Treatment Options for Children with ADHD

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When you think of treatment options for children with ADHD, you may think of prescription drugs like Adderall and Ritalin. But did you know there are numerous alternative treatment options for children with ADHD, such as an FDA-approved medical device, dietary supplements, and pet therapy, that have proven safety and efficacy? To learn more about treatment options for children with ADHD, keep reading below.

What is ADHD?

ADHD stands for attention-deficit/hyperactivity disorder. According to the National Institute of Mental Health, ADHD is defined as, “a disorder that makes it difficult for a person to pay attention and control impulsive behaviors. He or she may also be restless and almost constantly active.” For example, children with ADHD may make careless mistakes in or fail to finish schoolwork, seem to not listen when spoken to directly, become easily distracted, have trouble waiting his or her turn, talk nonstop, or fidget while seated. ADHD is the most common neuropsychiatric disorder of childhood and one of the most prevalent chronic conditions among school-aged children.

Heredity is the most common cause of ADHD. Other non-genetic factors that may contribute to ADHD include low birth weight, brain injuries, cigarette smoking, alcohol use, or drug use during pregnancy, and exposure to environmental toxins (such as high levels of lead) at a young age. Furthermore, recent research suggests that sleep deprivation, circadian rhythm disturbances, and sleep-disordered breathing (including mouth breathing) may lead to the induction of ADHD-like symptoms.

Prescription medication for ADHD

There are two primary classes of prescription medication for children with ADHD: stimulants and non-stimulants.

While it may seem unusual to treat ADHD with a stimulant medication, it is effective. Researchers theorize that stimulants are effective because the medication increases the neurotransmitter dopamine, which plays critical roles in thinking and attention. Unfortunately, stimulant drugs can cause quite a few side effects, including sleep problems, decreased appetite, delayed growth, headaches, tics, moodiness and irritability. Examples of stimulant prescription drugs include Adderall (dextroamphetamine-amphetamine), Ritalin (methylphenidate), and Vyvanse (lisdexamfetamine).

Non-stimulant prescription drugs also help to improve focus, attention, and impulsivity in a child with ADHD, but they often take longer to start working than stimulants. A doctor may prescribe a non-stimulant if a child had bothersome side effects from stimulants, if a stimulant was not effective, or in combination with a stimulant to increase effectiveness. Examples of non-stimulant prescription drugs include Strattera (atomoxetine) and Intuniv (guanfacine).

FDA-approved medical device to treat ADHD

In April of 2019, the first medical device to treat ADHD in children won marketing approval from the FDA. The prescription-only device is called Monarch external Trigeminal Nerve Stimulation (eTNS) System, and was developed by the company NeuroSigma. The Monarch eTNS System is approved for children 7 to 12 years of age who are not being treated with ADHD medication. The device delivers low-level electrical stimulation to branches of the trigeminal nerve, sending signals to parts of the brain thought to be involved in ADHD. The pocket-sized device is designed to be used externally at night under caregiver supervision.

The safety and efficacy of the Monarch eTNS System was evaluated in a clinical trial involving 62 children with moderate to severe ADHD. The children were randomized to the eTNS device or placebo device for 4 weeks. A clinician-administered ADHD Rating Scale was used to assess ADHD symptoms, with a higher score indicating worsening symptoms. Results of the trial indicated that treatment with the Monarch eTNS device led to statistically significant improvement in ADHD symptoms compared with placebo. The clinical trial also revealed that the most common adverse reactions associated with eTNS therapy include drowsiness, increased appetite, sleep disturbance, teeth clenching, headache, and fatigue. No serious adverse events have been associated with use of the device.

Natural treatment options for children with ADHD

The natural treatment options for children with ADHD include research-based dietary supplements that improve cognitive function and/or support neurotransmitters. Below are examples of the most effective natural treatment options for children with ADHD.

  • Fish oil - Fish oil is a source of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA are critical for brain function, and also improve neurogenesis and neurotransmitter production. Research has shown that fish oil supplementation reduces symptoms and improves learning in children with ADHD.

  • Phosphatidylserine - Phosphatidylserine (PS) is a phospholipid naturally produced by the body. Along with EPA and DHA, PS is used to build cell membranes and is vital to the maintenance of all cellular function, particularly in the brain. PS has been shown to increase dopamine levels. In a randomized, double-blind, placebo-controlled clinical trial, researchers evaluated the effects of PS on 36 children, aged 4 to 14 years, who had not previously received any drug treatment related to ADHD. Results of the study demonstrated that PS significantly improved ADHD symptoms and short-term auditory memory in children.

  • Magnesium - Magnesium plays a critical role in the release of several neurotransmitters. Studies have shown that magnesium supplementation benefits children with ADHD. For example, one study evaluated 50 children with ADHD and other behavioral issues and found that 6 months of 200mg magnesium supplementation lead to significant improvement in hyperactivity symptoms.

  • Vitamin B6 - Vitamin B6 (pyridoxine) is needed for normal brain development and function, and also plays a role in the formation of several neurotransmitters. Several studies have found that vitamin B6 combined with magnesium can help to reduce hyperexcitability, aggressiveness, and behavioral problems in school aged children.

  • Vitamin D - Vitamin D plays a vital role in the development and function of the brain. Research shows that higher maternal vitamin D levels are associated with lower risk of developing ADHD-like symptoms in childhood. A 2018 study examined the effects of vitamin D supplementation in 50 children with ADHD, and found that vitamin D supplementation may improve cognitive function.

Another popular therapeutic intervention is pet therapy, which uses a trained animal to help children cope with their condition. A small clinical study that evaluated non-medicated ADHD children 7 to 9 years of age found that pet therapy involving dogs improved parent-reported symptoms of ADHD when compared with a control group. Equine therapy (interactions with horses) twice weekly for 12 weeks has been shown to help improve attention, impulsivity, and quality of life.

In sum

Children with ADHD have problems with paying attention and controlling impulsive behaviors, which can affect how well they perform in school and how they interact with other children. There are numerous prescription drugs available that effectively treat ADHD, however, many of these drugs come with undesirable side effects. If your child has ADHD, it may be worth considering natural treatment options, such as the Monarch eTNS System, dietary supplements, or pet therapy. Of course, it’s important to discuss these treatment options with your child’s doctor first.

References:

NIH, “Attention-Deficit/Hyperactivity Disorder (ADHD): The Basics”

Child Mind Institute, “Side Effects of ADHD Medication” Roy Boorady, MD

Clinical Advisor, “First Prescription Device Approved to Treat ADHD” Diana Ernst, RPh, April 24, 2019

Clin Psychopharmacol Neurosci. 2017 Feb; 15(1): 9–18.

DrJockers.com, “12 Strategies to Beat ADHD Naturally”

Magnes Res. 1997 Jun;10(2):149-56.

Journal of the American College of Nutrition, “Magnesium VitB6 Intake Reduces Central Nervous System Hyperexcitability in Children”, 2004 23:5, 545S-548S

Epidemiology. 2015 Jul;26(4):458-65

J Hum Nutr Diet. 2014 Apr;27 Suppl 2:284-91

Ann Pharmacother. 2018 Jul;52(7):623-63

Natural Medicines, “Natural Medicines and Alternative Therapies in the Clinical Management of Pediatric Developmental Disorders”