Options to prescription meds for ADHD seem to be a big interest to a lot of parents struggling to help their kids with this issue. Here's a link to and some quotes from an interesting NY Times article that talks about some of the more popular choices and some of the research, if any, about them: link (http://www.nytimes.com/2008/06/17/health/17well.html?_r=1&ref=health&oref=slogin)

Weighing Nondrug Options for ADHD

About 2.5 million children in the United States take stimulant drugs for attention and hyperactivity problems. But concerns about side effects have prompted many parents to look elsewhere: as many as two-thirds of children with attention deficit hyperactivity disorder, or A.D.H.D., have used some form of alternative treatment.
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Last week, The Journal of the American Medical Association reported that the first study of the herb St. John’s wort worked no better than a placebo to counter A.D.H.D. But the trial, of 54 children, lasted only eight weeks, and even prescription drugs can take up to three months to show a measurable effect.

But the larger issue may be that in complementary medicine, one treatment is rarely used alone, making the range of alternative remedies difficult to study. Natural treatments may well be beneficial, said the report’s lead author, Wendy Weber, a research associate professor at the school of naturopathic medicine at Bastyr University in Kenmore, Wash. “We just need to do more studies and document the effect.”

Other herbal treatments for the disorder include echinacea, ginkgo biloba and ginseng. There are no reliable data on echinacea; a 2001 study showed improvement after four weeks in children using ginkgoginseng, but there was no control group for comparison.

There is more hope for omega-3 fatty acids, found in fish and fish-oil supplements. A review last year in the journal Pediatric Clinics of North America concluded that a “growing body of evidence” supported the use of such supplements for children with A.D.H.D.

As for dietary changes, a 2007 study in The Lancet examined the effect of artificial coloring and preservatives on hyperactive behavior in children. After consuming an additive-free diet for six weeks, the children were given either a placebo beverage or one containing a mix of additives in two-week intervals. In the additive group, hyperactive behaviors increased.
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Data on sugar avoidance are less persuasive. Several studies suggest that any link between sugar and hyperactivity is one of parental perception, rather than reality. In one study, mothers who were told the child received sugar reported more hyperactive behavior, even when the food was in fact artificially sweetened. Mothers who were told the child received a low-sugar snack were less likely to report worse behavior.
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Thanks Ari. This is a wonderful artical, very interesting

I really don't know a lot about this issue and wonder how better/worse ADHD is from when I was growing up. If it is worse, then what I want to know is why? The impression I am getting is that it is worse, but that might because now it has a name (ADHD), and it is being studied/treated, when before it was just some kids had no attention span.

What happens to kids who don't get treatment of ADHD, do they grow up to be adults with a lot of problems, or do they develop the ability/skills to cope with ADHD. My concern is that drugs block kids from developing coping skills. Not to suggest that drugs are always a bad, but I do beleive severe cases of any type of health problem, drugs might be required as part the the solution.

Neal, it really depends on how severe the condition is in the child/adult. My first husband has ADHD..he went off meds when he was 17, and from that point on, his ability to cope and function was minimal. He couldn't focus, he couldn't concentrate, he self-medicated. When he got back on daily meds, he became a much more productive person.
My son was diagnosed ADHD, and took meds on school days for about six months, then was taken off them. He hasn't had a problem with functioning in society since that time.

I really don't know a lot about this issue and wonder how better/worse ADHD is from when I was growing up. If it is worse, then what I want to know is why? The impression I am getting is that it is worse, but that might because now it has a name (ADHD), and it is being studied/treated, when before it was just some kids had no attention span.

Interesting questions.

