Alternative Treatments for Adults with AD/HD
A rose is a rose is a rose... or is it?
The reason medications like Ritalin or Adderall are so popular is because they work. Medications are manufactured according to tightly controlled specifications, which makes them very predictable. A five mg tablet of methyphenidate will always be a five mg table of methylphenidate.
Many alternative treatments are not held to this same standard of quality. Research by Consumer Reports (December, 2000) found that the amount of certain key ingredients in some herbal products can vary considerably from brand to brand. Other sources claim that doses are inconsistent from batch to batch, with variations occurring even among tablets or pills in the same bottle. The Federal Drug Administration has no control over these products. The consumer is left strictly at the mercy of the manufacturer.
Arnold cites European studies on St. John's Wort (hypericum) for depression that found it more effective than placebo. Many people with ADHD and depression claim to have been helped by using the medication. Other studies, which are not cited by Arnold, appear to contradict these results. This uncertainty, combined with the lack of regulation and quality control, make some doctors hesitant about recommending the herbal antidepressant.
One size does not fit all
Some treatments are not appropriate for all people who have AD/HD. For example, there has been some speculation that thyroid treatments could also help control AD/HD symptoms. But Arnold's research does not support any such connection: "For the 2-5% of patients with ADHD who have thyroid abnormality, correction of the thyroid problem should logically be the first line of treatment, but is not indicated for the majority with normal thyroid function."
The same is true of patients with a deficiency of specific nutrients: "For patients with demonstrated deficiencies of any nutrient (e.g., zinc, iron, magnesium, vitamins), correction of that deficiency is the logical first-line treatment." Arnold maintains that while dietary therapies are not effective for most people who have AD/HD, they may be appropriate "in the small subgroup with sensitivity to foods" (emphasis included in the original text).
Other treatments, according to Arnold, cost nothing, pose no risk, and show some promise. He cites research on meditation which he says showed significant advantage in classroom behavior but not in parent ratings or psychological tests. Mirrors have to help children with ADHD to self-monitor and better control their behavior. Arnold acknowledges that these have not been proven to help ADHD, but believes there is sufficient research to show that they may be helpful for children and adults who have the disorder.
It should be noted that these interventions are not "cures" for ADHD, but are tools that could be helpful.
More study is needed
"The most basic recommendation for future research on treatment alternatives in ADHD is that there should be more," says Arnold. "Most of the alternatives have been relatively neglected by most mainstream investigators -- especially for adults with ADHD -- and by peer-reviewed funding, despite the fact that some of them could be relatively cheaply tested." Arnold believes that this lack of research has meant that potentially useful treatments are being overlooked and that possibly ineffective or even dangerous treatments are being sold without the data necessary to debunk them.
"Dogma (both establishment and anti-establishment) fills the void left by absence of data," says Arnold. "This research void requires our scientific attention."