Part II - Alternative Treatments and ADHD - Magnesium

     Magnesium

     Another supplement frequently recommended as an alternative or adjunctive treatment for ADHD is magnesium. An initial look at the research gives reason to believe that magnesium supplementation may offer some treatment benefit. In a 1997 research study on the effectiveness of magnesium supplementation in hyperactive children, 50 subjects ages 7-12 were observed over the course of 6 months.^E At the conclusion of the 6 month trial period, the test group showed increased levels of magnesium as well as decreased incidence of hyperactivity when compared to the control group.^E The small sample size may pose a limitation to the outcome of this study. With similar findings, a longitudinal, observational study was conducted in Germany with 810 children ages 5-12 over the course of 3 months.^F Results showed that when subjects were given Esprico (a food supplement combining omega 3, omega 6, zinc and magnesium), they experienced substantial reductions in ADHD symptoms, emotional and behavioral problems and sleep challenges.^F Once again, significant limitations to this study exist. A drop-out rate of 14% was noted due to absence of positive effect, lack of compliance or adverse reactions.^F Further, 7.3% of the subjects were taking other medications or involved in alternate treatment as well, such as medications for obstructive pulmonary disease, thyroid therapeutics, psycho stimulants, unspecified amphetamines, non-stimulant medication and homeopathic remedies.^F In addition, the study did not provide a control group, posing considerable limitation to the reliability of the research outcomes.^F Perhaps most significant of the limitations of this study is the fact that it was funded by a grant from Engelhard Arneimittel, a German Pharmaceutical company, likely leading to investigator bias. A review of the literature regarding magnesium supplementation in children with the ADHD diagnosis can shed light on the problematic nature of stating that magnesium is an effective treatment for this disorder. Esparham et al. reviewed multiple articles in the efficacy of magnesium supplementation in ADHD-diagnosed children.^G Though a summary of the study outcomes showed benefit with this therapy, a marked number of limitations were present across the studies.^G Systematic review revealed that the majority of the studies had methodological limitations such as lack of double-blind randomized controlled study design and lack of measurement standardization in regard to the levels of magnesium.^G The general outcome of these studies may, at best, offer reason to investigate this treatment modality in future research. 

References

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.

E. Starobrat-Hermelin B, Kozielec T. The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test. Magnesium Research. 1997; 10: 149-156.

F. Huss M, Volp A, Strauss-Grabo M. Supplementation of polyunsaturated fatty acids, magnesium and zinc in children seeking medical advice for attention-deficit/hyperactivity problems – an observational cohort study. Lipids in Health and Disease. 2010; 9: 105-117.

G. Esparham A, Evans RG, Wagner LE, Drisko JA. Pediatric integrative medicine approaches to attention deficit hyperactivity disorder (ADHD). Children. 2014; 1: 186-207.