ADHD: Drugs, Diet, and Naturopathic Medicine
ADHD: Drugs, Diet, and Naturopathic Medicine
Dr. Eric Viegas, ND
I recently watched a standup comedy special starring Norm MacDonald. He was commenting on his childhood, and how all he wanted to do while sitting in a classroom was to go outside and play with a big tree branch. He then wondered about hyperactive kids today and their feelings about being stuck in a classroom with the addition of authority figures yelling, “Now we’re going to drug you.” While this commentary is an oversimplification of the plight of modern kids, it does raise the question of whether or not medications are the only option when dealing with attention deficit hyperactivity disorder (ADHD).
It is estimated that 5% of all Canadian children ages 3 to 9 fit the criteria for a diagnosis of ADHD (1). Boys are more commonly affected. Inattention, hyperactivity and impulsivity, in both the classroom and at home, are the main symptoms of ADHD. The recent changes to the DSM-V now include details to help doctors identify ADHD in adults, and changes the previous age cutoff in children from 7 to 12 years old (2). It is important to not jump to a hasty diagnosis of ADHD, as there are many other disorders that mimic it.
Children who are on the autism spectrum often suffer from ADHD. Oppositional Defiant Disorder (ODD) is often mistaken for ADHD. In ODD, children display angry and irritable mood, argumentative or defiant behaviour, or vindictiveness for at least 6 months. Children and adults with ODD will direct their anger towards at least one person who is not a sibling, and will have significant problems at work, in the classroom, or at home (3). While children with ODD are more likely to also have a learning disability, the important issue here is to receive a thorough workup and diagnosis from a trained psychologist. An accurate diagnosis will ensure that appropriate treatment is provided for you or your child.
The American Academy of Pediatrics recommends that preschool children with ADHD receive behavioural therapy as a first line treatment. In school children with ADHD, stimulant medications like methylphenidate (aka Ritalin) and atomoxetine are considered first line treatment (4). Common side effects of these medications include reduced appetite and weight loss, problems sleeping, and stunted growth. Long-term use of methylphenidate can also lead to depletion of zinc in children with ADHD (5). When supplemented with zinc + methylphenidate, children with ADHD in a 2004 study improved in teacher and parent rating scales compared to children taking placebo + methylphenidate (6).
In a 2016 retrospective study of around 4200 children in the Netherlands, researchers found that children with ADHD were more likely to be medicated for asthma, seasonal allergies, and eczema. Furthermore, ADHD was deemed to be more common in children whose parents were taking medications for asthma and seasonal allergies (7). In 2015, a systematic review of hypoallergenic diets for children with ADHD found a small but significant improvement in symptom severity (8). Another 2015 study showed that supplementing fish oil into children’s diets for 16 weeks brought down both inflammatory markers and ADHD symptom severity (9).
The reality of ADHD is that some people require medication to control their symptoms. A variety of naturopathic interventions can target the side effects of commonly prescribed ADHD medications, ADHD symptoms, and comorbid conditions like allergies and digestive concerns. Speak with your Naturopathic Doctor to find out which interventions are best suited for you or your child.
- Brault MC, Lacourse E. Prevalence of prescribed ADHD medications and diagnosis among Canadian preschoolers and school-aged children: 1994-2007. Cdn J Psychiatry 2012; 57:93-101.
- http://www.icd10data.com/ICD10CM/Codes/F01-F99/F90-F98/F90-/F90.9. Accessed June 17, 2017.
- http://www.icd10data.com/ICD10CM/Codes/F01-F99/F90-F98/F91-/F91.3. Accessed June 17, 2017.
- ADHD: Clinical practice guideline for the diagnosis, evaluation and treatment of ADHD in children and adolescents. American Academy of Pediatrics 2011.
- Viktorinova A, et al. Changed plasma levels of zinc and copper to zinc ratio and their possible associations with parent-and-teacher-rated symptoms in children with ADHD. Biol Trace Elem Res. 2016; 169(1):1-7.
- Akhonzadeh S., et al. Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial. BMC Psychiatry 2004; 4: 1-6.
- Van der Schans J, et al. Association between medication prescription for atopic diseases and attention-deficit/hyperactivity disorder. Ann Allergy Asthma Immunol 2016.
- Heilskov Rytter MJ et al. Diet in the treatment of ADHD in children: a systematic review of the literature. Nord J Psychiatry 2015;69(1): 1-18.
- Bos DJ, et al. Reduced symptoms of inattention after dietary omega-3 fatty acid supplementation in boys with and without ADHD. Neuropsychopharm 2015; 40(10): 2298-2306.