Omega-3 PUFA Supplements for ADHD (2024)

Table of Contents

ABSTRACT Continue Reading… $40.00 References Impact of Disability on Medical Care Balancing Psychiatric Stability and Cardiometabolic Health in Bipolar I Disorder Dr Goldberg takes viewers through two case profiles of patients with bipolar I disorder, including assessment, diagnosis, and treatment, with a focus on cardiometabolic safety. Why Ask Patients to Cut Into Quarters 10 mg THC Gummies From a Dispensary When 2.5 mg THC Is Available by Prescription? Accounting for Differences in Incident Guideline Discordant Prescribing for PTSD Among Women and Men Veterans Epilepsy, Antiepileptic Drugs, and Adverse Pregnancy Outcomes, 1: Recent Research References

JOURNALS
- - - Journals
- - - The Journal of Clinical Psychiatry
      JCP Current Issue
      JCP Weekly
      JCP Archives
      ASCP
  - - The Primary Care Companion for CNS Disorders
      PCC Current Issue
      PCC Weekly
      PCC Archives
News
COLLECTIONS
- - - 5 Minute Pearls
      Academic Highlights
      Alzheimer Disease
      ASCP Corner
      Banner Alzheimer’s Institute
      Childhood and Adolescent Mental Health
  - - Clinical and Practical Psychopharmacology
      Early Career Psychiatrists
      Focus on Geriatric Psychiatry
      Focus on Psychosis
      Focus on Psychotherapy
      Focus on Suicide
  - - InfoPacks
      Insights Videos
      LGBTQ
      Rare Diseases
      Rounds in the General Hospital
      Women’s Mental Health
TOPICS
- - - Topics
- - - See all Topics
For Authors
- JCP: Submit Your Manuscript
- JCP: Info for Authors
- JCP: Info for Reviewers
- PCC: Submit Your Manuscript
- PCC: Info for Authors
- PCC: Info for Reviewers

Error: Search field were incomplete.

Back To Top
Reprints
Sections

Subscribe to read the entire article

This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s

Meta-Analysis

Ting-Hui Liu, MD; Jheng-Yan Wu, BS; Po-Yu Huang, MD; Chih-Cheng Lai, MD; Jane Pei-Chen Chang, MD, PhD; Chien-Ho Lin, MD, PhD; and Kuan-Pin Su, MD, PhD

Published: August 30, 2023

ABSTRACT

Objective: Previous studies have shown conflicting results for the effectiveness of omega-3 polyunsaturated fatty acids (PUFAs) in improving attention-deficit/hyperactivity disorder (ADHD) symptoms. This inconsistency may be due to differences in dosage, composition, and treatment duration. The current meta-analysis aims to address this inconsistency by improving subtype analyses and focusing on heterogeneity in treatment duration, omega-3 PUFA composition, and eicosapentaenoic acid (EPA) dose.

Data Sources and Study Selection: We searched PubMed, EMBASE, PsycINFO, and Cochrane Library for randomized controlled trials of omega-3 PUFAs for ADHD, without publication year or language limitations, up to November 27, 2022. The primary outcome was the improvement of ADHD core symptoms. Subgroup analyses were conducted based on the formula, dosages, and composition ratios of omega-3 PUFAs. To ensure methodological quality, the Cochrane Risk-of-Bias Tool 1.0 was utilized to assess the risk of bias for each study included in the analysis. The pooled data were then analyzed using the random-effect meta-analysis, and the inverse variance method was employed.

Data Extraction: The outcomes of interest were extracted using a data extraction form developed for this study.

Results: Twenty-two studies with 1,789 participants were included in the analysis. Overall, omega-3 PUFAs did not significantly improve ADHD core symptoms compared to placebo (standardized mean difference [SMD]: −0.16; 95% CI, −0.34 to 0.01; P = .07). However, in the subgroup of studies with a treatment duration of at least 4 months, omega-3 PUFAs were significantly more effective than placebo (SMD: −0.35; 95% CI,−0.61 to −0.09; P = .007). Neither high eicosapentaenoic acid (EPA) dosage nor high EPA/docosahexaenoic acid (DHA) ratio was found to improve ADHD symptoms.

