Use of Non-Pharmacological Supplementations in Children and Adolescents with Attention Deficit/Hyperactivity Disorder: A Critical Review

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.

Composition of the Gut Microbiota in Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis

“…Another point to highlight is that several studies have demonstrated that the use of probiotics or prebiotics may improve ADHD symptoms (19,36), but we did not conduct an analysis, as most studies included in this meta-analysis did not report on this topic clearly.…”

Nutritional Quality Implications: Exploring the Impact of a Fatty Acid-Rich Diet on Central Nervous System Development

“…The available literature suggests that the intake of both omega-3 and omega-6 FAs may have beneficial effects on the overall symptoms of ADHD as well as on cognitive performance, inattention, and hyperactivity, although the impact is usually either small or statistically insignificant [120,128,129]. The results of 13 out of 18 clinical trials considered in the critical review by Rosi et al [130] demonstrated that PUFAs (DHA, EPA, ALA, and/or others) administered to children and adolescents with ADHD as monotherapy or standard pharmacotherapy contributed to the improvement of their sympathology, which was measured with diverse scales (i.e., Conners' Parent Rating Scale, Parent-rated ADHD Rating Scale, Clinical Global Impression-Severity-Attention-Deficit/Hyperactivity Disorder Scale, Child Behavior Checklist, Continuous Performance Test, Strengths and Difficulties Questionnaire, Child Health Questionnaire, and others). However, it was not observed that any positive changes were linked to a specific behavioral or cognitive characteristic.…”

Emerging Role and Place of Probiotics in the Management of Pediatric Neurodevelopmental Disorders

“…As a result, clinicians are showing their inclination for non-pharmacological agents like dietary and nutritional supplements, which include the micronutrient supplementation of minerals, multiple vitamins (Zinc, Vitamin-D), and peptides comprising L-carnosine (2 studies in ASD and 1 study in ADHD among children) followed by phospholipids like phosphatidylserine, ketogenic diet, fatty acids, and gluten-free, thus, in conjunction with psychosocial techniques, they were reported to have specific impacts on distinct ADHD or ASD condition symptoms like rehabilitation, revalidation, and psychological interventions, towards improving the QoL of both child and family members with a decrease in stress, anxiety, and improvement in auditory memory. 15 …”