases in blood pressure, and potential abuse or misuse [8]. Atomoxetine use has been associated with increased risk of suicidal behavior in youths [9]
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