Conclusions: Our findings indicate that omega-3 PUFAs did not improve ADHD core symptoms, but long-term supplementation may have potential benefits. The main limitation of the study was the moderate heterogeneity and small sample sizes in subgroup analyses and the lack of dietary pattern information.

J Clin Psychiatry 2023;84(5):22r14772

Author affiliations are listed at the end of this article.

Advertisem*nt

Quick Links:

Continue Reading…

Forgot your login?Paid print subscriber?

$40.00

Buy this Article as a PDF

References

1.Epstein JN, Loren RE. Changes in the definition of ADHD in DSM-5: subtle but important. Neuropsychiatry (London). 2013;3(5):455–458. PubMed CrossRefShow Abstract

2.Polanczyk GV, Willcutt EG, Salum GA, et al. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43(2):434–442. PubMed CrossRefShow Abstract

3.Subcommittee on Attention-Deficit/Hyperactivity Disorder SCoQI. Management. ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. IL, USA: American Academy of Pediatrics Elk Grove Village; 2011:1007–1022.

4.Sokoła-Wysoczańska E, Wysoczański T, Wagner J, et al. Polyunsaturated fatty acids and their potential therapeutic role in cardiovascular system disorders: a review. Nutrients. 2018;10(10):1561. PubMed CrossRefShow Abstract

5.Calder PC. Polyunsaturated fatty acids and inflammation. Prostaglandins Leukot Essent Fatty Acids. 2006;75(3):197–202. PubMed CrossRefShow Abstract

6.Hawkey E, Nigg JT. Omega-3 fatty acid and ADHD: blood level analysis and meta-analytic extension of supplementation trials. Clin Psychol Rev. 2014;34(6):496–505. PubMed CrossRefShow Abstract

7.LaChance L, McKenzie K, Taylor VH, et al. Omega-6 to omega-3 fatty acid ratio in patients with ADHD: a meta-analysis. J Can Acad Child Adolesc Psychiatry. 2016;25(2):87–96. PubMedShow Abstract

8.Carucci S, Romaniello R, Demuru G, et al. Omega-3/6 supplementation for mild to moderate inattentive ADHD: a randomised, double-blind, placebo-controlled efficacy study in Italian children. Eur Arch Psychiatry Clin Neurosci. 2022;272:1453–1467. PubMed CrossRefShow Abstract

9.Chang JP-C, Su K-P, Mondelli V, et al. High-dose eicosapentaenoic acid (EPA) improves attention and vigilance in children and adolescents with attention deficit hyperactivity disorder (ADHD) and low endogenous EPA levels. Transl Psychiatry. 2019;9(1):303. PubMed CrossRefShow Abstract

10.Assareh M, Davari Ashtiani R, Khademi M, et al. Efficacy of polyunsaturated fatty acids (PUFA) in the treatment of attention deficit hyperactivity disorder: a randomized, double-blind, placebo-controlled clinical trial. J Atten Disord. 2017;21(1):78–85. PubMed CrossRefShow Abstract

11.Bos DJ, Oranje B, Veerhoek ES, et al. Reduced symptoms of inattention after dietary omega-3 fatty acid supplementation in boys with and without attention deficit hyperactivity disorder. Neuropsychopharmacology. 2015;40(10):2298–2306. PubMed CrossRefShow Abstract

12.Cornu C, Mercier C, Ginhoux T, et al. A double-blind placebo-controlled randomised trial of omega-3 supplementation in children with moderate ADHD symptoms. Eur Child Adolesc Psychiatry. 2018;27(3):377–384. PubMed CrossRefShow Abstract

13.Crippa A, Tesei A, Sangiorgio F, et al. Behavioral and cognitive effects of docosahexaenoic acid in drug-naïve children with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled clinical trial. Eur Child Adolesc Psychiatry. 2019;28(4):571–583. PubMed CrossRefShow Abstract

14.Dashti N, Hekmat H, Soltani HR, et al. Comparison of therapeutic effects of omega-3 and methylphenidate (Ritalin) in treating children with attention deficit hyperactivity disorder. Iran J Psychiatry Behav Sci. 2014;8(4):7–11. PubMedShow Abstract

15.Döpfner M, Dose C, Breuer D, et al. Efficacy of omega-3/omega-6 fatty acids in preschool children at risk of ADHD: a randomized placebo-controlled trial. J Atten Disord. 2021;25(8):1096–1106. PubMed CrossRefShow Abstract

