Stimulant-Responsive and Stimulant-Refractory Aggressive Behavior Among Children With ADHD Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder Omega 3/6 fatty acids for reading in children: a randomized, double‐blind, placebo‐controlled trial in 9‐year‐old mainstream schoolchildren in Sweden Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. Safety of phosphatidylserine containing omega3 fatty acids in ADHD children: a double-blind placebo-controlled trial followed by an open-label extension. Effect of supplementation with long-chain ω-3 polyunsaturated fatty acids on behavior and cognition in children with attention deficit/hyperactivity disorder (ADHD): a randomized placebo-controlled intervention trial. Increased Erythrocyte Eicosapentaenoic Acid and Docosahexaenoic Acid Are Associated With Improved Attention and Behavior in Children With ADHD in a Randomized Controlled Three-Way Crossover Trial Combined ω3 and ω6 Supplementation in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Refractory to Methylphenidate Treatment Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Protective effects of dietary supplementation with natural ω-3 polyunsaturated fatty acids on the visual acuity of school-age children with lower IQ or attention-deficit hyperactivity disorder. A randomized, double-blind, placebo-controlled trial of docosahexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder. Effect of n-3 supplementation on hyperactivity, oxidative stress and inflammatory mediators in children with attention-deficit-hyperactivity disorder. Biochemical and Psychological Effects of Omega-3/6 Supplements in Male Adolescents with Attention-Deficit/Hyperactivity Disorder: A Randomized, Placebo-Controlled, Clinical Trial. Omega-3/Omega-6 Fatty Acids for Attention Deficit Hyperactivity Disorder Efficacy and Safety of Omega-3/6 Fatty Acids, Methylphenidate, and a Combined Treatment in Children With ADHD Fatty acids in ADHD: plasma profiles in a placebo-controlled study of Omega 3/6 fatty acids in children and adolescents The influence of short-chain essential fatty acids on children with attention-deficit/hyperactivity disorder: a double-blind placebo-controlled study. Eicosapentaenoic and docosahexaenoic acids, cognition, and behavior in children with attention-deficit/hyperactivity disorder: a randomized controlled trial.
OBJECTIVES : The objective of this study was to examine factors that are associated with aggression that is responsive versus refractory to individualized optimization of stimulant monotherapy among children with attention-deficit/hyperactivity disorder ( ADHD ) . METHODS : Children who were aged 6 to 13 years and had ADHD , either oppositional defiant disorder or conduct disorder , significant aggressive behavior , and a history of insufficient response to stimulants completed an open stimulant monotherapy optimization protocol  . Stimulant titration with weekly assessment s of behavior and tolerability identified an optimal regimen for each child . Families also received behavioral therapy . Parents completed the Retrospective-Modified Overt Aggression Scale ( R-MOAS ) at each visit . Children were classified as having stimulant-refractory aggression on the basis of R-MOAS ratings and clinician judgment . Differences that pertained to treatment , demographic , and psychopathology between groups with stimulant monotherapy – responsive and –refractory aggression were evaluated . RESULTS : Aggression among 32 ( 49.3 % ) of 65 children was reduced sufficiently after stimulant dosage adjustment and behavioral therapy to preclude adjunctive medication . Those who responded to stimulant monotherapy were more likely to benefit from the protocol 's methylpheni date preparation ( once-daily , triphasic release ) , showed a trend for lower average dosages , and received fewer  behavioral therapy  sessions than did children with stimulant-refractory aggression . Boys , especially those with higher ratings of baseline aggression and of depressive and manic symptoms , more often exhibited stimulant-refractory aggression . CONCLUSIONS : Among children whose aggressive behavior develops in the context of ADHD and of oppositional defiant disorder or conduct disorder , and who had insufficient response to previous stimulant treatment in routine clinical care , systematic , well-monitored titration of stimulant monotherapy often culminates in reduced aggression that averts the need for additional agents Attention deficit/hyperactivity disorder ( ADHD ) is one of the most common child psychiatric disorders , and is often treated with stimulant medication . Nonpharmacological treatments include dietary supplementation with omega-3 fatty acids , although their effectiveness remains to be shown conclusively . In this study , we investigated the effects of dietary omega-3 fatty acid supplementation on ADHD symptoms and cognitive control in young boys with and without ADHD . A total of 40 boys with ADHD , aged 8–14 years , and 39 matched , typically developing controls participated in a 16-week double-blind r and omized placebo-controlled trial . Participants consumed 10 g of margarine daily , enriched with either 650 mg of eicosapentaenoic acid (EPA)/docosahexaenoic acid ( DHA ) each or placebo . Baseline and follow-up assessment s addressed ADHD symptoms , fMRI of cognitive control , urine homovanillic acid , and cheek cell phospholipid sampling . EPA/DHA supplementation improved parent-rated attention in both children with ADHD and typically developing children . Phospholipid DHA level at follow-up was higher for children receiving EPA/DHA supplements than placebo . There was no effect of EPA/DHA supplementation on cognitive control or on fMRI measures of brain activity . This study shows that dietary supplementation with omega-3 fatty acids  reduces symptoms of ADHD , both for individuals with ADHD and typically developing children . This effect does not appear to be mediated by cognitive control systems in the brain , as no effect of supplementation was found here . Nonetheless , this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD ( NCT01554462 : The Effects of EPA/DHA Supplementation on Cognitive Control in Children with ADHD ; http:// clinical trials.gov/show/NCT01554462 ) BACKGROUND Previous research has shown positive effects of Omega 3/6 fatty acids in children with inattention and reading difficulties .  We aim ed to investigate if Omega 3/6 improved reading ability  in mainstream schoolchildren . METHODS We performed a 3-month parallel , r and omized , double-blind , placebo-controlled trial followed by 3-month active treatment for all subjects . Mainstream schoolchildren aged 9 - 10 years were r and omized 1:1 to receive three Omega 3/6 capsules twice daily or identical placebo . Assessment s were made at baseline , 3 months , and 6 months . The primary outcome measure was the Logos test battery for evaluating reading abilities . The trial is registered with Clinical Trials.gov , number NCT02557477 . RESULTS The study enrolled 154 children ( active n = 78 ; placebo n = 76 ) , of whom 122 completed the first 3 months ( active n = 64 ; placebo n = 58 ) and 105 completed the whole study ( active/active n = 55 ; placebo/active n = 50 ) . Outcomes were assessed by per protocol ( PP ) and intention-to-treat ( ITT ) analyses . Active treatment was superior to placebo at 3 months for improvement in phonologic decoding time ( PP active/placebo difference -0.16 ; 95 % CI -0.03 , -0.29 ; effect size ( ES ) .44 ; p = .005 ; and ITT ES .37 ; p = .036 ) , in visual analysis time ( PP active/placebo difference -0.19 ; 95 % CI -0.05 , -0.33 ; ES .49 ; p = .013 ; and ITT ES .40 ; p = .01 ) , and for boys in phonologic decoding time ( PP -0.22 ; 95 % CI -0.03 , -0.41 ; ES .62 ; p = .004 ) . Children with ADHD-RS scores above the median showed treatment benefits in visual analysis time ( PP ES .8 , p = .009 ) , reading speed per word ( PP ES .61 , p = .008 ) , and phonologic decoding time per word ( PP ES .85 , p = .006 ) . Adverse events were rare and mild , mainly stomach pain/diarrhea ( active n = 9 , placebo n = 2 ) . CONCLUSIONS Compared with placebo , 3 months of Omega 3/6 treatment improved reading ability - specifically the clinical ly relevant ' phonologic decoding time ' and ' visual analysis  time ' - in mainstream schoolchildren . In particular , children with attention problems showed treatment benefits OBJECTIVE To test the hypotheses that in children with attention-deficit/hyperactivity disorder ( ADHD ) ( 1 ) symptoms of ADHD , oppositional defiant disorder , and overall functioning are significantly