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Nondrug Options for ADHD

Taking the holistic approach; diet changes

Nondrug Options for ADHD

An article in the June 17, 2008 issue of the New York Times states that almost a third of the 2.5 million children who have been prescribed stimulant drugs for attention and hyperactivity disorders (ADHD) have experienced troubling side effects, including decreased appetite and weight loss, insomnia, personality changes, and abdominal pain. Since 2006, the Food and Drug Administration has required that stimulants used in the treatment of ADHD (including Adderall, Ritalin, and Concerta) carry warnings of the risk for sudden death, heart attacks, and hallucinations in some patients. It's not surprising, then, that as many as two-thirds of children diagnosed with ADHD have been given some form of alternative treatment.

Seeking Alternatives to Prescription Drugs

Most doctors will advise parents that scientific research has not yet substantiated the value of alternative treatments for ADHD, and will term reports of their efficacy "purely anecdotal." Keep in mind that the lack of scientific validation for a treatment doesn't necessarily mean that the treatment doesn't work; the studies simply may not have been performed. It may take some effort, but parents who wish to pursue a holistic approach to ADHD treatment can find a pediatrician willing to try alternatives (many are listed on the Integrative Pediatrics Council's website: www.integrativepeds.org). Remember that every child is an individual, with his or her own body chemistry and physiology: Be prepared to spend some time (and money) trying the different approaches to find ones that help. And if you need a second opinion when you think you see improvement in your child, remember that your child's teacher may be your most objective judge. Following are some nondrug options.

Diet Changes

According to the New York Times, several studies seem to suggest that any link between sugar and hyperactivity is one of "parental perception, rather than reality." However, in a 2007 study published in The Lancet, researchers from the University of Southampton in the U.K. found that artificial coloring and preservatives can cause an increase in hyperactive behaviors.

An elimination diet is the best way to monitor the effects of diet changes. Eliminate only one food or food additive at a time, and monitor the child's behavior closely when you reintroduce it after a period of time has elapsed.

Herbal therapy; vitamins & supplements; homeopathy

Herbal Therapy

Among the herbs suggested for treatment of ADHD are St. John's wort, echinacea, gingko biloba, and ginseng. It is best to undertake herbal therapy under the guidance of a naturopathic physician, since herbs can have their own side effects if misused.

In the system of traditional Chinese medicine, herbal preparations are typically compounded for the individual patient, based on his or her particular symptoms. The Shaanxi College of Traditional Chinese Medicine in Xianyang and the Pediatric Dept. of the Affiliated Hospital of Shandong College of TCM in Jinan have reported on the positive effects of two herbal formulas for ADHD treatment. At the Affiliated Hospital of Guangzhou College of TCM, a Chinese herbal formula was compared to a western medicine approach (Ritalin)in a side-by-side clinical trial. The herbal formula performed as well as Ritalin in that trial, with fewer side-effects.

Vitamins and Supplements

Research has found that some children with ADHD are deficient in magnesium, iron, zinc, and/or vitamin B6. Megadoses of vitamins are controversial, but a good multiple vitamin is a safe and reasonable approach to treating such deficiencies. There is also a growing body of evidence that omega-3 fatty acids, found in fish and fish oil, can be helpful to children with ADHD (reported in 2007 in the Journal of the Pediatric Clinics of North America).

Homeopathic Remedies

A double-blind study published in the British Homeopathic Journal gave 43 children with ADHD either a homeopathic treatment or a placebo for ten days. Researchers found that those who were given homeopathic medicines showed significantly fewer signs of ADHD behavior than those given placebos. Two months after the study's end, 57 percent of the children who showed improvement with homeopathy had continued to improve, even though they had discontinued the homeopathic medicines; 24 percent relapsed by the time of the follow-up; and the remaining 19 percent continued to experience positive results, but only while taking the homeopathic medicines. The homeopathic medicines found to be most helpful for ADHD were Stramonium, Cina, and Hyoscyamus niger.

