Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder

Bilici, Mustafa; Yıldırım, Fatma; Kandil, Sema; Bekaroǧlu, Mehmet; Yıldırmış, Sermet; Değer, Orhan; Ülgen, Metin; Yıldıran, Alişan; Aksu, Hatice

doi:10.1016/j.pnpbp.2003.09.034

Cited by 166 publications

(125 citation statements)

References 24 publications

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“…The crossover design used in this study, comprising a short washout period of 1 week may have also impacted on the findings, as there were significant positive effects from all treatment conditions. Zinc has strong antioxidant properties and also has support as a stand-alone treatment in reducing hyperactivity and impulsivity, but not inattention in children and adolescents with ADHD (Bilici et al 2004). As an adjunct treatment to methylphenidate, zinc also enhanced treatment gains compared to methylphenidate and a placebo in children with ADHD (Akhondzadeh et al 2004).…”

Section: The Potential For Antioxidant-related Therapies In Adhdmentioning

confidence: 99%

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Lopresti

2015

ADHD Atten Def Hyp Disord

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Attention deficit hyperactivity disorder (ADHD) has a complex etiology although theories associated with disturbances in dopaminergic and noradrenergic activity are most commonly cited.The importance of these catecholamines in ADHD is supported by its effective treatment utilising stimulant and non-stimulant medications that modify their activity. Recently there has been interest in oxidative and nitrosative stress (O&NS) in ADHD and its potential to contribute to this condition. In this article, research investigating O&NS in ADHD is reviewed and its impact on catecholaminergic activity and neurological structure is discussed. Lifestyle, environmental, ADHD is most commonly treated with stimulant medications such as methylphenidate and amphetamines, non-stimulants such as atomoxetine, and alpha2-adrenergic agonists such as clonidine and guanfacine. Through their effects on dopamine and noradrenaline transporters, stimulants inhibit the reuptake of dopamine and noradrenaline, thereby increasing the extracellular levels of these neurotransmitters. These stimulants also inhibit monoamine oxidase, the enzyme that metabolises these catecholamines (Wilens et al. 2011). Atomoxetine works as a selective reuptake inhibitor of noradrenaline leading to its increased extracellular concentration (Garnock- Jones and Keating 2009).While effective, these medications are associated with several adverse effects. These include loss of appetite, growth delay and sleep disturbances (Cortese et al. 2013). It is important to note that despite their widely accepted short-term efficacy, the long-term effectiveness of pharmacological treatments on social, educational and occupational functioning in people with ADHD continues to be debated (Huang and Tsai 2011;Langberg and Becker 2012;Nijmeijer et al. 2008). On a positive note, recent analyses using the Swedish national registrar suggests that long-term stimulant use in people with ADHD is associated with reduced rates of substance use, criminality, and serious traffic accidents (Chang et al. 2014a;Chang et al. 2014b;Lichtenstein et al. 2012).Despite wide appreciation of catecholaminergic theories associated with ADHD, there has been increased research into other biological mechanisms associated with ADHD. For example, in psychiatry there has been interest in immune-inflammatory pathways and oxidative and nitrosative stress (O&NS). In particular, it has been confirmed through recent meta-analyses that depression is Increased O&NS has also been found in bipolar disorder (Andreazza et al. 2008;Brown et al. 2014),

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Section: The Potential For Antioxidant-related Therapies In Adhdmentioning

confidence: 99%

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Lopresti

2015

ADHD Atten Def Hyp Disord

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“…Zinc is an essential trace element in the body (6,7), which is required for development of the brain and also for its function (9)(10)(11). So far, positive effects of supplemental Zn on depression (15,36,37), OCD (6), ADHD (14,31), and AD (11) have been reported in other studies.…”

Section: Discussionmentioning

confidence: 95%

“…So far, the only side-effect of Zn sulfate that has been reported to occur significantly more than placebo is a metallic taste (14,31). Gastrointestinal discomfort (nausea, vomiting, abdominal pain, and diarrhea) has also been reported with the same rate as placebo (14,31). Skin dermatitis caused by the Zn element of dental fillings has been reported before (32).…”

Section: Safetymentioning

confidence: 99%

Efficacy of Zinc Sulfate as an Add-on Therapy to Risperidone versus Risperidone Alone in Patients With Schizophrenia: A Double-Blind Randomized Placebo-Controlled Trial

Mortazavi

Farzin

Zarhghami

et al. 2015

Iran J Psychiatry Behav Sci

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Background: Zinc can modulate fast-excitatory transmission, facilitate the release of amino butyric acid and potentiate nicotinic acetylcholine receptors. There are also emerging evidences discussing the implication of these neurotransmitters in pathophysiology of schizophrenia. Objectives: The purpose of this study was to evaluate the efficacy of Zn sulfate as an add-on therapy in the treatment of schizophrenia in a 6-week, double-blind and placebo-controlled trial. Patients and Methods: Eligible participants were 30 inpatients with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. Patients were randomly allocated into two equal groups; one group of patients received risperidone 6 mg/day plus capsules of Zn sulfate (each containing 50 mg elemental Zn) three times a day and another group received risperidone 6 mg/day plus placebo. The Positive and Negative Syndrome Scale (PANSS) was applied to assess the psychotic symptoms and aggression risk at baseline, week 2, 4, and 6 of the study. Results:The results of this study showed that both protocols significantly decreased the scores on all subscales of the PANSS and supplemental aggression risk subscale as well as PANSS total score over the study. However, this improvement was significantly higher in Zn sulfate receiving group compared to the placebo group. No major clinical side-effects were detected. Conclusions: It may be concluded that Zn is an effective adjuvant agent in the management of patients with schizophrenia.

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“…Although small intervention studies show that supplementation decreases behavioral symptoms associated with ADHD (64,65), the benefits of supplementation have only been documented in populations with marginal intakes or overt deficiencies. In a systematic review, Hariri and Azadbakht (66) note that evidence on the effects of mineral supplementation for children with ADHD is inconclusive, and data showing a positive impact of iron, zinc, or magnesium supplementation in non-nutrient deficient populations is lacking (67).…”

Section: Grains Chos and Dietary Patternsmentioning

confidence: 99%

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Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder

Cited by 166 publications

References 24 publications

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Efficacy of Zinc Sulfate as an Add-on Therapy to Risperidone versus Risperidone Alone in Patients With Schizophrenia: A Double-Blind Randomized Placebo-Controlled Trial

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