improved by methylpheni date combined with intensive multimodal psychosocial treatment compared with methylpheni date alone and with methylpheni date plus attention control and ( 2 ) more children receiving combined treatment can be taken off methylpheni date . METHOD One hundred three children with ADHD ( ages 7 - 9 ) , free of conduct and learning disorders , who responded to short-term methylpheni date were r and omized for 2 years to ( 1 ) methylpheni date alone ; ( 2 ) methylpheni date plus psychosocial treatment that included parent training and counseling , social skills training , psychotherapy , and academic assistance , or ( 3 ) methylpheni date plus attention psychosocial control treatment . Assessment s included parent , teacher , and psychiatrist ratings , and observations in academic and gym classes . RESULTS Combination treatment did not lead to superior functioning and did not facilitate methylpheni date discontinuation . Significant improvement occurred across all treatments and continued over 2 years . CONCLUSIONS In stimulant-responsive children with ADHD , there is no support for adding ambitious long-term psychosocial intervention to improve ADHD and oppositional defiant disorder symptoms . Significant benefits from methylpheni date were stable over 2 years OBJECTIVE To evaluate the safety of phosphatidylserine ( PS ) enriched with omega3 fatty acids , mainly eicosapentaenoic ( PS-Omega3 ) in children with attention-deficit hyperactivity disorder ( ADHD ) . METHODS Two hundred children diagnosed with ADHD were r and omised to receive either PS-Omega3 ( 300 mg PS-Omega3/day ) or placebo for 15 weeks . One hundred and fifty children continued into an open-label extension for an additional 15 weeks in which they all consumed PS-Omega3 ( 150 mg PS-Omega3/day ) . St and ard blood biochemical and haematological safety parameters , blood pressure , heart rate , weight and height were evaluated . Adverse events and the Side Effect Rating Scale were also assessed . RESULTS One hundred and sixty-two participants completed the double-blind phase . No significant differences were noted between the two study groups in any of the safety parameters evaluated . One hundred and forty participants completed the open-label phase . At the end of this phase , no significant changes from baseline were observed in any of the studied parameters among participants who consumed PS-Omega3 for 30 weeks . CONCLUSIONS Study results demonstrate that consumption of PS-Omega3 by children with ADHD , as indicated in a 30-week evaluation period , is safe and well tolerated , without any negative effect on body weight or growth OBJECTIVE To determine whether supplementation with the long-chain omega-3 polyunsaturated fatty acids eicosapentaenoic ( EPA ) and docosahexaenoic acid ( DHA ) affects behavioral symptoms and cognitive impairments in children 6 - 12 years of age diagnosed with attention-deficit/hyperactivity disorder ( ADHD ) . STUDY DESIGN The r and omized , double-blind placebo-controlled 16 weeks trial was conducted with 95 children diagnosed with ADHD according to DSM-IV criteria . Behavior was assessed by parents , teachers and investigators using st and ardized rating scales and question naires . Further outcome variables were working memory , speed of information processing and various measures of attention . For a subgroup of 81 participants , erythrocyte membrane fatty acid composition was analyzed before and after the intervention . RESULTS Supplementation with the omega-3 fatty acid mix increased EPA and DHA concentrations in erythrocyte membranes and improved working memory function , but had no effect on other cognitive measures and parent- and teacher-rated behavior in the study population . Improved working memory correlated significantly with increased EPA , DHA and decreased AA ( arachidonic acid ) Objective : To investigate effects of omega-3 polyunsaturated fatty acids ( n-3 PUFA ) docosahexaenoic acid ( DHA ) and eicosapentaenoic acid ( EPA ) on attention , literacy , and behavior in children with ADHD . Method : Ninety children were r and omized to consume supplements high in EPA , DHA , or linoleic acid ( control ) for 4 months each in a crossover design . Erythrocyte fatty acids , attention , cognition , literacy , and Conners ’ Parent Rating