In the News – ADHD

I saw an article in the news this morning: St. John's wort fails to help kids with ADHD.

The article talks about how a study was recently completed that had children suffering from ADHD take St. John's Wort. Half the participants took the St. John's Wort and half took the placebo. The conclusion? St. Johns' Wort does nothing to curb ADHD. But I'll get back to that in a minute. I always hear about ADHD in the news and although I think I have an idea as to what it is, I want to have a better picture.

So, the first question is, what exactly is Attention Deficit Hyperactivity Disorder (ADHD)? According to Wikipedia, "Attention-Deficit Hyperactivity Disorder (ADHD) is a neurobehavioral developmental disorder affecting about 3-5% of the world's population under the age of 19."

Surprisingly, both WebMD and The National Institute of Mental Health (NIMH) did not have a definition like that. They simply said that it's a "common condition in children" (according to WebMD) and "a condition that becomes apparent in some children in the preschool and early school years." (according to NIMH).

Brief History of ADHD (from NIMH)

ADHD was first described by Dr. Heinrich Hoffman in 1845. A physician who wrote books on medicine and psychiatry, Dr. Hoffman was also a poet who became interested in writing for children when he couldn't find suitable materials to read to his 3-year-old son. The result was a book of poems, complete with illustrations, about children and their characteristics. "The Story of Fidgety Philip" was an accurate description of a little boy who had attention deficit hyperactivity disorder. Yet it was not until 1902 that Sir George F. Still published a series of lectures to the Royal College of Physicians in England in which he described a group of impulsive children with significant behavioral problems, caused by a genetic dysfunction and not by poor child rearing—children who today would be easily recognized as having ADHD. Since then, several thousand scientific papers on the disorder have been published, providing information on its nature, course, causes, impairments, and treatments.

Symptoms of ADHD (from NIMH)

The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. These symptoms appear early in a child’s life. Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional.

Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more. Different symptoms may appear in different settings, depending on the demands the situation may pose for the child’s self-control. A child who "can't sit still" or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked. The impulsive child who acts before thinking may be considered just a "discipline problem," while the child who is passive or sluggish may be viewed as merely unmotivated. Yet both may have different types of ADHD. All children are sometimes restless, sometimes act without thinking, sometimes daydream the time away. When the child’s hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships with other children, or behavior at home, ADHD may be suspected. But because the symptoms vary so much across settings, ADHD is not easy to diagnose. This is especially true when inattentiveness is the primary symptom.

How is ADHD Diagnosed? (from NIMH)

Ideally, the diagnosis should be made by a professional in your area with training in ADHD or in the diagnosis of mental disorders. Child psychiatrists and psychologists, developmental/behavioral pediatricians, or behavioral neurologists are those most often trained in differential diagnosis. Clinical social workers may also have such training.

The family can start by talking with the child’s pediatrician or their family doctor. Some pediatricians may do the assessment themselves, but often they refer the family to an appropriate mental health specialist they know and trust. In addition, state and local agencies that serve families and children, can help identify appropriate specialists.

Now that we know a little more about ADHD, back to the article...

St. John's wort, pine bark extract and blue-green algae are among commonly used herbal treatments for children with ADHD. They appeal to parents who want to avoid stimulants like Ritalin and other drugs used to help children control their behavior.

"Do an Internet search and you'll find a wide variety of herbal products marketed for ADHD,'' said lead author Wendy Weber of Bastyr University's School of Naturopathic Medicine in suburban Seattle. "I've found there is very little research on the majority of products out there.''

Weber, working with colleagues at Harvard University and University of Washington, focused on St. John's wort because studies in rats found it increases brain chemicals like norepinephrine, which is thought to help focus attention.

Weber reasoned St. John's wort might work the same way as the prescription drug Strattera, approved by the Food and Drug Administration to treat ADHD. Strattera makes norepinephrine more available in the brain.

In the study, appearing in Wednesday's Journal of the American Medical Association, 54 children with ADHD were randomly assigned to take either St. John's wort capsules three times a day or placebos. They ranged in age from 6 to 17 years old.

Symptoms were measured at the start of the study and four other times. After eight weeks, the two groups showed no difference in symptoms or side effects.

The study's results should give pause to parents who have avoided well researched prescription medicines in favor of herbal remedies, said Dr. Eugenia Chan of Children's Hospital Boston, who was not involved in the new research.

But "natural'' doesn't mean risk-free. St. John's wort can increase sensitivity to the sun and reduces the effectiveness of some medications, including birth control pills.

The research follows other studies with disappointing results for alternative remedies such as echinacea for the common cold, saw palmetto for prostate problems and glucosamine and chondroitin for arthritis pain.




I personally never saw a benefit from using herbal remedies for anything, but that's just me. Some people swear by them. Now hopefully you know a little more about ADHD.