European Child & Adolescent Psychiatry

, Volume 15, Issue 6, pp 329–335 | Cite as

Treatment of ADHD with French maritime pine bark extract, Pycnogenol®

  • Jana Trebatická
  • Soňa Kopasová
  • Zuzana Hradečná
  • Kamil Činovský
  • Igor Škodáček
  • Ján Šuba
  • Jana Muchová
  • Ingrid Žitňanová
  • Iweta Waczulíková
  • Peter Rohdewald
  • Zdeňka Ďuračková
ORIGINAL CONTRIBUTION

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) is the most common psychiatric disorder in children. Pycnogenol®, an extract from the bark of the French maritime pine, consisting of phenolic acids, catechin, taxifolin and procyanidins, has shown improvement of ADHD in case reports and in an open study. Aim of the present study was to evaluate the effect of Pycnogenol® on ADHD symptoms. Sixty-one children were supplemented with 1 mg/kg/day Pycnogenol® or placebo over a period of 4 weeks in a randomised, placebo-controlled, doubleblind study. Patients were examined at start of trial, 1 month after treatment and 1 month after end of treatment period by standard questionnaires: CAP (Child Attention Problems) teacher rating scale, Conner’s Teacher Rating Scale (CTRS), the Conner’s Parent Rating Scale (CPRS) and a modified Wechsler Intelligence Scale for children. Results show that 1-month Pycnogenol® administration caused a significant reduction of hyperactivity, improves attention and visual–motoric coordination and concentration of children with ADHD. In the placebo group no positive effects were found. One month after termination of Pycnogenol® administration a relapse of symptoms was noted. Our results point to an option to use Pycnogenol as a natural supplement to relieve ADHD symptoms of children.

Keywords

inattention hyperactivity ADHD Pycnogenol® 

Abbreviations

BMI:

body mass index

CAP:

Child Attention Problems

CPRS:

The Conner’s Parent Rating Scale

CTRS:

The Conner’s Teacher rating Scale

ICD-10:

International Statistical Classification of Diseases and Related Health Problems

PDW:

Prague Wechsler Intelligence Scale for children

WISC:

