How do clinicians approach the treatment of ADHD?

When it comes to treating Attention Deficit Hyperactivity Disorder (ADHD), clinicians carefully weigh the options and make a recommendation based on relevant factors. Every treatment option has a different risk-to-benefit ratio. Obviously, the higher the benefit and the lower the risk, the more attractive a treatment option becomes.

Typically, though, when a treatment with little to no risks, shows even a modest benefit (e.g., walking 20 minutes per day, or eating an additional serving of fruits or vegetables per day), then it’s something that clinicians can recommend for any individual either as a supplement to an existing treatment or as a primary treatment for those with a milder illness.

Supplementing with omega-3 fatty acids, especially doses containing eicosapentaenoic acid (EPA), is one of those treatments that has little to no risks and modest benefit, so it’s worth adding as a recommended treatment for children with ADHD (whether mild or severe). Let’s look at the science and the benefits.

The Science Behind Omega-3s as an Alternative Treatment For ADHD

Several studies have found differences in omega-3 fatty acid composition in the blood of people with ADHD versus unaffected control groups. Because we know that omega-3 fatty acids have anti-inflammatory properties and can affect the fluidity of central nervous system cell membranes, which can alter serotonin and dopamine levels, it stands to reason that omega-3’s could prove effective in the treatment of ADHD.

Indeed, this is what scientists found after running ten trials involving 699 children. Children receiving omega-3 fatty acid supplements demonstrated a small, but statistically significant, improvement in their symptoms of ADHD. Of course, the efficacy of such a treatment was modest when compared to other pharmacological treatments such as psychostimulants (e.g., amphetamines, methylphenidate), atomoxetine (e.g., strattera), or alpha-2 agonists (e.g., clonidine, guanfacine). 

Nonetheless, given its relatively benign side-effects and evidence of modest benefits, it’s reasonable to recommend omega-3 fatty acids in addition to traditional pharmacological interventions or as a primary treatment option for families who decline other options.

How to Start Treatment

It’s important to note that in the above studies, omega-3 supplements with higher doses of EPA (as opposed to DHA and ALA) were significantly associated with increased efficacy in treating ADHD symptoms. For this reason, I recommend that you aim for an EPA dose between 600mg and 750mg, and DHA dose between 1/100 to 1/2 of the EPA dose.

Also, the duration of these studies ranged from 4-16 weeks. So, I recommend patients treated with omega-3’s take the supplements on a daily basis for at least four months before drawing conclusions about their efficacy.

6 Benefits of Omega-3’s

Clearly, taking omega-3 fatty acids alone is not the best treatment option for patients with severe symptoms. However, there are several great reasons to add essential fatty acids to an existing treatment plan for ADHD. Here are six benefits:

1. Speed in starting treatment: Parents and patients can stop at Walmart or their local pharmacy to pick up a bottle of pills on their way home from work and begin taking the proper dosage immediately.
2. There are essentially no side effects: Unlike prescription psychopharmaceuticals, like Adderall and Ritalin, which have side effects that can range from mild to more severe, omega-3’s are fine for nearly anyone to take.
3. Other physical and mental health benefits: Even if omega-3’s have no noticeable effect on reducing ADHD symptoms, they provide other health benefits, like improved heart function, improved cognitive function, and ease in weight management.
4. Long-term convenience: If you move to a new city, you don’t need to worry about finding a new doctor to prescribe this supplement. If you travel overseas and forget your supplement, you can buy it from a drugstore, whereas if you forget your prescription medication, you have a much bigger issue.
5. Minimal time commitment: Most ADHD treatments require an investment of time. For instance, coaching or cognitive therapy to control your ADHD symptoms requires time to meet with your therapist weekly and when you’re prescribed medication, you must attend visits every 4-12 weeks for refills and monitoring. With omega-3 fatty acids, all you have to do is take one or two pills daily.
6. Low upfront and ongoing costs: ADHD prescription drugs, along with psychiatric treatment and therapy can be cost-prohibitive for many families, especially those without enough medical insurance coverage. But omega-3 supplements are relatively low in price and can be found in many healthy foods. Fish, such as salmon, mackerel, herring, and sardines, are an especially good source of omega-3 fatty acids containing EPA. 

For all these benefits and more, omega-3 fatty acids with EPA are a good option for families who want to provide treatment for their child’s ADHD (or suspected ADHD) symptoms, but who don’t feel comfortable starting a medication for it, and/or don’t have the time, money, or resources to obtain a formal diagnosis.

And for families who are comfortable with the medication and therapy routes and who can afford such treatments, omega-3’s are a great addition because they can actually reduce the amount of medication or therapy needed to control ADHD symptoms.

If you or your child have been recently diagnosed with ADHD, it’s a good time to add omega-3 fatty acids to your treatment plan and if you or your child are looking to give your current treatment a boost, you basically can’t go wrong taking an omega-3 supplement.

Are you or your child struggling with hyperactivity, impulsivity, or difficulty focusing? Contact our clinic today to start exploring treatment options.