Biofeedback; allergy treatment; vision therapy

Biofeedback

In biofeedback therapy, children with ADHD wear electrodes on their head and learn to control video games by exercising the parts of the brain related to attention and focus. Research to date suggests not only that children enjoy this therapy; it actually works as well as medication. Clinical studies published in the Journal of Neurotherapy have revealed that as many as 86 percent of ADHD subjects show improvement in attention, impulse control, and information processing speed after such sessions, as well as a reduction in problems associated with ADHD such as seizures, nightmares, bed-wetting, and depression.

Allergy Treatment

Food allergies and environmental allergies can cause abnormal learning patterns and symptoms in children. If you suspect that your child may have an allergy, testing or an elimination diet may be in order. Since cow's milk is often the culprit in kids' allergies, try removing all milk products for at least a month and watch for signs of improvement. Other suspect foods are wheat, corn, soy, eggs, citrus, and peanuts.

Environmental problems such as molds, dust, chemicals used for cleaning, perfumes, pesticides, and other toxins can also cause children to develop allergies and display behaviors associated with the ADD/ADHD label. Make sure that your home and your child's school are not "environmentally sick."

Vision Therapy

This treatment is based on the theory that faulty eye movement and sensitivities cause behavioral problems. The goal of vision therapy is to train the patient's brain to use the eyes to receive information effectively, comprehend it quickly, and react appropriately. Individualized therapy sessions include procedures designed to enhance the brain's ability to control eye alignment, eye movements, focusing abilities, and eye teamwork (binocular vision).

In a study at Northeastern State University's College of Optometry, 62 children completed a course of optometric in-office vision therapy. The College of Optometrists in Vision Development Quality of Life checklist (COVD-QOL) was used to collect symptoms data before and after the therapy, and analysis of the data found that the mean total scores, as well as each individual item score on the COVD-QOL, were significantly better on post-test than on pre-test.

Massage; yoga; evaluating treatments

Massage

Professional massage can be an effective treatment for kids with ADHD, helping them to develop an age-appropriate ability to focus, a calmer disposition, and even increased confidence, according to studies conducted by the Touch Research Institute at the University of Miami. Their research reported that regular massage therapy helped children be more attentive, less fidgety, better behaved in the classroom, and generally happier. Two 20-minute massages a week are enough to show significant improvement in ADHD children. Because these kids have trouble staying still for prolonged periods, they better tolerate shorter, more frequent massages.

For parents seeking skilled bodywork for their kids, chair massage is a great choice, done for about 20-30 minutes at a time, with the child fully clothed. In addition, the massage therapist may be able to train you to perform home massages on your child between professional sessions.

Yoga

Yoga uses physical postures (asanas), breathing exercises (pranayama) and deep-relaxation techniques to calm and strengthen the central nervous system. It can help children and teenagers with ADHD get in touch with their bodies in a relaxed and non-competitive way. The asanas promote stretching, strengthening, and balancing. Deep breathing promotes relaxation and mental awareness, and alternate nostril breathing calms the mind and is thought to balance the left and right hemispheres of the brain.

A study conducted at the School of Behavioral & Community Health Sciences, University of Sydney, found that yoga has merit as a complementary treatment for boys with ADHD who are already stabilized on medication, particularly after the medication has worn off in the evening.

Evaluating Treatments

Before jumping into any alternative treatment, seek as much information about it as you can, including any reports of its effectiveness. You know your own child best, and you are in the best position to evaluate your child's tolerance for a given approach. Give each approach some time to work before moving on to another one. If one seems to be helping some, but not enough, consider adding another approach.

The NACE offers these tips to help you recognize treatments that are questionable:

• Overstatement and exaggerated claims are red flags. Be suspicious of any product or treatment that is described as astonishing, miraculous, or an amazing breakthrough.
• Be suspicious of any treatment that claims to treat a wide variety of ailments. Common sense tells us that the more grandiose the claim, the less likely it is that there is any real merit behind it.
• Do not rely solely on testimonials from people who say they have been helped by the product or the treatment.
• Be skeptical about claims that a treatment is being suppressed or unfairly attacked by the medical establishment.