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Vitamin–mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial

  • Julia J. Rucklidge (a1), Chris M. Frampton (a2), Brigette Gorman (a1) and Anna Boggis (a3)
Abstract
Background

The role of nutrition in the treatment of attention-deficit hyperactivity disorder (ADHD) is gaining international attention; however, treatments have generally focused only on diet restriction or supplementing with one nutrient at a time.

Aims

To investigate the efficacy and safety of a broad-based micronutrient formula consisting mainly of vitamins and minerals, without omega fatty acids, in the treatment of ADHD in adults.

Method

This double-blind randomised controlled trial assigned 80 adults with ADHD in a 1:1 ratio to either micronutrients (n = 42) or placebo (n = 38) for 8 weeks (trial registered with the Australian New Zealand Clinical Trials Registry: ACTRN12609000308291).

Results

Intent-to-treat analyses showed significant between-group differences favouring active treatment on self- and observer- but not clinician-ADHD rating scales. However, clinicians rated those receiving micronutrients as more improved than those on placebo both globally and on ADHD symptoms. Post hoc analyses showed that for those with moderate/severe depression at baseline, there was a greater change in mood favouring active treatment over placebo. There were no group differences in adverse events.

Conclusions

This study provides preliminary evidence of efficacy for micronutrients in the treatment of ADHD symptoms in adults, with a reassuring safety profile.

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Copyright
Corresponding author
Julia Rucklidge, Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand. Email: julia.rucklidge@canterbury.ac.nz
Footnotes
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Declaration of interest

None.

Footnotes
References
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Vitamin–mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial

  • Julia J. Rucklidge (a1), Chris M. Frampton (a2), Brigette Gorman (a1) and Anna Boggis (a3)
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RE: Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial

I read with interest the paper by Dr. Rucklidge and collaborators on the “preliminary evidence of efficacy of micronutrients in ADHD” (1). I would comment on those results:

1. The findings are rather controversial since only two measurements (self- and observer’s ratings) showed some difference while a third one (clinician rating) did not.

2. It is not clear from this or other papers celebrating the wonders of nutrients which of those ingredients is effective (and which is not) or why that particular combination was chosen.

3. I am not sure that I would recommend a combination of 36 micronutrients at doses up to 10 times higher than the daily allowed for undefined periods of times. Are there studies on the long-term consequences of at least one of them?

4. A quick verification of the cost of EMPowerplus (the nutrient combination advertised by the paper) is about 70 USD for 30 days. Of course, this is not reimbursed by the NHS.

5. Since the paper acknowledges the above-mentioned program which is sold online, it is hard to believe that the authors have no conflict of interest as claimed in the Declaration of Interest.

Reference

1. Rucklidge JJ, Frampton CM, Gorman B, Boggis A. Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial. Br J Psychiatry 2014;204:306–315.

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Conflict of interest: None Declared

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Vitamin-mineral treatment of attention-deficit hyperactivity disorder (ADHD)

Manjeet S, Bhatia
16 May 2014

The article by Rucklidge et al (1) merits attention by the experts dealing with patients having ADHD. Being a prospective and placebo controlled study, it has demonstrated the role of micronutrient treatment in managing ADHD. Iron and magnesium deficiency has been consistently reported (2,3). The correction of these deficiencies lead to improvement in ADHD. A review of all studies (4) relating to ADHD and iron levels in 2012 found mixed results. Some studies showed clear correlations, including improvements in the Conner's Parent Rating when children were given iron supplements. One study showed increased levels of iron. But there were also many studies that did not indicate any correlation betweenADHD and iron levels. A systematic search identified 11 RCTs that investigated the effects of these food supplements. Despite positive results for some individual trials, more studies are required before conclusions can be reached on the value in reducing ADHD symptoms of any of these additional supplements(5). The prospective groups can include ADHD with and without micronutrient deficiency and then finding out role of nutrient supplementation in both these groups.References:1.Rucklidge jj, Frampton CM, Gorman B,Boggis A.Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial.Br J Psychiatry 2014 204:306-315.2.Philips A.Kids with ADHD: Iron Deficiency and the Need for Magnesium. http://voices.yahoo.com/kids-adhd-iron-deficiency-magnesium-10463961.html?cat=253.Parisi P1, Villa MP, Donfrancesco R, et al.Could treatment of iron deficiency both improve ADHD and reduce cardiovascular risk during treatment with ADHD drugs? Med Hypotheses 2012;79(2):246-9.4.Cortese S, Angriman M, Lecendreux M, Konofal E. Iron and attention deficit/hyperactivity disorder: What is the empirical evidence so far? A systematic review of the literature. Expert review of neurotherapeutics. Oct 2012;12(10):1227-1240.5. Stevensoni J, Buitelaar J, Cortease S, et al.Research Review: The role of diet in the treatment of attention-deficit/hyperactivity disorder - an appraisal of the evidence on efficacy and recommendations on the design offuture studies.J Child Psychol Psychiatry 2014;55:416-427.

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