ADHD, which stands for Attention Deficit Hyperactivity Disorder, refers to symptoms such as inattentiveness and hyperactivity. Of course every child who is on occasion particularly careless, easily distracted, noisy or energetic does not earn this label. It takes time to reach a correct diagnosis.
In ADHD, certain areas of the brain are less used, and these areas are also 10% smaller in volume. Because the Omega 2 fatty acid DHA is a nutrient for the brain, it seemed reasonable to investigate whether it was possible to correct this slight deviation by taking more Omega 3. Observational studies suggest that a low level of Omega 3 in the blood is associated with a higher probability of ADHD symptoms.
What does the science say?
Firstly, supplements of both EPA and DHA were tested in children and young people with ADHD. EPA and DHA are the Omega 3 fatty acids from fish oil. The most significant results are encouraging: When the quantity of EPA +DHA was increased in the blood stream, these patients were better able to concentrate and, according to their parents, their ADHD symptoms were better controlled.
The dominant symptoms of hyperactivity and impulsiveness could only be addressed with a high level of EPA in the fish oil supplement (a daily dose of > 500 mg EPA). Any trial of an Omega-3 supplement must be given a chance for at least 15 weeks. That is the length of the study that lead to beneficial results.
'A low level of Omega 3 is associated with a higher probability of ADHD symptoms'
Can Omega 3 be combined with methylphenidate?
Yes, and in fact the combination is beneficial. Methylphenidate is the medication used in ADHD, but there are some drawbacks. The most common side-effects are lack of apetite and sleep problems. Headaches, irritability and stress have also been reported. When methylphenidate is combined with Omega 3, these side-effects occur less frequently.
In a comparative stidy, 70% of the children taking methylphenidate had significant loss of apetite, compared with only 33% of children who combined methylphenidate with Omega 3. When it was combined with Omega 3, insomnia was no longer found.
There is second advantage to the combination with Omega 3, because the same clinical effect can be obtained from the combination in a lower dose than when methylphenidate is used alone.
The verdict remains positive
After over fifteen years of research, the verdict remains positive: the Omega-3 fatty acids EPA and DHA have a place in tackling the symptoms of ADHD. Some children and young people can be treated with Omega 3 alone, others can reduce their medication if it is taken in combination with Omega 3.
The target value for the EPA component of the supplement is at least 500 mg daily, particularly for dominant symptoms of hyperactivity and impulsiveness. Naturally, ADHD demands a multi-faceted approach, in which every aspect of treatment is important. Combining forces leads to a good result.
- Agostoni C, Nobile M, Ciappolino V, Delvecchio G, Tesei A, Turolo S, Crippa A, Mazzocchi A, Altamura CA10, Brambilla P. The Role of Omega-3 Fatty Acids in Developmental Psychopathology: A Systematic Review on Early Psychosis, Autism, and ADHD. Int J Mol Sci 2017; 18(12).
- Barragán E, Breuer D, Döpfner M. Efficacy and Safety of Omega-3/6 Fatty Acids, Methylphenidate, and a Combined Treatment in Children With ADHD. J Atten Disord 2017; 21(5):433-441.
- Chang JP, Su KP, Mondelli V, Pariante CM. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology 2018; 43(3):534-545.