A double-blind placebo-controlled randomised trial of omega-3 supplementation in children with moderate ADHD symptoms
- 717 Downloads
Clinical trials and inconclusive meta-analyses have investigated the effects of omega-3 supplements in children with Attention-Deficit Hyperactivity Disorder (ADHD). We performed a randomised placebo-controlled trial to evaluate the efficacy of omega-3 fatty acids.
Children aged 6–15 years with established diagnosis of ADHD were randomised 1:1 to receive either supplements containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) or a placebo for 3 months. Psychotropic or omega-3-containing treatments were not authorised during the study. The primary outcome was the change in the Attention-Deficit Hyperactivity Disorder Rating Scale version 4 (ADHD-RS-IV). Other outcomes included safety, lexical level (Alouette test), attention (Test of Attentional Performance for Children—KiTAP), anxiety (48-item Conners Parent Rating Scale-Revised—CPRS-R), and depression (Children’s Depression Inventory—CDI).
Between 2009 and 2011, 162 children were included in five French child psychiatry centres. The mean age was 9.90 (SD 2.62) years and 78.4% were boys. The inclusion ADHD-RS-IV at was 37.31 (SD 8.40). The total ADHD-RS-IV score reduction was greater in the placebo group than in the DHA–EPA group: −19 (−26, −12) % and −9.7 (−16.6, −2.9) %, respectively, p = 0.039. The other components of the Conners score had a similar variation but the differences between groups were not significant. Two patients in the DHA–EPA group and none in the placebo group experienced a severe adverse event (hospitalisation for worsening ADHD symptoms).
This study did not show any beneficial effect of omega-3 supplement in children with mild ADHD symptoms.
KeywordsChild ADHD Omega-3 rich fatty acid supplementation Randomized controlled trial
Compliance with ethical standards
Conflict of Interest
The authors declare they have no conflicts of interest to disclose.
- 1.APA (2010) Diagnostic and statistical manual of mental disorders, 4th edn, text revision (DSM-IV-TR). American Psychiatric Association. 943 ppGoogle Scholar
- 2.American Psychiatric Association (1996) DSM4 V, Manuel diagnostique et statistique des troubles mentaux. Traduction française, Paris, Masson, 1056 ppGoogle Scholar
- 6.Schachter HM, Pham B, King J, Langford S, Moher D (2001) How efficacious and safe is short-acting methylphenidate for the treatment of attention-deficit disorder in children and adolescents? A meta-analysis. CAMJ 165(11):1475–1488Google Scholar
- 8.Attention deficit hyperactivity disorder: diagnosis and management. NICE guidelines [CG72] Published date: September 2008 Last updated: February 2016Google Scholar
- 9.Storebø OJ, Krogh HB, Ramstad E, Moreira-Maia CR, Holmskov M, Skoog M, Nilausen TD, Magnusson FL, Zwi M, Gillies D, Rosendal S, Groth C, Rasmussen KB, Gauci D, Kirubakaran R, Forsbøl B, Simonsen E, Gluud C (2015) Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents: cochrane systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. BMJ 25(351):h5203CrossRefGoogle Scholar
- 15.Parletta N, Niyonsenga T, Duff J (2016) Omega-3 and omega-6 polyunsaturated fatty acid levels and correlations with symptoms in children with attention deficit hyperactivity disorder, autistic spectrum disorder and typically developing controls. PLoS ONE 11(5):e0156432CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Lange KW, Hauser J, Lange KM, Makulska-Gertruda E, Nakamura Y, Reissmann A, Sakaue Y, Takeuchi Y (2017) The role of nutritional supplements in the treatment of ADHD: what the evidence says. Curr Psychiatry Rep 19(2):8Google Scholar
- 18.Gillies D, Sinn JKh, Lad SS, Leach MJ, Ross MJ (2012) Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev, 7: p. CD007986Google Scholar
- 19.Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J, European ADHD Guidelines Group (2013) Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 170(3):275–289CrossRefPubMedGoogle Scholar
- 21.DuPaul GJ, Power TJ, Anastopoulos AD (1998) ADHD Rating Scale IV: checklists, norms, and clinical interpretations. Guilford Press, New York (NY)Google Scholar
- 24.Lefavrais P. Test de l’Alouette, Éditions du Centre de Psychologie Appliquée. 2ème édition ed. 1967, ParisGoogle Scholar
- 29.Staquet Maurice J, Hays Ron D (1998) Peter M. Methods and Practice, Fayers. Quality of Life Assessment in Clinical TrialsGoogle Scholar
- 30.Goodman D, Faraone SV, Adler LA et al (2010) Interpreting ADHD rating scale scores: linking ADHD rating scale scores and CGI levels in two randomized controlled trials of Lisdexamfetamine Dimesylate in ADHD. Primary Psychiatry 17(3):44–52Google Scholar
- 36.Richardson AJ, Burton JR, Sewell RP, Spreckelsen TF, Montgomery P (2012) Docosahexaenoic acid for reading, cognition and behavior in children aged 7–9 years: a randomized, controlled trial (the DOLAB Study). PLoS One 7(9):e43909. doi: 10.1371/journal.pone.0043909. Epub 2012 Sep 6
- 37.Bos DJ, van Montfort SJ, Oranje B, Durston S, Smeets PA (2016) Effects of omega-3 polyunsaturated fatty acids on human brain morphology and function: what is the evidence? Eur Neuropsychopharmacol 26(3):546–561. doi: 10.1016/j.euroneuro.2015.12.031. Epub 2015 Dec 21. Review
- 38.Vyncke KE, Libuda L, De Vriendt T, Moreno LA, Van Winckel M, Manios Y, Gottrand F, Molnar D, Vanaelst B, Sjöström M, González-Gross M, Censi L, Widhalm K, Michels N, Gilbert CC, Xatzis C, Cuenca García M, de Heredia FP, De Henauw S, Huybrechts I; HELENA consortium (2012) Dietary fatty acid intake, its food sources and determinants in European adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Br J Nutr 108(12):2261–273. doi: 10.1017/S000711451200030X. Epub 2012 Feb 28