16.Gustafsson PA, Birberg-Thornberg U, Duchén K, et al. EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD. Acta Paediatr. 2010;99(10):1540–1549. PubMed CrossRefShow Abstract

17.Kean JD, Sarris J, Scholey A, et al. Reduced inattention and hyperactivity and improved cognition after marine oil extract (PCSO-524) supplementation in children and adolescents with clinical and subclinical symptoms of attention-deficit hyperactivity disorder (ADHD): a randomised, double-blind, placebo-controlled trial. Psychopharmacology (Berl). 2017;234(3):403–420. PubMed CrossRefShow Abstract

18.Manor I, Magen A, Keidar D, et al. The effect of phosphatidylserine containing Omega3 fatty-acids on attention-deficit hyperactivity disorder symptoms in children: a double-blind placebo-controlled trial, followed by an open-label extension. Eur Psychiatry. 2012;27(5):335–342. PubMed CrossRefShow Abstract

19.Milte CM, Parletta N, Buckley JD, et al. Increased erythrocyte eicosapentaenoic acid and docosahexaenoic acid are associated with improved attention and behavior in children with ADHD in a randomized controlled three-way crossover trial. J Atten Disord. 2015;19(11):954–964. PubMed CrossRefShow Abstract

20.Moghaddam MF, Shamekhi M, Rakhshani T. Effectiveness of methylphenidate and PUFA for the treatment of patients with ADHD: a double-blinded randomized clinical trial. Electron Physician. 2017;9(5):4412–4418. PubMed CrossRefShow Abstract

21.Mohammadzadeh S, Baghi N, Yousefi F, et al. Effect of omega-3 plus methylphenidate as an alternative therapy to reduce attention deficit hyperactivity disorder in children. Korean J Pediatr. 2019;62(9):360–366. PubMed CrossRefShow Abstract

22.Perera H, Jeewandara KC, Seneviratne S, et al. Combined ω3 and ω6 supplementation in children with attention-deficit hyperactivity disorder (ADHD) refractory to methylphenidate treatment: a double-blind, placebo-controlled study. J Child Neurol. 2012;27(6):747–753. PubMed CrossRefShow Abstract

23.Rodríguez C, García T, Areces D, et al. Supplementation with high-content docosahexaenoic acid triglyceride in attention-deficit hyperactivity disorder: a randomized double-blind placebo-controlled trial. Neuropsychiatr Dis Treat. 2019;15:1193–1209. PubMed CrossRefShow Abstract

24.Salehi B, Mohammadbeigi A, Sheykholeslam H, et al. Omega-3 and Zinc supplementation as complementary therapies in children with attention-deficit/hyperactivity disorder. J Res Pharm Pract. 2016;5(1):22–26. PubMed CrossRefShow Abstract

Impact of Disability on Medical Care

Given that many people have disabilities, physicians should develop skills that assess the...

Mirza Baig and others

SPOTLIGHT

Balancing Psychiatric Stability and Cardiometabolic Health in Bipolar I Disorder

Dr Goldberg takes viewers through two case profiles of patients with bipolar I disorder, including assessment, diagnosis, and treatment, with a focus on cardiometabolic safety.

Joseph F. Goldberg, MD

LETTER TO THE EDITOR

Why Ask Patients to Cut Into Quarters 10 mg THC Gummies From a Dispensary When 2.5 mg THC Is Available by Prescription?

The authors discuss a study by Sawicki et al of dementia patients for whom 2.5 mg of THC w...

Marina Goldman and others

Advertisem*nt

ORIGINAL RESEARCH

Accounting for Differences in Incident Guideline Discordant Prescribing for PTSD Among Women and Men Veterans

Women Veterans with PTSD were 67% more likely to initiate a guideline discordant medicatio...

Kenda R. Stewart Steffensmeier and others

CLINICAL AND PRACTICAL PSYCHOPHARMACOLOGY

Epilepsy, Antiepileptic Drugs, and Adverse Pregnancy Outcomes, 1: Recent Research

This article provides women who have epilepsy and who use antiepileptic drugs during pregn...

Chittaranjan Andrade

Advertisem*nt