Attention deficit hyperactivity disorder (ADHD)

Family therapy: Family therapy can help parents and siblings deal with the stress of living with a child who has ADHD.

Behavioral therapy (BT): BT helps individuals with ADHD develop more effective ways to work on immediate issues. Practical assistance may be offered such as helping organize school tasks and studying for school, or assisting the individual with powerful emotional issues. Anger control is an example of BT.

Psychotherapy: Psychotherapists work to help people with ADHD to live as functioning members of society, increasing self-esteem and dealing with other psychological issues. Psychotherapy alone, however, does not address the symptoms or underlying causes of the disorder. Upsetting thoughts and feelings are verbalized, along with exploration of self-defeating patterns of behavior. Individuals with ADHD can learn alternative ways to handle their emotions.

Social skills training: Social relationships are studied with a therapist to help the individual with ADHD develop and maintain social relationships, like waiting for a turn, sharing toys, asking for help, or responding to teasing. Social skills training helps the child to develop better ways to play and work with other children, and provides the adult with better social skills.

Support groups: Support groups help individuals with ADHD and parents to connect with other people who have similar problems and concerns. Meetings occur on a regular basis (usually weekly) to share frustrations and successes and to hear lectures from experts on ADHD, obtain referrals to qualified specialists and information about what works.

Parenting skills training: Parents face special obstacles when raising a child with ADHD, and often feel frustrated and like there is no help. Parenting skills training is offered by therapists or in special classes, and can give parents tools and techniques for managing their child's behavior. Time outs, reward systems, and organization are just a few of the skills taught.

Stimulants: The most frequently prescribed medications for ADHD are stimulants, which work by stimulating the areas of the brain responsible for focus, attention, and impulse control. Stimulant drugs include Methylphenidate (Ritalin®, Metadate®, Focalin®, Concerta®, Daytrana® - a topical methylphenidate patch), amphetamine, mixed salts (Adderall®, Adderall XR®), dextroamphetamine (Dexedrine®), modafinil (Provigil®), methamphetamine (Desoxyn®), and the recently approved lisdexamfetamine (Vyvanse®).

Non-stimulants:

Atomoxetine (Strattera®) is a norepinephrine reuptake inhibitor and helps regulate brain function. Atmoxetine is usually taken once or twice a day, depending on the individual, every day, and takes up to 6 weeks to begin working fully.

Amantadine (Symmetrel®) is used to increase dopamine in the brain. Reports suggest that low-dose amantadine has been successfully used off label to treat ADHD.

Antidepressant medications may be used off label for ADHD, including serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs, including selegiline (Emsam®)), and bupropion (Wellbutrin®).

Good scientific evidence :

Zinc: One study has shown a correlation between low serum free fatty acids and zinc serum levels in children with attention deficit hyperactivity disorder. Two other studies found that zinc supplements reduced hyperactive, impulsive and impaired socialization symptoms, but did not reduce attention deficiency symptoms. Zinc supplementation may be a more effective treatment for older children with higher body mass index (BMI) scores.

Unclear or conflicting scientific evidence :

Flaxseed and flaxseed oil (: Preliminary evidence supports the idea that deficiencies or imbalances in certain highly unsaturated fatty acids may contribute to attention deficit hyperactivity disorder (ADHD). Based on preliminary clinical evidence, alpha linolenic acid-rich nutritional supplementation in the form of flax oil may improve symptoms of ADHD. More research is needed to confirm these results.

Gamma linolenic acid (GLA): Clinical trials investigating the effect of GLA on symptoms associated with attention-deficit disorder are limited. There is no evidence of effectiveness of treatment with GLA, but more study is needed to confirm these results.

Glyconutrients: Glyconutrients are supplements that contain monosaccharides (sugar-type molecules), which are required for the synthesis of glycoproteins (help form hormones and immune system components). The effect of a glyconutritional product has been investigated in children with ADHD. A decrease in the number and severity of symptoms was noted.

