Non-Pharmacological Treatments for ADHD

Non-Pharmacological Treatments for ADHD

Attention deficit hyperactivity disorder (ADHD), although most commonly diagnosed during the school years, can affect individuals across the lifespan. It is characterised by symptoms of inattention, overactivity, and/or impulsiveness that are age inappropriate, persistent, and pervasive. According to a 10-year follow up study by Biederman and colleagues, in the long term, ADHD is associated with significant risk of educational failure, interpersonal problems, mental illness, and delinquency. These can create substantial burden on families, healthcare, and the community. As such, many treatment approaches have been trialled.

While pharmacological treatments are widely known, according to Sonuga-Barke and colleagues, they are limited in a number of ways: normalisation is rare, long-term effectiveness remains to be established, and there are adverse effects on sleep, appetite, and growth. Conversely, a number of nonpharmacological approaches have been introduced to address the limitations of pharmacological alternatives.

In a systematic review and meta-analysis, Sonuga-Barke and colleagues assessed the efficacy of dietary (restricted elimination diets, artificial food colour exclusions, and free fatty acid supplementation) and psychological (cognitive training, neurofeedback, and behavioural interventions) ADHD treatments. The results showed that when the outcome measure was based on ADHD assessments by raters closest to the therapeutic setting, all dietary and psychological treatments produced statistically significant effects.

Biederman, J., Monuteaux, M.C., Mick, E., Spencer, T., Wilens, T.E., Silva, J.M., Snyder, L.E., Faraone, S.V. (2006). Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychological Medicine, 36, 167–179.

Sonuga-Barke, E. J. S., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., Stevenson, J., Danckaerts, M., van der Oord, S., Dopfner, M., Dittmann, R. W., Simonoff, E., Zuddas, A., Banaschewski, T., Buitelaar, J., Coghill, D., Hollis, C., Konofal, E., Lecendreux, M., Wong, I . C. K., Segeant, J., & European ADHD Guidelines Group. (2013). Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomised controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170, 275-289.

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