Efficacy and Safety of Polyunsaturated Fatty Acids Supplementation in the Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adolescents: A Systematic Review and Meta-Analysis of Clinical Trials

Based on epidemiological and animal studies, the rationale for using polyunsaturated fatty acids (PUFAs) as a treatment for Attention Deficit Hyperactivity Disorder (ADHD) seems promising. Here, the objective was to systematically identify and critically assess the evidence from clinical trials. The primary outcome was ADHD core symptoms. The secondary outcomes were behavioral difficulties, quality of life, and side effects. We performed a systematic search in Medline, Embase, Cinahl, PsycInfo, and the Cochrane Library up to June 2020. The overall certainty of evidence was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). We identified 31 relevant randomized controlled trials including 1755 patients. The results showed no effect on ADHD core symptoms rated by parents (k = 23; SMD: −0.17; 95% CI: −0.32, −0.02) or teachers (k = 10; SMD: −0.06; 95% CI: −0.31, 0.19). There was no effect on behavioral difficulties, rated by parents (k = 7; SMD: −0.02; 95% CI: −0.17, 0.14) or teachers (k = 5; SMD: −0.04; 95% CI: −0.35, 0.26). There was no effect on quality of life (SMD: 0.01; 95% CI: −0.29, 0.31). PUFA did not increase the occurrence of side effects. For now, there seems to be no benefit of PUFA in ADHD treatment; however, the certainty of evidence is questionable, and thus no conclusive guidance can be made. The protocol is registered in PROSPERO ID: CRD42020158453.

Download Full-text

Quality of Life and Attention-Deficit/Hyperactivity Disorder Core Symptoms

Journal of Clinical Psychopharmacology ◽

10.1097/jcp.0b013e3181d21763 ◽

2010 ◽

Vol 30 (2) ◽

pp. 145-151 ◽

Cited By ~ 19

Author(s):

Rodrigo Escobar ◽

Alexander Schacht ◽

Peter M. Wehmeier ◽

Thomas Wagner

Keyword(s):

Quality Of Life ◽

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Hyperactivity Disorder ◽

Core Symptoms

Download Full-text

Differences between children and adolescents in treatment response to atomoxetine and the correlation between health-related quality of life and Attention Deficit/Hyperactivity Disorder core symptoms: Meta-analysis of five atomoxetine trials

Child and Adolescent Psychiatry and Mental Health ◽

10.1186/1753-2000-4-30 ◽

2010 ◽

Vol 4 (1) ◽

Cited By ~ 14

Author(s):

Peter M Wehmeier ◽

Alexander Schacht ◽

Rodrigo Escobar ◽

Nicola Savill ◽

Val Harpin

Keyword(s):

Quality Of Life ◽

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Meta Analysis ◽

Health Related Quality ◽

Hyperactivity Disorder ◽

Related Quality ◽

Health Related ◽

Core Symptoms

Download Full-text

Estimating minimal important differences for several scales assessing function and quality of life in patients with attention-deficit/hyperactivity disorder

CNS Spectrums ◽

10.1017/s1092852916000353 ◽

2016 ◽

Vol 22 (1) ◽

pp. 31-40 ◽

Cited By ~ 8

Author(s):

Paul Hodgkins ◽

Andrew Lloyd ◽

M. Haim Erder ◽

Juliana Setyawan ◽

Margaret D. Weiss ◽

...

Keyword(s):

Quality Of Life ◽

Attention Deficit Hyperactivity Disorder ◽

Clinical Trials ◽

Attention Deficit ◽

Total Sample ◽

Parent Report ◽

Hyperactivity Disorder ◽

Quality Of Life Scale ◽

Patient Reported

ObjectiveDefining minimal important difference (MID) is critical to interpreting patient-reported outcomes data and treatment efficacy in clinical trials. This study estimates the MID for the Weiss Functional Impairment Rating Scale–Parent Report (WFIRS-P) and the Child Health and Illness Profile–Parent Report (CHIP-CE-PRF76) among parents of young people with attention-deficit/hyperactivity disorder (ADHD) in the UK.MethodsParents of children (6–12 years; n=100) and adolescents (13–17 years; n=117) with ADHD completed a socio-demographic form, the CHIP-CE-PRF76, the WFIRS-P, and the Pediatric Quality of Life scale at baseline and 4 weeks later. At follow-up, a subset of parents completed anchor questions measuring change in the child/adolescent from baseline. MIDs were estimated using anchor-based and distribution-based methods, and separately for children and adolescents.ResultsThe MID estimates for overall change in the WFIRS-P total score ranged from 11.31 (standard error of measurement) to 13.47 (anchor) for the total sample. The range of MID estimates for the CHIP-CE-PRF76 varied by domain: 6.80–7.41 (satisfaction), 6.18–7.34 (comfort), 5.60–6.72 (resilience), 6.06–7.57 (risk avoidance), and 4.00–5.63 (achievement) for the total sample. Overall, MID estimates for WFIRS-P MID and CHIP-CE-PRF76 were slightly higher for adolescents than for children.ConclusionThis study estimated MIDs for these instruments using several methods. The observed convergence of the MID estimates increases confidence in their reliability and could assist clinicians and decision makers in deriving meaningful interpretations of observed changes in the WFIRS-P and CHIP-CE in clinical trials and practice.

Download Full-text