Primary care plays a key role in the management of
ADHD
Alternative therapies4
Many parents concerned about long-term stimulant medication for their child will seek alternative therapies. In general the results of studies are mixed and none have been found to be as effective as stimulant medications. However some may be suitable for particular individuals and a trial may be considered as long as this does not unduly delay the use of treatments of proven effectiveness.
Diet therapies usually involve restricting the diet to a limited range of foods or excluding food dyes and preservatives. Studies involving dietary modification show that this may help alleviate some symptoms but there appears to be no relationship between food dyes and ADHD.
Iron supplementation may improve academic performance in children with ADHD and iron deficiency and certainly iron deficiency. There is no evidence that iron supplementation for people with ADHD without iron deficiency is helpful.
Some herbal medications have been shown to reduce ADHD-like symptoms in patients with other disorders such as dementia or problems with concentration problems. This has led to experimentation with Ginko biloba, for people for whom inattention is the predominant feature of ADHD.
The use of essential fatty acids and L-glutamine in ADHD has not been subject to controlled clinical trials although claims for effectiveness have been made.
A study of electroencephalogram (EEG) biofeedback, the main goal being to provide neurofeedback to allow a person to produce an appropriate mental state for the task at hand. However the trial was of short duration, was not randomised, had no controls and included very few subjects.
Sugar has been suggested to increase hyperactivity in children. Although most studies find no link between sugar and ADHD, they are by no means conclusive. It is sensible to reduce refined sugar intake in all children whether or not they have ADHD.
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