Nutritional Complementary and Alternative Medicine for Pediatric Attention-Deficit/Hyperactivity Disorder

By Karpouzis, Fay; Bonello, Rod | Ethical Human Psychology and Psychiatry, April 1, 2012 | Go to article overview

Nutritional Complementary and Alternative Medicine for Pediatric Attention-Deficit/Hyperactivity Disorder


Karpouzis, Fay, Bonello, Rod, Ethical Human Psychology and Psychiatry


Increasing prevalence rates of pediatric and adolescent attention-deficit/hyperactivity disorder (ADHD), concerns over the safety and efficacy of psychostimulants, and fears about long-term use of psychostimulants have led many parents to seek alternative therapies for their children. Numerous environmental factors have been suspected of influencing ADHD. Over the last few decades, there has been an increasing awareness of the importance of nutrition and the potential role it has on influencing ADHD and ADHD symptomatology.

This article focuses on nutrition, dietary modifications, and nutraceuticals, which are the most commonly used complementary and alternative medicine (CAM) therapies for the management of pediatric and adolescent ADHD. The aim is to present a narrative literature review for dietary modifications and nutritional supplementation for pediatric and adolescent ADHD.

Searches were made in full-text English language articles from 2000 to February 2012 in the PubMed Central, Medline, Cochrane Library, Psych INFO, Scopus, and CINAHL databases. The review revealed a full range of research strategies, but this article concentrates on randomized controlled trials, observational studies, longitudinal studies, epidemiological studies, surveys, qualitative reviews, narrative reviews, systematic reviews, and meta-analyses. The literature reveals a mixture of results in respect to dietary modifications and nutritional supplementation for children and adolescents with ADHD; however, the future of nutritional research appears promising.

Keywords: attention-deficit/hyperactivity disorder; pediatric; adolescent; complementary and alternative medicine; nutrition; nutraceuticals

The use of complementary and alternative medicine (CAM) has increased over the years in the general population, including children (Eisenberg et al., 1998; Sinha & Efron, 2005). CAM therapies are sought more often by parents who have children with developmental and behavioral disorders such as attention-deficit/hyperactivity disorder (ADHD), than with any other condition (Chan, 2002; Rojas & Chan, 2005; Sawni-Sikand, Schubiner, & Thomas, 2002; Sinha & Efron, 2005).

Parents with children diagnosed with ADHD have a variety of reasons for seeking CAM therapies (Baumgaertel, 1999; South & Lim, 2003) such as: a particular treatment considered ineffective, dissatisfaction with conventional medicine, fear of drug adverse effects, and a need for more personal attention for their children (Kemper, Vohra, & Walls, Task Force on Complementary and Alternative Medicine, & Provisional Section on Complementary, Holistic, and Integrative Medicine, 2008; Spigelblatt, LaÎné-Ammara, Pless, & Guyver, 1994). Controversy over the safety and appropriateness of stimulant treatment has led to increased parental anxiety and the increased use of CAM therapies (Chan, 2002; Chan, Rappaport, & Kemper, 2003; Kemper et al., 2008; Rucklidge, Johnstone, & Kaplan, 2009; Schab & Trinh, 2004). Major concerns regarding the side-effect profile of stimulant medications (Baumgaertel, 1999; Brue & Oakland, 2002; DosReis & Myers, 2008; Kemper et al., 2008; Sawni, 2008; Sinha & Efron, 2005) has been the main reason parents have turned to alternative therapies (Baumgaertel, 1999; Bush, Valera, & Seidman, 2005; Chan, 2002; Gross-Tsur, Lahad, & Shalev, 2003; Sawni, 2008; Sinha & Efron, 2005; Stubberfield, Wray, & Parry, 1999) Other reasons why parents seek CAM therapies are because of the chronicity of the disorder (Sawni-Sikand et al., 2002) and the fact that it affects multiple domains of functioning such as academic, social, and behavioral domains (Sinha & Efron, 2005).

Chan et al. (2003) found few systematic studies of the prevalence of CAM use in ADHD. Estimates of the use of nontraditional treatments (i.e., CAM therapies) varies greatly between 9% and 46% (Bussing, Zima, Gary, & Garvan, 2002). …

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