MHM Magazine

Issue 6 | 2022 | MENTAL HEALTH MATTERS | 27 MHM parents or teachers, and the other where the best possible blinded assessments (i.e. placebo- and non-placebo controlled trials where the assessments made were by an individual blinded to treatment) of improvement on ADHD measures were included. Although all dietary and psychological interventions produced statistically significant effects, in the latter group only free fatty acid supplementation and artificial food colouring exclusion remained significant. It therefore seems that free fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessments, although the clinical effects of these effects remain to be determined. Artificial food colouring exclusion produced larger effects but often in individuals selected for food sensitivities. But what is the current evidence? COGNITIVE TRAINING AND NEUROFEEDBACK There has been an increasing interest in and the use of computer- based cognitive training (CBCT) as a treatment of ADHD, with some empirical support in recent years from controlled studies. However, a review of the current evidence found that the effects were stronger for unblinded measures, while controlled trails with blinded measures could not support any significant effect. DIET Throughout the years, many dietary fads and beliefs have made their appearance: from the exclusion of food colourants, sugar, and other restriction elimination diets, to supplementation with fish oils, mega-dose vitamins, amino acids, magnesium, iron and zinc. However, a systematic review of the literature found that only elimination diets and fish oil supplementation seem to be able to reduce ADHD symptoms – although both interventions need more thorough investigations prior to recommending them as part of ADHD treatment. N-3 omega-3 polyunsaturated fatty acids (n-3 PUFAs) are promoted as cognitive enhancers in the general population, as well as for patients ADHD. Not only is there evidence that mild symptoms of ADHD respond well to omega supplementation, but omega also enhance the effectiveness of the prescription ADHD treatment, which means lower doses can be used, which then lessen the potential of side-effects. Recent studies highlighted the role of micronutrients and vitamins, although the findings remain controversial. Vit D supplementation (if deficient) has some benefit, but no evidence was found for supplementation with nutrients such as zinc, vitB12, iron and folate. Other dietary supplements available on the market (but which we can’t recommend as evidence-based treatment for ADHD) include citociline (which increases phosphatidylcholine, acetylcholine and dopamine (DA)), acety L-carnitine (an amino acid), dimethylethanolamine (an acetylcholine esterase inhibitor), and L-theanine (which increases GABA and DA). COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) CAMs include health and wellness products and techniques not presently considered to be part of conventional Western medicine. CAM includes mind-body medicine (such as meditation, acupuncture, and yoga), manipulative and body- based practices (such as massage therapy and spinal manipulation),