Document Type : letter to the editor
Authors
1 Department of Traditional Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
2 School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
The number of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) is increasing significantly. Common treatment options mainly include pharmacotherapies, as well as behavioral and psychosocial treatments applied separately or in combination. Currently, however, there is an increasing trend in the use of complementary and alternative medicines (CAM) in children with ADHD. A significant number of parents of children diagnosed with ADHD prefer to use CAM alone or in combination with current pharmacotherapies for their children's symptoms.
Palliative interventions on ADHD patients lead to symptomatic reliefs, which can greatly improve the quality of life among these patients. According to the viewpoints of traditional Persian medicine, there are several nutritional advice and medicinal herbs, recommended for palliating ADHD and improving the patients’ quality of life. In this article we present some recommended medicinal plants for these patients, and the suggested changes in their lifestyle, especially in the dietary programs.
Keywords
Dear Editor,
Attention deficit hyperactivity disorder (ADHD) is commonly recognized as a neurodevelopmental disease in children and adolescents, which puts a huge economic burden on societies. Its prevalence rate equals to 5–7% in school-aged children worldwide (1, 2). Briefly, a range of clinical manifestations, including inattention, hyperactivity, impulsivity, along with comorbidities such as obesity and sleep disorders have been observed in these children. Sleep problems in ADHD children are almost fivefold more than in the healthy population. In addition, treatment-induced sleep 'disorder' including reduction in total sleep time, decreased sleep efficiency, insomnia, and drowsiness have been reported among them (3).
Common treatment options mainly include pharmacotherapies, as well as behavioral and psychosocial treatments applied separately or in combination. Currently, however, there is an increasing trend in the use of complementary and alternative medicines (CAM) in children with ADHD. A significant number of parents of children diagnosed with ADHD prefer to use CAM alone or in combination with current pharmacotherapy for their children's symptoms. Palliative interventions on ADHD patients have led to symptomatic reliefs, which can greatly improve the quality of life (QOL) in these patients (4, 5). Although the exact term of ADHD is not stated as a distinguished disease in the manuscripts of the traditional Persian medicine (TPM), considering its symptoms and signs, there seem to be some similarities in the clinical manifestations of ADHD and some types of diseases mentioned in TPM sources. One of them is “da'f-I dimāqh” (brain weakness), which is characterized by symptoms of brain dysfunction such as restlessness, difficulty concentrating, sleep disorders and impulsive behavior. In this condition, an accumulation of waste products occurs in the brain due to its inability to excrete them, and results in brain dystepmrament. Therefore, using brain tonics, which are called “muqawwiyat-i dimāqh”, can be helpful in improving these symptoms. There are several nutritional advice and medicinal herbs for the management of brain weakness, which can also be used for palliating ADHD symptoms and improving the patients’ QOL. Some medicinal plants that are brain tonics are shown in Table 1. These plants with strengthening effects on the central nervous system are considered mood and memory enhancers (6, 7). Recent studies have demonstrated the neuroprotective effects of such plants and their impacts on improving the memory functions (8).
Moreover, we presented some dietary programs and appropriate changes in patient’s lifestyle, which will be also supportive for other symptoms such as obesity and sleep disorders in these patients (6,7, 9) (Table 2). However, more clinical studies are required to evaluate the effectiveness of them.
Conflict of interest
None.
- Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J, Bellgrove MA, et al. The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neuroscience and biobehavioral reviews. 2021; 128:789-818.
- Raman SR, Man KKC, Bahmanyar S, Berard A, Bilder S, Boukhris T, et al. Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases. The Lancet Psychiatry. 2018; 5(10):824-35.
- Spruyt K, Gozal D. Sleep disturbances in children with attention-deficit/hyperactivity disorder. Expert review of neurotherapeutics. 2011; 11(4):565-77.
- Shier, A. C., Reichenbacher, T., Ghuman, H. S., & Ghuman, J. K. (2012). Pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: clinical strategies. Journal of central nervous system disease, 5, 1–17. https://doi.org/10.4137/JCNSD.S6691.
- Sarris, J., Kean, J., Schweitzer, I., & Lake, J. (2011). Complementary medicines (herbal and nutritional products) in the treatment of Attention Deficit Hyperactivity Disorder (ADHD): a systematic review of the evidence. Complementary therapies in medicine, 19(4), 216-227.
- Ibn Sina AAH (Avicenna). Al-Qānūn fī al-Tibb (Canon of Medicine). 2005; 1st ed Dare Ehyae al-Torathe al-Arabi; Beirut.
- Chashti MA. Exir-e- Azam. 2008; 1st ed. Research Institute for Islamic and Complementary Medicine; Tehran.
- Shirbeigi L, Dalfardi B, Abolhassanzadeh Z, Nejatbakhsh F. Dementia Etiologies and Remedies in Traditional Persian Medicine; a Review of Medicinal Plants and Phytochemistry. Current drug metabolism. 2018; 19(5):414-23.
- Aghili Khorasani MH. Kholasat ol-Hikmat. 2007; Esmaielian; Qom.
)