Prevalence of ADHD is around 5% in adults.Adult ADHD is less responsive to treatments compared with those in children. Stimulants are the standard treatment of choice. Diet and nutrient interventions have a long history in the search for alternative effective treatments. It is thought that such treatments might help by 1. functioning as cofactors for various metabolic pathways in the brain 2. correcting inborn errors of metabolism 3. Improving mitochondrial and membrane functioning 4. promoting healthy GI functioning and improved absorption of nutrients.
Julia J. Rucklidge, Chris M. Frampton, Brigette Gorman and Anna Boggis from New Zealand report the results of the first double-blind, parallel–group RCT designed to assess the efficacy and safety of a broad-spectrum micronutrient formula, EMPowerplus, compared with placebo in adult ADHD. 80 adults with ADHD (meeting criteria using Conners Adult ADHD Diagnostic Interview for DSM-IV) were assigned in a 1:1 ratio to 8 weeks of treatment with either micronutrients or placebo.Participants were not on psychotropics for at least 4 weeks. They were assessed at baseline and 1,2,4,6, and 8 weeks.
Self and observer rated scales showed significant benefit with micronutrients. Clinician rated CGI also showed better response in active treatment group. Clinician rated Conners scale did not show any significant benefit. The effect size of observed benefits are of medium to large range (0.46 to 0.67). 64% of those in the micronutrient group showed at least 30% drop on at least one subscale of the Conners scale from baseline compared to 37% in the placebo group .Micronutrient did not differ from placebo in side effects.
Limitations: Clinicians did not observe group differences on rating scales, but reported greater global functioning. Findings on attention were varied. Attention scores in the micronutrient group remained elevated.No neurocognitive measures were used. Study recruited only uncomplicated ADHD.Longterm effects unknown.Given the inconsistency across raters larger study is required.
Micro- nutrient treatment appears to benefit adult ADHD. Benefits with micronutrients are modest compared to medication trials.
Summary of the article:
Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial. Julia J. Rucklidge, Chris M. Frampton, Brigette Gorman and Anna Boggis. BJP published online January 30, 2014 Access the most recent version at DOI: 10.1192/bjp.bp.113.132126