The American Academy of Pediatrics' Committee on Quality Improvement, Subcommittee on on ADD/ADHD published clinical practice guidelines for the diagnosis and evaluation of ADD/ADHD. It's an interesting read that touches on some of this. Here's the link and a quote: Link (http://pediatrics.aappublications.org/cgi/content/full/105/5/1158?ijkey=f7f7f4ceef169f90ffb211ff9b5a953f82a4fcb e)

Recorded prevalence rates for ADHD vary substantially, partly because of changing diagnostic criteria over time, and partly because of variations in ascertainment in different settings and the frequent use of referred samples to estimate rates. Practitioners of all types (primary care, subspecialty, psychiatry, and nonphysician mental health providers) vary greatly in the degree to which they use Diagnostic and Statistical Manual of Mental Health Disorders, Fourth Edition (DSM-IV) criteria to diagnose ADHD. Reported rates also vary substantially in different geographic areas and across countries.
With increasing epidemiologic and clinical research, diagnostic criteria have been revised on multiple occasions over the past 20 years. A recent review of prevalence rates in school-aged community samples (rather than referred samples) indicates rates varying from 4% to 12%, with estimated prevalence based on combining these studies of ~8% to 10%. In the general population, 9.2% (5.8%-13.6%) of males and 2.9% (1.9%-4.5%) of females are found to have behaviors consistent with ADHD. With the DSM-IV criteria (compared with earlier versions), more females have been diagnosed with the predominantly inattentive type. Prevalence rates also vary significantly depending on whether they reflect school samples 6.9% (5.5%-8.5%) versus community samples 10.3% (8.2%-12.7%).

So the prevalence rate of ADD/ADHD has varied over time due in part to changes in diagnostic criteria. Current articles have found continuing variation, with prevalence varying by 1) whether the sample of kids was drawn for school or the community; 2) area of the country; and 3) diagnostic criteria used (i.e., whether the diagnostician used the bible of psychiatric diagnosis, the DSM, and, if the DSM is relied upon, which edition is used0).

In attempting to provide the best evidence-based guidelines for peds for standardization of evaluating and diagnosing ADD/ADHD, the Subcommittee suggested that a child be diagnosed with ADHD only after meeting the requirements of the DSM-IV. It recommends extensive information about the child's behavior from parents, other caregivers, and teachers. It also recommends that kids be screened for possible co-existing problems.

The article with these and other guidelines, along with discussion of the available research and current research needs, was published in the journal Pediatrics in 2000. Pediatrics is the 300-lb gorilla of pediatric literature as it is the journal of the AAP. Hopefully, these guidelines and continuing scrutiny of the methods of evaluating and diagnosing ADD and ADHD will result in a clearer picture of the true prevalence of these disorders.


What happens to kids who don't get treatment of ADHD, do they grow up to be adults with a lot of problems, or do they develop the ability/skills to cope with ADHD. My concern is that drugs block kids from developing coping skills. Not to suggest that drugs are always a bad, but I do beleive severe cases of any type of health problem, drugs might be required as part the the solution.

What I've read in several places is that more than half the kids with ADHD will continue to have similar problems in adulthood. But I haven't seen a comprehensive article on it.

Thanks Ari. Do you how does this effect their ability to learn? The idea being if they can't hold their attention very long on anything, then they have learning difficulties.

Thanks Ari. Do you how does this effect their ability to learn? The idea being if they can't hold their attention very long on anything, then they have learning difficulties.

To qualify for the diagnosis of ADD/ADHD, a kid not only needs to meet the behavioral requirements for hyperactivity or attention deficiency, but the problems caused by these behaviors much be present in two or more settings. For most kids, this means both school and home. Further, the diagnosis also requires "clear evidence of significantly impairment in social, academic, or occupational functioning". For a lot of kids, the occupational part usually doesn't pertain, of course. But significant social impairment usually is accompanied by problems academically as the kids are disruptive in the classroom.

These requirements are a theme of the DSM diagnostic criteria for most psych problems: the behavior or thinking must cause a severe impairment in a major life function and has broad consequences in the person's life. This is even a requirement for a diagnosis as specific as a specific phobia (e.g., fear of heights). And it is what separates a person with ADD from someone who is at the upper limit of normal activity but whose behavior isn't so severe as to cause major impairment.

Furthermore, the majority of kids diagnosed with ADHD or ADD have other diagnosed problems that would affect their ability to perform at school, such as learning disabilities or anxiety. My nephew is an example of this: He has ADHD and Asperger's. He is mainstreamed with an IEP. School has been a big challenge for him, and I doubt he would have been able to stay in a mainstream school if not for the incredible amount of time my parents have put into his education.