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Micronutrient Supplement May Ease Adult ADHD, Boost Mood
Megan Brooks
January 30, 2014
A nutritional supplement packed with vitamins and minerals
helped reduce symptoms of attention-deficit/hyperactivity disorder (ADHD) in
adults and improved mood in a subset with moderate depression, new research
shows.
A double-blind, randomized, placebo-controlled trial
conducted by investigators at the University of Canterbury, Christchurch, New
Zealand, showed that a micronutrient formula consisting of vitamins and minerals
was significantly better than placebo in reducing ADHD symptoms.
"Our study provides preliminary evidence of the
effectiveness of micronutrients in the treatment of ADHD symptoms in adults.
This could open up treatment options for people with ADHD who may not tolerate
medications or do not respond to first-line treatments," lead investigator
Julia Rucklidge, PhD, clinical psychology professor, University of Canterbury,
Christchurch, New Zealand, said in a statemen
The study was published online January 30 in the British
Journal of Psychiatry.
Area of Growing Interest
The role of nutrition in the treatment of ADHD is gaining
interest. However, the focus has largely been on diet restriction or
supplementing with 1 nutrient at a time, the investigators note.
They conducted the first double-blind, randomized,
placebo-controlled trial of a broad-spectrum micronutrient formula called
EMPowerplus in adults with ADHD.
EMPowerplus contains 36 ingredients (14 vitamins, 16
minerals, 3 amino acids, and 3 antioxidants). According to its makers, TrueHope
Nutritional Support, EMPowerplus "works by giving the brain the right
balance of vitamins and trace minerals on a regular basis."
"This micronutrient formula has been examined in over
20 published studies for treating various mental conditions, has documented
evidence of both short- and long-term safety data, and has been more
extensively examined in psychiatric conditions than any other
multivitamin/multimineral formula; however, as of yet, no masked trials have been
conducted on it," the investigators note.
Dr. Julia Rucklidge
"I simply got interested in whether the claims could be
substantiated with a double-blind clinical trial," Dr. Rucklidge told
Medscape Medical News.
The study involved 80 adults with untreated ADHD. For 8
weeks, 42 took the micronutrient supplement (15 capsules per day, in 3 doses of
5 capsules, taken with food and water), and 38 took matching placebo.
According to the investigators, the micronutrient treatment
induced "statistically robust improvements in several indices, from ADHD
symptoms to global assessment of functioning, compared with placebo, with
effect sizes ranging from 0.46 to 0.67."
Adults taking the micronutrient formula reported greater
improvement in both inattention and hyperactivity/impulsivity compared with
those taking a placebo. Improvement in hyperactivity/impulsivity was also noted
by observers ― typically, a friend, partner, or parent.
Clinicians did not observe group differences on ADHD rating
scales, but they did rate the individuals taking the micronutrients as
functioning better in terms of their work, social relationships, and global
psychological functioning.
In post hoc analyses, adults with moderate/severe depression
at baseline had a greater change in mood favoring micronutrient treatment over
placebo. This finding is consistent with other randomized controlled trials
that show benefit of micronutrients in improving mood, the investigators note.
There were no group differences in adverse events.
Novel and Noteworthy
"There is much research linking diet and also nutrient
supplements to mental health, but this new study is noteworthy and novel for
many reasons," Bonnie Kaplan, PhD, from the University of Calgary in
Alberta, Canada, told Medscape Medical News.
"First, it's placebo-controlled. Even though there is a
growing body of more than 20 peer-reviewed publications on this broad-spectrum
formula (actually developed in Alberta), this is the first trial that was
placebo-controlled," said Dr. Kaplan. She was not involved in the study
but has long studied the relationship between nutrition and mental health.
"Another important aspect that is novel is that the
researchers are independent academic scientists, and the study was not funded
by any manufacturers. One could not make this statement about most medication
trials," Dr. Kaplan said.
"Another very important novelty is that they studied a
broad-spectrum vitamin plus mineral formula, which is likely the way in which
humans have evolved to need nutrients. Single-nutrient research does not
respect the fact that we need all these vitamins and minerals every day, and in
balance. This means this vitamin plus mineral intervention is more ecologically
valid than many studies," Dr. Kaplan said.
Jerome Sarris, PhD, MHSc, senior research fellow, Department
of Psychiatry, University of Melbourne, Australia, agrees."Minerals and
vitamins work in synergy, and combinations are often required for the body to
utilize to perform many neurochemical activities (such as those that influence
maintaining concentration or mood)," Dr. Sarris told Medscape Medical
News.
"This new study is novel and of value, due to the
common issue of most nutraceutical studies using only isolated nutrients,"
added Dr. Sarris, who also was not involved in the research.
He cautioned that more randomized controlled trials are
needed in the field to "truly assess the potential benefits of
nutrient-based formulas. These results, while positive, are preliminary and
need to be repeated in a larger sample for a longer period of time to be fully
validated."
Dr. Rucklidge and colleagues have just started recruitment
for a similar trial in children with ADHD.
"We plan to recruit 100 children 8 to 12 to see whether
the micronutrients may be helpful in reducing ADHD symptoms as compared with
placebo," she said.
"We hope to move further towards understanding
mechanisms of action, although with all the ingredients, this can be a
challenge. We are also running other studies in the lab, looking at the effect
of micronutrients on sleep, anxiety, and addictions. We are also investigating
other ways forward for treating mental illness, including the use of
probiotics," she said.
The authors, Dr. Kaplan, and Dr. Sarris report no relevant
financial relationships.
Br J Psychiatry. Published online January 30, 2014. Abstract
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