Wechsler Intelligence Scale for children

References

  1. 1.
    Barkley RA (1990) Attention deficit hyperactivity disorder: a handbook for diagnosis and treatment. Guilford Press, New YorkGoogle Scholar
  2. 2.
    Biederman J (2005) Attention-deficit/hyperactivity disorder: a selective overview. Biol Psychiatry 57:1215–1220PubMedCrossRefGoogle Scholar
  3. 3.
    Buitelaar JK, Danckaerts M, Gillberg C, Zuddas A, Becker K, Bouvard M, Fagan J, Gadoros J, Harpin V, Hazell P, Johnson M, Lerman-Sagie T, Soutullo CA, Wolanczyk T, Zeiner P, Fouche DS, Krikke-Workel J, Zhang S, Michelson D (2004) A prospective, multicenter, open-label assessment of atomoxetine in non-North American children and adolescent with ADHD. Eur Child Adolesc Psychiatry 13:249–257PubMedGoogle Scholar
  4. 4.
    Conners CK, Sitarenios G, Oarker JDA, Epstein JN (1998) The revised Conners’ Parent Rating Scale (CPRS-R): factor structure, reliability, and Criterion Validity. J Abnorm Child Psychol 26:257–268PubMedCrossRefGoogle Scholar
  5. 5.
    Dulcan MK, Popper CW (1991) Concise guide to child and adolescent psychiatry. American Psychiatric Press, WashingtonGoogle Scholar
  6. 6.
    Ďuračková Z, Muchová J, Sivoňová M, Chovanová Z, Hauserová M, Blažíček P, Trebatická J, Rohdewal P (2004) Oxidative stress in pathophysiology of attention deficit hyperactivity disorder and its influence by a polyphenolic natural extracts, pycnogenol. In: Hoikkala A, Soidinsal O, Wähälä K (eds) XXII International Conference on Polyphenols “Polyphenols communications 2004” Helsinki, Finland, 25–28 August 2004. Jyväskyla, Gummerus Printing, pp 177–178, ISBN 952-10-1977-8Google Scholar
  7. 7.
    Fitzpatrick DF, Bin B, Rohdewald P (1998) Endothelium-dependent vascular effects of Pycnogenol. J Cardiovasc Pharmacol 32:509–515PubMedCrossRefGoogle Scholar
  8. 8.
    Gillberg C, Gillberg IC, Rasmussen P, Kadesjo B, Soderstrom H, Rasatam M, Johnson M, Rothenberger A, Niklasson L (2004) Co-existing disorders in ADHD – implications for diagnosis and intervention. Eur Child Adolesc Psychiatry 13:180–192CrossRefGoogle Scholar
  9. 9.
    Grosse Düweler K, Rohdewald P (2000) Urinary metabolites of French maritime pine bark extract in humans. Pharmazie 55:364–368Google Scholar
  10. 10.
    Hanley JL (1999) Attention deficit disorder. Impact Communications Inc, Green BayGoogle Scholar
  11. 11.
    Heimann SW (1999) Pycnogenol® for ADHD? J Am Acad Child Adolesc Psychiatry 38:357–358PubMedCrossRefGoogle Scholar
  12. 12.
    Ingram DK, Shimada A, Spangler EL, Ikari H, Hengemihle J, Kuo H, Greig N (1996) Cognitive enhancement. New strategies for stimulating cholinergic, glutamatergic, and nitric oxide systems. Ann NY Acad Sci 786:348–361PubMedGoogle Scholar
  13. 13.
    Kaminester DD (1997) Attention Deficit Hyperactivity Disorder and methylphenidate: when society misunderstands medicine. McGill J Med 3:105–114Google Scholar
  14. 14.
    Kubička L, Bursik R, Jirásek J (1973) PDW – Prague child Wechsler. Psychodiagnostic and didactic tests, Bratislava (in Slovak)Google Scholar
  15. 15.
    Liu F, Zhang Y, Lau BHS (1999) Pycnogenol® improves learning impairment and memory deficit in senescence-accelerated mice. J Anti Aging Med 2:349–355Google Scholar
  16. 16.
    Malá E (2000) Hyperkinetické poruchy (F90) In: Hort V, Hrdlička M, Kocourková J, Malá E (eds) Dětská a adolescentní psychiatrie. Portál, Praha pp 307–314Google Scholar
  17. 17.
    Masao H (2000) Pycnogenol®’s therapeutic effect in improving ADHD symptoms in children. Mainichi Shimbun, Oct. 21Google Scholar
  18. 18.
    Michelson D, Faries D, Wernicke J, Kelsey D, Kendrick K, Sallee FR, Spencer T (2001) Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, dose-response study. Pediatrics 108:E83PubMedCrossRefGoogle Scholar
  19. 19.
    Packer L, Rimbach G, Virgili F (1999) Antioxidant activity and biologic properties of a procyanidin-rich extract from pine (Pinus maritima) bark, Pycnogenol. Free Rad Biol Med 27:704–724PubMedCrossRefGoogle Scholar
  20. 20.
    Paclt I, Florian J (1998) Dotazník pro rodiče (CPQ-Conners instrukce). In: Paclt I, Florian J Psychofarmakoterapie dětského a dorostového věku. Praha, Grada Publishing, pp 296–303 (in Slovak)Google Scholar
  21. 21.
    Passwater RA (1998) All about Pycnogenol®. Avery Publishing Group, New YorkGoogle Scholar
  22. 22.
    Pogun S, Kuhar MJ (1994) Regulation of neurotransmitter reuptake by nitric oxide. Ann NY Acad Sci 738:305–315PubMedGoogle Scholar
  23. 23.
    Rohdewald PJ (2005) Pycnogenol®, French maritime pine bark extract In: Coates PM, Blackman MR, Cragg G, Levine M, Moss J, White J (eds) Encyclopedia of dietary supplements. Marcel Dekker, New York, pp 545–553, ISBN 0-8247-5504-9Google Scholar
  24. 24.
    Schmidt HW, Walter U (1994) NO at work. Cell 78:919–925PubMedCrossRefGoogle Scholar
  25. 25.
    Stanislavov R, Nikolova V (2005) Prelox® Plus testosterone for achieving fertilization in previously infertile men. Eur Bull Drug Res 13: 7–13Google Scholar
  26. 26.
    Stough C, Ryan J, Croft K (2004) Anti-oxidants to ameliorate normal cognitive deterioration due to age. Presented at the International Conference On Healthy Ageing and Longevity. Sydney, Australia, March 5–7, 2004Google Scholar
  27. 27.
    Tenenbaum S, Paull JC, Sparrow EC, Dodd DK, Green L (2002) An experimental comparison of Pycnogenol® and methylphenidate in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). J Atten Disord 6:49–60PubMedGoogle Scholar
  28. 28.
    Trebatická J, Škodáček I, Šuba J, Kopasová S, Hradečná Z, Činovský K, Rohdewald P, Ďuračková Z (2004) Treatment success of ADHD by Pycnogenol®. In: Hoikkala A, Soidinsal O, Wähälä K (eds) XXII International Conference on Polyphenols “Polyphenols communications 2004” Helsinki, Finland, 25–28 August 2004. Jyväskyla, Gummerus Printing, pp 179–180, ISBN 952-10-1977-8Google Scholar
  29. 29.
    Yamada K, Noda Y, Nakayama S, Komori Y, Sugihara H, Hasegawa T, Nabeshima T (1995) Role of nitric oxide in learning and memory and in monoamine metabolism in the rat brain. Br J Pharmacol 115:852–858PubMedGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Jana Trebatická
    • 1
  • Soňa Kopasová
    • 1
  • Zuzana Hradečná
    • 1
  • Kamil Činovský
    • 1
  • Igor Škodáček
    • 1
  • Ján Šuba
    • 1
  • Jana Muchová
    • 2
  • Ingrid Žitňanová
    • 2
  • Iweta Waczulíková
    • 3
  • Peter Rohdewald
    • 4
  • Zdeňka Ďuračková
    • 2
  1. 1.Dept. of Child Psychiatry, Child University Hospital, Faculty of MedicineComenius UniversityBratislavaSlovakia
  2. 2.Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of MedicineComenius UniversityBratislavaSlovakia
  3. 3.Dept. of Nuclear Physics and Biophysics, Division of Biomedical Physics, Faculty of Mathematics, Physics and InformaticsComenius UniversityBratislavaSlovakia
  4. 4.Institute of Pharmaceutical ChemistryUniversity of MünsterMünsterGermany

Personalised recommendations