Scales ( CPRS ) were measured at 0 , 4 , 8 , 12 months . Results : Fifty-three children completed the treatment . Outcome measures showed no significant differences between the three treatments . However , in children with blood sample s ( n = 76 - 46 ) , increased erythrocyte EPA + DHA was associated with improved spelling ( r = .365 , p < .001 ) and attention ( r = −.540 , p < .001 ) and reduced oppositional behavior ( r = −.301 , p < .003 ) , hyperactivity ( r = −.310 , p < .001 ) , cognitive problems ( r = −.326 , p < .001 ) , Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . ; DSM-IV ) hyperactivity ( r = −.270 , p = .002 ) and DSM-IV inattention ( r = −.343 , p < .001 ) . Conclusion : Increasing erythrocyte DHA and EPA via dietary supplementation may improve behavior , attention , and literacy in children with ADHD Children ( 6 - 12 years ) with attention-deficit hyperactivity disorder ( ADHD ) being treated with methylpheni date and st and ard behavior therapy for more than 6 months , whose parents reported no improvement in behavior and academic learning , were r and omly assigned to receive supplementation with a combined ω3 and ω6 preparation or a placebo . Outcome was measured at 3 and 6 months after treatment using a self- assessment checklist completed by the parents . Statistically significant improvement was found in the treatment group compared with the placebo group ( P < .01 ) in the following measures : restlessness , aggressiveness , completing work , and academic performance . Statistically significant improvement was not found at 3 months of treatment between groups but was evident at 6 months of treatment ( P < .05 ) with inattention , impulsiveness , and cooperation with parents and teachers . Distractibility failed to show improvement . Effect sizes ranged from 0.3 to 1.1 at 3 months and 0.2 to 1.4 at 6 months for individual symptom variables BACKGROUND Our objective was to estimate the lifetime prevalence of psychopathology in a sample of youth with and without attention deficit hyperactivity disorder ( ADHD ) through young adulthood using contemporaneous diagnostic and analytic techniques . METHOD We conducted a case-control , 10-year prospect i ve study of ADHD youth . At baseline , we assessed consecutively referred male , Caucasian children with ( n=140 ) and without ( n=120 ) DSM-III-R ADHD , aged 6 - 18 years , ascertained from psychiatric and pediatric sources to allow for generalizability of results . At the 10-year follow-up , 112 ( 80 % ) and 105 ( 88 % ) of the ADHD and control children , respectively , were reassessed ( mean age 22 years ) . We created the following categories of psychiatric disorders : Major Psychopathology ( mood disorders and psychosis ) , Anxiety Disorders , Antisocial Disorders ( conduct , oppositional-defiant , and antisocial personality disorder ) , Developmental Disorders ( elimination , language , and tics disorder ) , and Substance Dependence Disorders ( alcohol , drug , and nicotine dependence ) , as measured by blinded structured diagnostic interview . RESULTS The lifetime prevalence for all categories of psychopathology were significantly greater in ADHD young adults compared to controls , with hazard ratios and 95 % confidence intervals of 6.1 ( 3.5 - 10.7 ) , 2.2 ( 1.5 - 3.2 ) , 5.9 ( 3.9 - 8.8 ) , 2.5 ( 1.7 - 3.6 ) , and 2.0 ( 1.3 - 3.0 ) , respectively , for the categories described above . CONCLUSIONS By their young adult years , ADHD youth were at high risk for a wide range of adverse psychiatric outcomes including markedly elevated rates of antisocial , addictive , mood and anxiety disorders . These prospect i ve findings provide further evidence for the high morbidity associated with ADHD across the life-cycle and stress the importance of early recognition of this disorder for prevention and intervention strategies OBJECTIVE Little attention has been paid to the possible protective role of ω-3 polyunsaturated fatty acids ( PUFAs ) on the visual acuity of school-age children with lower IQs or attention-deficit hyperactivity disorder ( ADHD ) . The aim of this study was to evaluate the effect of dietary ω-3 PUFAs on the visual acuity and red blood cell ( RBC ) fatty acid compositions of these children . METHODS We r and omly assigned 179 children with lower IQs or ADHD to receive