title: Effect of vitamin D supplementation as adjunctive therapy to methylphenidate on ADHD symptoms: A randomized, double blind, placebo-controlled trial.
abstract: OBJECTIVE
  Previous studies have shown that serum levels of vitamin D were lower in attention deficit hyperactivity disorder (ADHD) children compared to healthy controls. The aim of the study was to determine the effect of vitamin D supplementation as adjunctive therapy to methylphenidate on symptoms of children with ADHD.
  
  
  METHODS
  Sixty-two children aged 5-12 years with a diagnosis of ADHD based on DSM-IV criteria were randomly assigned into two groups to receive either 2000IU vitamin D or placebo in addition to methylphenidate for 8 weeks. Symptoms severity was assessed by Conner's Parent Rating Scale-Revised[S] (CPRS), ADHD rating scale-IV (ADHD-RS), and Weekly Parent Ratings of Evening and Morning Behavior (WPREMB) at weeks 0, 4, and 8. Serum levels of 25(OH)D were measured at baseline and after 8 weeks. Anthropometric variables, dietary intake, physical activity, sun exposure, and side effects were assessed.
  
  
  RESULTS
  Fifty-four participants completed the trial. After 8 weeks of supplementation, serum levels of 25(OH)D significantly increased in the vitamin D group. ADHD symptoms decreased significantly in both groups (P < 0.05). Evening symptoms and total score of WPREMB scale were significantly different at weeks 4 and 8 between the two groups (P = 0.013, 0.016, respectively), but no differences were found in symptoms by CPRS and ADHD-RS scales.
  
  
  CONCLUSIONS
  Vitamin D supplementation as adjunctive therapy to methylphenidate improved ADHD evening symptoms. Future research is needed to clarify vitamin D effects as monotherapy in ADHD and its mechanism. The trial was registered in www.irct.ir is (IRCT201404222394N10).
authors.affiliation: a Department of Clinical Nutrition , School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Nakisa
authors.initials: N
authors.lastname: Mohammadpour
authors.affiliation: b Pediatric Growth and Development Research Center , Institute of Endocrinology and Metabolism, Iran University of Medical Sciences , Tehran , Iran.|c Department of Nutrition , School of Public Health, Iran University of Medical Sciences , Tehran , Iran.
authors.forename: Shima
authors.initials: S
authors.lastname: Jazayeri
authors.affiliation: d Department of Psychiatry, Roozbeh Hospital , Tehran University of Medical Sciences , Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Tehrani-Doost
authors.affiliation: e Department of Cellular and Molecular Nutrition , School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Djalali
authors.affiliation: f Department of Epidemiology and Biostatistics , School of Public Health, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Hosseini
authors.affiliation: g Ziaean Hospital, School of Medicine, International Campus , Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Effatpanah
authors.affiliation: h Behavioral Sciences Research Center, Imam Hossein Hospital , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Rozita
authors.initials: R
authors.lastname: Davari-Ashtiani
authors.affiliation: a Department of Clinical Nutrition , School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Karami
mesh_terms: D000203:Activities of Daily Living; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy* / Q000503:physiopathology; D002112:Calcifediol / Q000097:blood; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000187:drug effects; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019587:Dietary Supplements / Q000009:adverse effects; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D010290:Parents; D012720:Severity of Illness Index; D063189:Symptom Assessment; D014807:Vitamin D / Q000009:adverse effects / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology
chemical_list: D018765:Dopamine Uptake Inhibitors; D014807:Vitamin D; D008774:Methylphenidate; D002112:Calcifediol
keywords: Attention deficit hyperactivity disorder; Conners’ Parent Rating Scale-Revised; Supplementation; Symptoms; Vitamin D