EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD.
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.
Gustafsson
Per A
PA
Department of Child Psychiatry, Linköping University, Sweden. per.a.gustafsson@liu.se
Birberg-Thornberg
Ulrika
U
Duchén
Karel
K
Landgren
Magnus
M
Malmberg
Kerstin
K
Pelling
Henrik
H
Strandvik
Birgitta
B
Karlsson
Thomas
T
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
D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D010743:Phospholipids; D015118:Eicosapentaenoic Acid