Treatment alternatives for Attention-Deficit/ Hyperactivity Disorder (ADHD)

Twenty-three alternate Tx were identified, ranging in scientific documentation from discrediting controlled studies through mere hypotheses to positive controlled double-blind clinical trials. Many of them are applicable only to a restricted etiological subgroup. The oligoantigenic or few-foods diet has convincing double-blind evidence of efficacy in multiple trials for a properly selected subgroup. Enzyme-potentiated desensitization to foods, relaxation/EMG biofeedback, and deleading also have controlled evidence of efficacy. Glyconutritional supplementation, iron supplementation, magnesium supplementation, Chinese herbals, EEG biofeedback, meditation, mirror feedback, channel-specific perceptual training, and vestibular stimulation all have promising prospective pilot data. Single-vitamin megadosage has some intriguing pilot trial data. Zinc supplementation is hypothetically supported by systematic case-control data but has no systematic clinical trial. Laser acupuncture has promising unpublished pilot data. Essential fatty acid supplementation has promising systematic case-control data but clinical trials are equivocal. Recommended-Daily-Allowance vitamin supplementation, nonChinese herbals, homeopathic remedies, and antifungal therapy have no systematic data in ADHD. Megadose multivitamin combinations are probably ineffective for most patients and possibly dangerous. Simple sugar restriction and hypnosis seem ineffective. Amino acid supplementation, though mildly effective in the short term, is not effective beyond a few weeks. Thyroid Tx is effective in the presence of documented thyroid abnormality, but not otherwise.