Part 1 - Alternative Treatments and ADHD - Omega 3/Fish Oil

 Omega 3 Fatty Acids and Fish Oil

     Consistent disagreement remains in the discussion regarding the benefit of including Omega 3 fatty acids or fish oil in the diets of those suffering from ADHD, yet the majority of evidence seems to support the conclusion that this supplement is questionable at best.  A 2016 study examined the effects of a marine oil extract on the levels of hyperactivity, inattention, cognition, and mood in children.^A Researchers discovered that the ingestion of such supplementation did not result in the improvement of parental reports in regard to hyperactivity, inattention and impulsivity, though some positive effect was seen in children without the ADHD diagnosis.^A  Additionally, extensive review articles can be found on the subject, comparing numerous studies on this topic.  In a review of 16 randomized controlled trials including 1,514 youth with the ADHD diagnosis, overall conclusions displayed that the use of Omega-3/6 supplementation had promising effects and could be effectively used as adjunctive therapy to the more traditional approaches.^A  However, this review has significant limitations as the authors were funded by Equazen, a company that manufactures Omega-3/6 supplements, thus likely bringing significant bias into the findings.^B Another review considered multiple studies investigating the benefits of Omega-3 supplementation in children labeled with the ADHD diagnosis and found multiple discrepancies among those examined.^C Lack of placebo groups, small sample sizes, and minimal trial length contributed to the inconsistencies of the studies and subsequent lack of reliability.^C  In a study investigating the effectiveness of Omega 3 supplementation used in conjunction with methylphenidate (a drug commonly prescribed for ADHD), researchers concluded that the Omega 3 addition provided subjects with significantly better outcomes when compared with controls.^D Though this double-blinded randomized clinical trial shows benefit, there are limitations which require attention and are acknowledged by the researchers.^D The study looked at a notably small sample size of 40 children within a limited age range of 6-12 years and lasted over a period of only 8 weeks.^D These factors alone bring into question the validity of the results, thus requiring further investigation before concrete conclusions can be made. Therefore, though some research points to the potential benefits of Omega 3 supplementation in children with the ADHD diagnosis, it appears that greater bodies of research point to the ineffectiveness or at best, minimal effectiveness of this treatment.

References

A. Kean JD, Sarris J, Scholey A, et al. Reduced inattention and hyperactivity and improved cognition after marine oil extract (PCSO-524^R) supplementation in children and adolescents with clinical and subclinical symptoms of attention-deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled trial. Psychopharmacology. 2017; 234: 403-420.
B. Derbyshire E Do omega-3/6 fatty acids have a therapeutic role in children and young people with ADHD. Journal of Lipids. 2017; 2017: 1-9.

C. Konigs A, Kiliaan AJ. Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment. Neuropsychiatric Disease and Treatment. 2016; 12: 1869-1882.
D. Moghaddam MF, Shamekhi M, Rakshani T. Effectiveness of methylphenidate and PUFA for the treatment of patients with ADHD: a double-blinded randomized clinical trial. Electronic Physician. 2017; 9: 4412-4418. Available from: http://www.ephysician.ir. Accessed December 15, 2017.