From coffee to restrictive diets, unconventional treatments for ADHD are being sought by parents and studied by scientists. a growing body of literature suggests omega-3 fatty acid supplementation may be helpful for treatment of some cases of ADHD.

Omega-3 fatty acids are considered necessary for our health yet not produced by our bodies. to obtain omega-3s, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), we must include them in our diet from sources like fish or nuts.

While omega-3s have been reported to confer benefit in chronic diseases such as heart disease, cancer, and arthritis, they are also thought to play a crucial role in brain function and are one of the most studied alternative treatments for ADHD. from a 2009 review article, the role of fatty acids in the treatment of ADHD, published in Neuropharmacology:

Several arguments have been proposed to support the hypothesis that supplementation with essential fatty acids (EFAs) could be valuable in the treatment of attention deficit-hyperactivity disorder (ADHD).

Indeed, this disorder seems to involve the monoaminergic systems which have been shown to be affected by polyunsaturated fatty acid (PUFA) status, at least in animal models. In addition, several studies have

reported abnormal nutritional status with regard to EFAs in ADHD, indicating that lower levels of longchain PUFAs occur more frequently in the plasma and/or red blood cells of ADHD subjects. few nutritional

EFA supplementation studies have been reported in ADHD to date, but several of them have shown increased blood EFA levels, although their effects on ADHD-related symptoms were not or were only partly successful.

Researchers from the Yale Child Study Center performed a systematic review of randomized placebo-controlled trials examining omega-3 fatty acid supplementation in children with ADHD symptomatology. their results were published online in the Journal of the American Academy of Child and Adolescent Psychiatry.

The analysis reviewed ten trials involving 699 children and included the following conclusion:

Omega-3 fatty acid supplementation, particularly with higher doses of eicosapentaenoic acid, was modestly effective in the treatment of ADHD. the relative efficacy of omega-3 fatty acid supplementation was modest compared with currently available pharmacotherapies for ADHD such as psychostimulants, atomoxetine, or alpha-2 agonists. however, given its relatively benign side-effect profile and evidence of modest efficacy, it may be reasonable to use omega-3 fatty supplementation to augment traditional pharmacologic interventions or for families who decline other psychopharmacologic options.

The authors go on to state that “using omega-3 fatty acid supplementation in lieu of traditional pharmacologic treatments is not

recommended in children with significant ADHD symptoms.”

Sandy Newmark, M.D., is a behavioral pediatrician at the UCSF Osher Center for Integrative Medicine and author of the book, ADHD without Drugs: a Guide to the Natural Care of Children with ADHD. since I first interviewed him on the radio, he has continued to answer my questions about integrative approaches to behavioral problems in children, and recently shared some of his thoughts on the aforementioned meta-analysis:

I’m glad to see this meta-analysis confirms the effect of omega-3s. I think they made a bigger deal than necessary of the effect size compared to stimulants. Note that they made no mention of the side-effects of stimulants or the lack of information on long-term effects. also, as a practical matter, omega-3s alone are only part of an integrative approach.

I think it is also worth noting that the authors don’t mention the possible side effects of omega-3s, such as gastrointestinal distress or excessive blood thinning.

Having taken omega-3s for several years, I can acknowledge that they contribute to occasional fish-oil flavored burps, but feel that the potential benefits far outweigh this minor side effect. even before the recent studies suggesting that the anti-inflammatory effect of omega-3s were helpful in anxiety, I found that regularly taking high EPA-DHA ratio fish oil helped me feel calmer, potentially making it easier for me to focus or be less impulsive.