title: Complementary medicines (herbal and nutritional products) in the treatment of Attention Deficit Hyperactivity Disorder (ADHD): a systematic review of the evidence.
abstract: BACKGROUND
  Complementary and Alternative Medicines (CAMs) are frequently given to children and adolescents for reputed benefits in the treatment of hyperkinetic and concentration disorders such as Attention Deficit Hyperactivity Disorder (ADHD). In such vulnerable populations high quality evidence is required to support such claims.
  
  
  OBJECTIVE
  The aim of the paper is to assess the current evidence of herbal and nutritional interventions for ADHD using a systematic search of clinical trials meeting an acceptable standard of evidence.
  
  
  METHODS
  PubMed, PsycINFO, Cochrane Library and CINAHL were searched up to May 26th, 2011 for randomised, controlled clinical trials using CAM products as interventions to treat ADHD. A quality analysis using a purpose-designed scale, and an estimation of effect sizes (Cohen's d) where data were available, were also calculated.
  
  
  RESULTS
  The review revealed that 16 studies met inclusion criteria, with predominant evidentiary support found for zinc, iron, Pinus marinus (French maritime pine bark), and a Chinese herbal formula (Ningdong); and mixed (mainly inconclusive) evidence for omega-3, and l-acetyl carnitine. Current data suggest that Ginkgo biloba (ginkgo), and Hypercium perforatum (St. John's wort) are ineffective in treating ADHD.
  
  
  CONCLUSIONS
  The research suggests only some CAMs may be beneficial in ADHD, thus clinicians need to be aware of the current evidence. Promising candidates for future research include Bacopa monniera (brahmi) and Piper methysticum (kava), providing potential efficacy in improving attentional and hyperkinetic disorders via a combination of cognitive enhancing and sedative effects.
authors.affiliation: The University of Melbourne, Department of Psychiatry, Australia. jsarris@unimelb.edu.au
authors.forename: Jerome
authors.initials: J
authors.lastname: Sarris
authors.forename: James
authors.initials: J
authors.lastname: Kean
authors.forename: Isaac
authors.initials: I
authors.lastname: Schweitzer
authors.forename: James
authors.initials: J
authors.lastname: Lake
mesh_terms: D000108:Acetylcarnitine / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D044623:Nutrition Therapy; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D010946:Plants, Medicinal; D014131:Trace Elements / Q000627:therapeutic use*; D015032:Zinc / Q000627:therapeutic use
chemical_list: D004365:Drugs, Chinese Herbal; D015525:Fatty Acids, Omega-3; D010936:Plant Extracts; D014131:Trace Elements; C545316:ningdong; D000108:Acetylcarnitine; D007501:Iron; D015032:Zinc