Q The parents of some children with attention deficit hyperactivity disorder (ADHD) have asked me about herbal remedies. Most questions are about products I have never heard of. Are there any herbal products that have documented efficacy in children who have ADHD? Are there any that I can categorically say have no benefit and are a waste of time and money? I try to reassure these parents that stimulants have been proved to be safe and effective, but those agents have received some bad press lately.
A One has only to walk through any chain drug store these days to recognize that people are buying herbal remediessomething that has developed during the past decade. Regrettably, most herbal remedies have not been subject to randomized, controlled clinical trials. And no herbal products have been documented as an effective treatment for ADHD. A few trials are in progress; more are needed.
Several well-controlled trials have been conducted of methylphenidate hydrochloride (Ritalin) and other stimulants, however. Those trials document that such agents are effective in treating correctly diagnosed ADHD.
One notable alternative treatment for ADHD is electroencephalographic feedback (so-called neural feedback), which has been used for nearly 20 years. An article in the September 2000 issue of Science described current research to develop video games that are connected to brain waves for treatment of ADHD (Science 2000; 289:1461). Neural feedback for ADHD remains a research tool, however, and should not be used routinely.
[For a review of the pharmacology and toxicology of the most popular herbs and dietary supplements that have been used in an attempt to treat ADHD, see "'At least it's natural...' Herbs and dietary supplements in ADHD" in the September 2000 issue of Contemporary Pediatrics.]
Behavior: Ask the experts. Contemporary Pediatrics 2001;12:35.