title: EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD.
abstract: OBJECTIVE
  Measure efficacy of eicosapentaenoic acid (EPA) in children with attention deficit hyperactivity disorder (ADHD).
  
  
  METHODS
  Randomized controlled trial (RCT) of 0.5 g EPA or placebo (15 weeks) in 92 children (7-12 years) with ADHD. Efficacy measure was Conners' Parent/Teacher Rating Scales (CPRS/CTRS). Fatty acids were analysed in serum phospholipids and red blood cell membranes (RBC) at baseline and endpoint with gas chromatography.
  
  
  RESULTS
  EPA improved CTRS inattention/cognitive subscale (p = 0.04), but not Conners' total score. In oppositional children (n = 48), CTRS total score improved ≥25% in 48% of the children receiving EPA vs. 9% for placebo [effect size (ES) 0.63, p = 0.01]. In less hyperactive/impulsive children (n = 44), ≥25% improvement was seen in 36% vs. 18% (ES 0.41, n.s.), and with both these types of symptoms 8/13 with EPA vs. 1/9 for placebo improved ≥25% (p = 0.03). Children responding to treatment had lower EPA concentrations (p = 0.02), higher AA/EPA (p = 0.005) and higher AA/DHA ratios (p = 0.03) in serum at baseline. Similarly, AA/EPA (p = 0.01), AA/DHA (p = 0.038) and total omega-6/omega-3 ratios (p = 0.028) were higher in RBC, probably because of higher AA (p = 0.011).
  
  
  CONCLUSIONS
  Two ADHD subgroups (oppositional and less hyperactive/impulsive children) improved after 15-week EPA treatment. Increasing EPA and decreasing omega-6 fatty acid concentrations in phospholipids were related to clinical improvement.
authors.affiliation: Department of Child Psychiatry, Linköping University, Sweden. per.a.gustafsson@liu.se
authors.forename: Per A
authors.initials: PA
authors.lastname: Gustafsson
authors.forename: Ulrika
authors.initials: U
authors.lastname: Birberg-Thornberg
authors.forename: Karel
authors.initials: K
authors.lastname: Duchén
authors.forename: Magnus
authors.initials: M
authors.lastname: Landgren
authors.forename: Kerstin
authors.initials: K
authors.lastname: Malmberg
authors.forename: Henrik
authors.initials: H
authors.lastname: Pelling
authors.forename: Birgitta
authors.initials: B
authors.lastname: Strandvik
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000097:blood / Q000188:drug therapy*; D002648:Child; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D005178:Faculty; D015525:Fatty Acids, Omega-3 / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D010743:Phospholipids / Q000097:blood; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D010743:Phospholipids; D015118:Eicosapentaenoic Acid