ordinary eggs ( control group , n = 90 ) or eggs rich in C18:3 ω-3 , eicosapentaenoic acid ( EPA , 20:5 ω-3 ) and docosahexaenoic acid ( DHA , 22:6 ω-3 ) for 3 mo ( study group , n = 89 ) . Before and after the intervention , distance visual acuity was tested using an E chart and the RBC fatty acid composition was determined using capillary gas chromatography . RESULTS Three months later , 171 children completed the follow-up with the exception of 8 children who were unavailable during follow-up . Both groups of children showed a significant improvement in visual acuity ( P < 0.05 ) , however , visual acuity in the study group was significantly better than that of the control group ( P = 0.013 ) . The C18:3 ω-3 ( P = 0.009 ) , DHA ( P = 0.009 ) and ∑ω-3 ( P = 0.022 ) levels of the intervention group were significantly higher than those of the control group , while the C20:4 ω-6 ( P = 0.003 ) , C22:4 ω-6 ( P = 0.000 ) , ∑ω-6 ( P = 0.001 ) , ∑ω-6/∑ω-3 ( P = 0.000 ) and arachidonic acid/DHA ( P = 0.000 ) of the study group were significantly lower than those of the control group . No significant differences in the levels of C18:2 ω-6 ( P = 0.723 ) , C20:2 ω-6 ( P = 0.249 ) , C20:3 ω-6 ( P = 0.258 ) , C20:5 ω-3 ( P = 0.051 ) , or C22:5 ( P = 0.200 ) were found between the two groups . CONCLUSIONS Dietary supplementation with ω-3 PUFAs improves both visual acuity and  the  RBC fatty acid profile in school-age children with lower IQs or ADHD OBJECTIVE To determine whether docosahexaenoic acid ( DHA ) supplementation for 4 months decreases the symptoms of  attention-deficit/hyperactivity disorder ( ADHD ) .  STUDY DESIGN Sixty-three 6- to-12-year-old children with ADHD , all receiving effective maintenance therapy with stimulant medication , were assigned r and omly , in a double-blind fashion , to receive DHA supplementation ( 345 mg/d ) or placebo for 4 months . Outcome variables included plasma phospholipid fatty acid patterns , scores on laboratory measures of inattention and impulsivity ( Test of Variables of Attention , Children 's Color Trails test ) while not taking stimulant medication , and scores on parental behavioral rating scales ( Child Behavior Checklist , Conners ' Rating Scale ) . Differences between groups after 4 months of DHA supplementation or placebo administration were determined by analysis of variance , controlling for age , baseline value of each outcome variable , ethnicity , and ADHD subtype . RESULTS Plasma phospholipid DHA content of the DHA-supplemented group was 2.6-fold higher at the end of the study than that of the placebo group ( 4.85 + /- 1.35 vs 1.86 + /- 0.87 mol % of total fatty acids ; P < .001 ) . Despite this , there was no statistically significant improvement in any objective or subjective measure of ADHD symptoms . CONCLUSION A 4-month period of DHA supplementation ( 345 mg/d ) does not decrease symptoms of ADHD BACKGROUND Attention-deficit/hyperactivity disorder ( ADHD ) is associated with difficulties in learning , behaviour and psychosocial adjustment that persist into adulthood . Decreased omega-3 fatty acids and increased inflammation or oxidative stress may contribute to neuro-developmental and psychiatric disorders such as ADHD . The aim of this study was to determine the effect of n-3 supplementation on hyperactivity , oxidative stress and inflammatory mediators in children with ADHD . METHODS In this double blind study , 103 children ( 6 - 12 years ) with ADHD receiving maintenance therapy were assigned r and omly into two groups . The n-3 group received n-3 fatty acids ( 635 mg eicosapentaenoic acid ( EPA ) , 195 mg docosahexaenoic acid ( DHA ) ) , and the placebo group received olive oil capsules which were visually similar to the n-3 capsules . The duration of supplementation was 8 weeks . Plasma C-reactive protein ( CRP ) , interleukin-6 ( IL-6 ) and the activity of glutathione reductase ( GR ) , catalase ( CAT ) and superoxide dismutase ( SOD ) were determined before and after the intervention . Likewise the Conners ' Abbreviated Question naires ( ASQ-P ) was applied . RESULTS After 8-week intervention , a significant reduction was observed in the levels of CRP ( P < 0.05 , 95 % CI = 0.72 - 2.02 ) and IL-6 ( P < 0.001 , 95 % CI = 1.93 - 24.33 ) in the n-3 group . There was also a significant increase in