Omega-3 fatty acids have been extolled as a treatment for everything from depression to high blood pressure. But how do they stack up for ADHD?A recent meta-analysis set out toanswer this, compiling the results of 10 randomized placebo controlled trialsof omega-3 supplementation involving close to 700 children. Nine of the 10 trials examined omega-3 monotherapy compared to placebo; one trial compared omega-3 augmentation of traditional medication therapy to placebo.
Omega-3 supplementation showed small but significant improvement in ADHD severity, based on improvement on a number of standard rating scales (effect size 0.31). There were no significant differences in efficacy between omega-3 as a monotherapy and omega-3 augmentation.
Omega-3 supplements come in a variety of doses, with many different bal- ances of eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA). Researchers found that EPA dose within the supple- ment had a strong correlation with improved ADHD symptoms. The greatest effect size was seen with doses of EPA between 450 and 600 mg (Bloch MH and Qawasmi A, JAACAP 2011;50(10):991– 1000).
CCPR’s Take: Omega-3s certainly don’t have the same effect size as our usual treatments for ADHD— methylphenidate, 0.78; clonidine, 0.58; and atomoxetine, 0.64 (Schachter HM et al, CMAJ 2001;165:1475–1488; Connor DF et al, JAACAP 1999;38:1551–1559; Cheng JY et al, Psychopharmacology (Berl) 2007;194:197–209). In addition, it’s well established that omega-3s can be helpful in treating depression, so we are left to wonder if some of the effect here was seen in kids whose ADHD was exacerbated by depression. Regardless, for some kids who either have trouble with traditional meds or whose parents are opposed to them, you might want to suggest omega-3 fatty acids. They have hardly any side effects, and they may help. Just be sure to recommend that patients or their parents look for higher doses of EPA for the best results.
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