Analysis: Homeopathy for ADHD Deemed ‘Invalid,’ ‘Biased’

 November 6, 2023

Pediatrics Research has retracted a paper on the effectiveness of using homeopathy to treat ADHD, citing “substantial concerns regarding the validity of the results presented in this article.” ¹

The original article “Is Homeopathy Effective for Attention Deficit and Hyperactivity Disorder? A Meta-Analysis” reported that “individualized homeopathy showed a clinically relevant and statistically robust effect in the treatment of ADHD.”¹ This retraction directly challenges those results and addresses the concerns of critics, who argue that science does not support the use of homeopathy for addressing ADHD symptoms.

The journal’s editor-in-chief issued the retraction after a review found four “deficiencies,” including the following:

• The authors’ overall allocation of Risk of Bias (ROB) did not align with guidance from the Cochrane Handbook of Systematic Reviews of Interventions.
• The article included a biased study where only children who showed improvements with homeopathy in the screening phase were selected for the trial. ²
• The article included misrepresented results; one study found the control group had more improvement than the homeopathy group, but the paper reported these results in favor of homeopathy.³
• The authors inaccurately averaged the effect size of three main outcomes from a study without indicating if they recalculated the effect sizes from the data in the study. ⁴

The paper’s retraction comes more than a year after critics first questioned the validity of the studies included in the meta-analysis. Shortly after the paper’s June 2022 publication, Edzard Ernst, M.D., Ph.D., MAE, FMedSci, FRSB, FRCP, FRCPEd, asked the editors of Pediatrics Research to add a caution notice or withdraw the paper.

“We conclude that the positive result obtained by the authors is due to a combination of the inclusion of biased trials unsuitable to build evidence together with some major misreporting of study outcomes,” he wrote.

In a follow-up letter sent in June 2023, Ernst wrote, “In our comment, we point out that the authors made a lot of errors — to say it mildly. They deny the doubtful quality of the studies they included in their meta-analysis; they did not stick to their own exclusion criteria, the data the authors report do not resemble the findings of the studies they were allegedly taken from, the one study setting the results is a mere pilot study… We ask you to review your decision, or better still, consider a retraction of the paper altogether.” A copy of both letters appears on Ernst’s blog.

Two of the paper’s authors — Harald Walach, Ph.D., of Change Health Science Institute, Berlin, Germany; and Michael Teut, M.D., of Charité Universitätsmedizin Berlin, Germany — agreed with the retraction. The paper’s third author, Katharina Gaertner, M.D., of the University of Witten/Herdecke, Institute for Integrative Medicine, Herdecke, Germany, disagreed.

“Homeopathy is a very controversial subject, so critics have looked closely at the work,” Teut told Retraction Watch. “Unfortunately, a transcription error was made in the data extraction, which is relevant to the overall result. From this, one can justify a retraction of the work. Ultimately, it is good that the error was made transparent; the scientific community worked here. However, we authors would have preferred a correction in the form of an amendment, which we asked the journal to publish. Three further points of criticism are, in our view, contentious and less relevant. The journal communicated professionally.”

What Is Homeopathy?

German physician Samuel Hahnemann invented homeopathy in 1796. It involves taking substances that cause undesired symptoms in healthy people — like arsenic or tuberculosis bacteria — and diluting them hundreds or thousands of times in alcohol or water until only minuscule amounts of the active ingredient remain. The final product, known as a homeopathic, is primarily water. According to Hahnemann’s theory, this small amount works similarly to a vaccine, triggering a symptom-reducing reaction in people who present with the disease.

Homeopathic preparations are dispensed without a doctor’s prescription and are available in natural foods stores or online. However, many in the international medical community consider homeopathy a pseudoscience. In 2009, the World Health Organization (WHO) issued an official statement specifically warning against the use of homeopathy for serious diseases like HIV, tuberculosis, or malaria. ⁵ The Australian National Health and Medical Research Council, the United Kingdom’s House of Commons Science and Technology Committee, and the Swiss Federal Health Office have all separately concluded that homeopathic remedies are ineffective and have recommended that they not receive government funding. The UK National Health Service no longer funds homeopathic medicine, declaring it a “misuse of resources.”

A randomized, double-blind, placebo-controlled trial conducted in a private homeopathic clinic in Seattle provided no evidence to support homeopathic remedies in children with ADHD, according to a 2005 study published in The Journal of Alternative and Complementary Medicine. ⁶  The authors of a 2007 study published in Cochrane Database of Systematic Reviews of Interventions found “little evidence for the efficacy of homeopathy for the treatment of ADHD.” ⁷

CHADD, a nonprofit organization serving people affected by ADHD, concluded that “No research to date has shown reliable peer-reviewed evidence that homeopathy offers the same benefits as proven treatments, including behavioral management and medication management” after reviewing 10 years of research on homeopathic remedies and ADHD symptoms. ⁸

“The effects that many people experience after homeopathic therapy are not due to the homeopathic remedy but to the usually long and empathetic therapeutic encounter, the placebo effect, and other non-specific effects,” Ernst wrote in a blog post. “To put it bluntly homeopathy is a kind of amateur psychotherapy.”

The American Academy of Pediatrics (AAP) recommends treating ADHD in children and adolescents aged 6 to 18 with FDA-approved medications, plus parent training in behavior modification and behavioral classroom interventions. Various research studies have found that “stimulant medications are most effective, and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.” All ADHD treatment decisions should be made in consultation and coordination with a licensed medical provider.

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