activity of SOD and GR ( P < 0.001 ) . A significant improvement was seen in the ASQ-P scores in the n-3 group ( P < 005 ) . CONCLUSION Eight weeks of EPA and DHA supplementation decreased plasma inflammatory mediators and oxidative stress in the children with ADHD . These results suggest that n-3 fatty acid supplementation may offer a safe and efficacious treatment for children with ADHD BACKGROUND An abnormality in long chain-polyunsaturated fatty acid ( LC-PUFA ) levels has been implicated in attention-deficit/hyperactivity disorder ( ADHD ) . Studies evaluating LC-PUFA supplementation for therapeutic efficacy in ADHD have shown mixed and , therefore , inconclusive results . METHODS Seventy-six male adolescents ( age 12 - 16 years , mean = 13.7 ) with ADHD were assessed for the effects of 12 weeks omega-3 and omega-6 supplements on biochemical and psychological outcomes in a r and omized , placebo-controlled , clinical trial . The primary outcome measure was change in the Conners ' Teacher Rating Scales ( CTRS ) following 12 weeks of supplementation of LC-PUFA or placebo . At baseline , the placebo and treatment groups had comparable levels of LC-PUFA as measured by red blood cell phosphatidylcholine . In the treatment group , supplementation enhanced eicosapentaenoic acid ( EPA ) , docosahexaenoic acid ( DHA ) , and total omega-3 fatty acid levels . RESULTS No superiority of LC-PUFAs to placebo was observed on the primary outcome . Further , there were no reliable treatment effects on aggression , impulsivity , depression , and anxiety . CONCLUSIONS Future studies should use larger sample sizes and longer supplementation period to detect small-modest effects for clinical recommendations in ADHD Objective : The aim of the study was to assess omega 3/6 fatty acids ( eye q ) in attention deficit hyperactivity disorder ( ADHD ) . Method : The study included a r and omized , 3-month , omega 3/6 placebo-controlled , one-way crossover trial with 75 children and adolescents ( 8—18 years ) , followed by 3 months with omega 3/6 for all .  Investigator-rated ADHD Rating Scale — IV and Clinical Global Impression ( CGI ) scale were outcome measures . Results : A majority did not respond to omega 3/6 treatment . However , a subgroup of 26 % responded with more than 25 % reduction of ADHD symptoms and a drop of CGI scores to the near-normal range . After 6 months , 47 % of all showed such improvement . Responders tended to have ADHD inattentive subtype and comorbid neurodevelopmental disorders . Conclusion : A subgroup of children and adolescents with ADHD , characterized by inattention and associated neurodevelopmental disorders , treated with omega 3/6 fatty acids for 6 months responded with meaningful reduction of ADHD symptoms . ( J. of Att . Dis . 2009 ; 12(5 ) 394 - 401 Objective : To compare efficacy of Omega-3/6 fatty acids ( Equazen eye q ™ ) with methylpheni date ( MPH ) and combined MPH + Omega-3/6 in children with ADHD . Method : Participants ( N = 90 ) were r and omized to Omega-3/6 , long-acting MPH , or combination for 12 months .  ADHD symptoms were assessed using the ADHD Rating Scale and Clinical Global Impressions – Severity ( CGI-S ) scale . Results : ADHD symptoms decreased in all treatment arms . Although significant differences favoring Omega + MPH over Omega-3/6 alone were found for ADHD Total and Hyperactivity-Impulsivity subscales , results on the Inattention subscale were similar . CGI-S scores decreased slowly and consistently with Omega-3/6 , compared with a rapid decrease and subsequent slight increase in the MPH-containing arms . Adverse events were numerically less frequent with Omega-3/6 or MPH + Omega-3/6 than MPH alone . Conclusion : The tested combination of Omega-3/6 fatty acids had similar effects to MPH , whereas the MPH + Omega combination appeared to have some tolerability benefits over MPH The aim of this study was to assess baseline levels and changes in plasma fatty acid profiles in children and adolescents with ADHD , in a placebo-controlled study with Omega 3/6 supplementation , and to compare with treatment response . Seventy-five children and adolescents aged 8–18 years with DSM-IV ADHD were r and omized to 3 months of Omega 3/6 ( Equazen eye q ) or placebo , followed by 3 months of open phase Omega 3/6 for all . n-3 , n-6 , n-6/n-3 ratio , EPA and DHA in plasma were measured at baseline , 3 and 6 months . Subjects with more than 25 % reduction in ADHD symptoms  were classified as responders . At baseline , no significant differences in mean fatty acid levels were seen across active/placebo groups or responder/non-responder groups . The 0–3 month changes in all parameters were significantly greater in the active group ( p < 0.01 ) . Compared to non-responders , the 6-month responders had significantly greater n-3 increase at 3 months and decrease in n-6/n-3 ratio at 3 and 6 months ( p < 0.05 ) . Omega 3/6 supplementation had a clear impact on fatty acid composition of plasma phosphatidyl choline in active versus placebo group , and the fatty acid changes appear to be associated with treatment response . The most pronounced and long-lasting changes for treatment responders compared to non-responders were in the n-6/n-3 ratio Essential fatty acids ( EFA ) are needed for normal sensory , cognitive , and motor function . The EFA blood profile seems to be different in children with attention-deficit/hyperactivity disorder ( ADHD ) as compared to matched controls . Previous open EFA supplementation trials were successful in demonstrating significant therapeutic effects in this population , whereas most of the r and omized controlled trials failed to show any benefit over placebo . The current r and omized , double-blind , placebo-controlled trial tested the influence of short-chain EFA supplementation on ADHD children , using parent and teacher question naires and a computerized continuous performance test . A total of 73 unmedicated children aged 7 - 13 years with a diagnosis of ADHD participated in the study ; 63 children completed the study . The EFA supplement contained 480 mg of linoleic acid and 120 mg of alpha-linolenic acid , and the placebo contained 1000 mg of vitamin C ( daily amounts ) ; both were given for a 7-week supplementation period . Analysis of variance for repeated measures revealed that both treatments ameliorated some of the symptoms , but no significant differences were found between the groups in any of the treatment effects OBJECTIVE To determine the effects of an eicosapentaenoic acid (EPA)-rich oil and a docosahexaenoic acid (DHA)-rich oil versus an ω-6 polyunsaturated fatty acid-rich safflower oil ( control ) on literacy and behavior in children with attention-deficit/hyperactivity disorder ( ADHD ) in a r and omized controlled trial . METHODS Supplements rich in EPA , DHA , or safflower oil were r and omly allocated for 4 mo to 90 Australian children 7 to 12 y old with ADHD symptoms higher than the 90th percentile on the Conners Rating Scales . The effect of supplementation on cognition , literacy , and parent-rated behavior was assessed by linear mixed modeling . Pearson correlations determined associations between the changes in outcome measurements and the erythrocyte fatty acid content ( percentage of total ) from baseline to 4 mo . RESULTS There were no significant differences between the supplement groups in the primary outcomes after 4 mo . However , the erythrocyte fatty acid profiles indicated that an increased proportion of DHA was associated with improved word reading ( r = 0.394 ) and lower parent ratings of oppositional behavior ( r = 0.392 ) . These effects were more evident in a subgroup of 17 children with learning difficulties : an increased erythrocyte DHA was associated with improved word reading ( r = 0.683 ) , improved spelling ( r = 0.556 ) , an improved ability to divide attention ( r = 0.676 ) , and lower parent ratings of oppositional behavior ( r = 0.777 ) , hyperactivity ( r = 0.702 ) , restlessness ( r = 0.705 ) , and overall ADHD symptoms ( r = 0.665 ) . CONCLUSION Increases in erythrocyte ω-3 polyunsaturated fatty acids , specifically DHA , may improve literacy and behavior in children with ADHD . The greatest benefit may be observed in children who have comorbid learning difficulties
BACKGROUND Attention deficit hyperactivity disorder ( ADHD ) is a debilitating behavioural disorder affecting daily ability to function , learn , and interact with peers .
This publication assesses the role of omega-3/6 fatty acids in the treatment and management of ADHD .
CONCLUSION ADHD is a frequent and debilitating childhood condition .