ADHD

Herbals and Herbal Formulas Used to Treat ADHD

Most findings are disappointing or inconsistent.

Posted May 03, 2018

Herbals used to treat ADHD: Mixed findings

This post is part of a series on non-pharmacologic treatments of ADHD. Previous posts briefly reviewed the evidence for dietary modification, EEG biofeedback, trace minerals and other alternative therapies. 

Disappointing findings for Ginkgo and Panax

In a 4-week open study involving 36 children diagnosed with ADHD, a herbal preparation containing Ginkgo biloba and Panax quinquefolium was added to their existing ADHD medication. Beneficial effects were observed in children taking the herbal combination after 4 weeks. It should be noted, however, that the absence of a placebo group (or a stimulant-only group) and the small size of the study limit the significance of findings. In a 6-week double-blind randomized parallel group comparison 50 children with a diagnosis of ADHD treated with Ginkgo biloba showed significantly less improvement in symptom severity than matched children who received methylphenidate (Ritalin) based on standardized Parent and Teacher ADHD rating scales (Salehi et al 2010). 

Inconsistent findings for Pycnogenol

Findings of open studies suggest that a standardized extract of Pinus pinaster (French Maritime Pine) bark is beneficial in ADHD; however, only one placebo-controlled randomized trial has been published to date. Sixty-one children and adolescents randomized to a standardized bark extract (Pycnogenol™) 1 mg/kg/day for 1 month experienced non-significant improvements in inattention, improved visual–motor coordination as evaluated by a psychologist but no improvements in symptoms of hyperactivity. Symptoms returned to pre-treatment baseline levels after a 1-month washout. Only one case of mild gastric discomfort was reported. These findings should be regarded as preliminary pending replication by large prospective studies. 

Bacopa monnieri is an Ayurvedic herbal used as a tonic and memory enhancer. In one randomized controlled trial 85 healthy men and women randomized to an extract containing G. biloba and B. monnieri did not perform better than a placebo group in tests of short-term memory, working memory, executive processing, planning, problem solving and information processing speed. These findings cannot be generalized to ADHD; however, they suggest that this herbal formula does not ameliorate the core symptoms of ADHD. 

Promising results of a patented herbal formula

In addition to single herbals various proprietary herbal and nutrient formulas are sometimes used to treat ADHD however little research evidence supports their use. A 4-month randomized double-blind placebo-controlled trial evaluated the efficacy of a patented herbal formula in 120 children diagnosed with ADHD. Evaluation of the efficacy of a patented, compound herbal preparation (CHP) in improving attention, cognition, and impulse control in children with ADHD (Katz et al 2010). Principle active ingredients included Paeoniae Alba, Withania Somnifera , Centella Asiatica, Spirulina Platensis, Bacopa Monieri, and Mellissa Officinalis. At study end the group receiving the herbal formula showed statistically significant improvement in symptoms of inattention, impulse control and cognition in all 4 subscales of the Test of Variables of Attention (TOVA) compared to no improvement in the control group. The herbal formula was well tolerated. Large prospective placebo-controlled studies are needed to confirm these preliminary findings.

For a concise review of the evidence for other non-pharmacologic treatments of ADHD read my e-book "ADHD--The Integrative Mental Health Solution

References

A compound herbal preparation (CHP) in the treatment of children with ADHD: a randomized controlled trial. https://www.ncbi.nlm.nih.gov/pubmed/?term=Katz+attention+deficit+disorder+herbals