Iron: Based on preliminary data, taking iron orally might improve symptoms of attention deficit-hyperactivity disorder (ADHD). A recent study found a 3-year-old child with ADHD and low iron levels improved significantly on ADHD testing scores after an eight month treatment with ferrous sulfate, 80 milligrams daily. Caution should be used when taking iron supplements as drug interactions are possible.

L-carnitine: One study has reported positive effects of using L-carnitine (also called acetyl-L-carnitine) supplements in children (boys) with ADHD. Acetyl-L-carnitine is an antioxidant and may help blood flow as well as neurological function.

Massage: Preliminary research suggests massage therapy may improve mood and behavior in children with ADHD.

Melatonin: There is some research of the use of melatonin in children with ADHD both in the treatment of ADHD and insomnia in ADHD children. Melatonin is not used for extended periods of time. Interactions with drugs may occur.

Music therapy: Music relaxes and may cause reduced heart rate, reduced blood pressure, reduced tension, and many other beneficial changes. Evidence that music therapy can lead to the relaxation response has been found in healthy individuals and individuals with health problems. More study is needed in the area of ADHD.

Pycnogenol®: Pycnogenol® is a potent antioxidant that may be effective in decreasing neurological imbalances. Preliminary research comparing Pycnogenol® vs. placebo in adults with ADHD reported improved concentration with both agents. In more recent studies in children, improvements in attention and various rating scales were noted with Pycnogenol® supplementation. Pycnogenol is safe in recommended dosages. If pregnant or breastfeeding, consult a qualified health care provider.

SAMe: S-adenosylmethionine, or SAMe, is formed in the body from the essential amino acid methionine and is used in depression and mood disorders. Preliminary evidence from an open trial suggests that SAMe may be of benefit for adults with ADHD. Caution should be used when taking SAMe supplements as drug interactions are possible.

Vitamin B6 (Pyridoxine): Some research suggests that pyridoxine supplementation alone or in combination with high doses of other B vitamins might help ADHD. Vitamin B6 may also be found in a multivitamin or a B-complex vitamin supplement.

Yoga:There is limited study in humans of yoga in the treatment of ADHD. Further research is needed before a recommendation can be made.

Traditional or theoretical uses lacking sufficient evidence :

Biofeedback: Ordinarily, this stress-reduction technique is used to help people learn to control certain body responses, such as heart rate and muscle tension. It has also been used with the intent of teaching adults and children with ADHD to change their brain wave patterns to more normal ones.

Omega-3 fatty acids: Essential fatty acids have many roles in the body, including proper nerve and brain function. Preliminary evidence supports the idea that deficiencies or imbalances in certain highly unsaturated fatty acids may contribute to ADHD. More research is needed in this area.

Fair negative scientific evidence :

Evening primrose oil (: Small human studies show no benefit from evening primrose oil in ADHD. Further research is needed to confirm this conclusion.

Psychotherapy: Psychotherapy is an interactive process between a person and a qualified mental health professional. Psychotherapy may not improve parenting, enhance academic achievement or improve emotional adjustment for children ages seven to nine with ADHD. It is unclear whether psychotherapy will reduce the use of stimulants, such as methylphenidate, in these children. More studies are needed in this area.

Nutritional changes along with the addition of supplements (vitamins, minerals and herbs) may be effective in preventing ADHD and improving the symptoms.

Avoid caffeine and other stimulants, alcohol, and smoking.

Eliminate potential food allergens, including dairy (milk, cheese and sour cream), eggs, nuts, shellfish, wheat (gluten), corn, preservatives, and food additives (such as dyes and fillers). Food allergies can be a contributing factor in mental imbalance.

Avoid refined foods such as white breads, pastas, and sugar. Doughnuts, pastries, bread, candy, soft drinks, and foods with high sugar content may all contribute to worsening symptoms of ADHD.