Children with attention-deficit/hyperactivity disorder (ADHD) and irritable mood who are not taking psychotropic medications may benefit from supplemental micronutrients, suggests a study in the Journal of the American Academy of Child & Adolescent Psychiatry.
Evaluations by clinicians revealed that a greater percentage of children who took micronutrient capsules for eight weeks experienced symptom improvements compared with children who took placebo pills, the study found. The children in the micronutrients group also grew taller on average over the eight-week trial.
“Although [the] findings did not demonstrate between-group differences on core symptoms of ADHD in this study, micronutrient supplementation was associated with global improvements that factored in a range of life domains including anxiety, anger, and sleep,” wrote Jeanette M. Johnstone, Ph.D., of Oregon Health & Science University and colleagues.
For the multisite trial, Johnstone and colleagues recruited children aged 6 to 12 who met DSM-5 criteria for ADHD and displayed at least one symptom of irritability or anger, according to parent reports. To be included in the trial, the participants had to be psychotropic medication free for at least two weeks and be willing to swallow 9 to 12 capsules a day with food.
The researchers randomly assigned 135 children to either the micronutrient or placebo groups. Children in the micronutrient group took capsules containing a blend of vitamins and essential minerals (including vitamins A and B12, folate, copper, potassium, and more), amino acids, and antioxidants. Children in the placebo group took the same number of placebo capsules from bottles with a mild vitamin/mineral scent. Parents completed the Child and Adolescent Symptom Inventory-5 (CASI-5), which assesses ADHD, oppositional defiant behavior, disruptive mood dysregulation, and peer conflict symptoms, at the start of the study as well as weeks 4 and 8. Clinicians completed the Clinical Global Impression-Improvement (CGI-I) subscale at week 8.
Of the 135 children randomized, 126 completed the trial. For the CGI-I, 54% of the micronutrient group and 18% of the placebo group were categorized as responders (defined by a CGI-I score of 1 or 2, “very much” or “much” improved). The parent-reported CASI-5 revealed significant improvements in both groups; however, there was no significant difference between these groups. Children in the micronutrient group on average grew six millimeters (about 0.24 inches) more than children in the placebo group. There were no differences in adverse events reported by children in either group.
“This fully-blinded RCT of micronutrients addresses several concerns related to existing ADHD treatment, including the possibility of counteracting height suppression and treating associated irritable mood, emotional dysregulation, and aggression,” the authors concluded. “Based on blood and urine tests and systematic adverse event reporting, micronutrients given at doses between the Recommended Dietary Allowance and Upper Tolerable Intake Level appear safe and may be developed into an alternative or complementary treatment for ADHD.”
For related information, see the Psychiatric News article “Irritable Symptoms in Youth With ADHD Don’t Necessarily Require Extra Medications.”