Behavioral treatments and ADHD medications are the frontline evidence-based interventions recommended for kids and teens with ADHD. While many kids and teens respond well to these treatments, not everyone has a strong response or even has access to these interventions. So, it’s not surprising that many parents explore alternative treatment options, like supplementation with omega-3 fatty acids. But what exactly are omega-3 fatty acids, and can they really help treat ADHD symptoms?
Omega-3 fatty acids are at type of fat that our bodies need to survive, and are found in foods like fish, flaxseed oil, and other plant-based foods. Fish oil supplements are a popular source of omega-3s. There are three types of fatty acids included in the omega-3 cluster: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – found in fish, and alpha-linolenic (ALA) – found in plant oils, like flaxseed oil. Omega-3 fatty acids play an important role in the body, influencing the development and healthy functioning of cells in our eyes, brain, cardiovascular system, endocrine system, and more. When it comes to ADHD, there is a theory that omega-3 fatty acids (specifically EPA and DHA), may help reduce ADHD symptoms by boosting the level of certain neurotransmitters in the brain, minimizing oxidative stress, and/or reducing inflammation.
Recent studies have found that some individuals with ADHD have low blood and plasma levels of omega-3 fatty acids, contributing to the theory that boosting blood levels of omega-3 fatty acids may reduce ADHD symptoms. While the theory is promising, studies examining the effect of omega-3 fish oil supplements on ADHD symptoms have shown mixed results. Some studies have found decreases in ADHD symptoms following supplementation, while others have not. In studies where symptom improvement was found, symptoms were not “normalized” – meaning that while symptoms decreased, these kids and teens were still impaired relative to kids and teens without ADHD. In a placebo-controlled study published last month in the Translational Psychiatry, researchers found that supplementation with a high dose of EPA (one of the omega-3 fatty acids found in fish oil) taken daily for 12 weeks improved ADHD symptoms in children and teens who had low blood and plasma levels of EPA at the start of the study, but did not significantly affect the ADHD symptoms of children and teens whose blood and plasma levels of EPA were “normal” before supplementation.1 This may explain some of the mixed findings observed in earlier research.
With this mixed evidence, should parents consider providing omega-3 supplements for their children and teens with ADHD? In 2018, a meeting was convened by 8 international ADHD experts to create omega-3 supplementation guidelines for health care professionals who treat children and teens with ADHD.2 The panel’s consensus is that omega-3 fatty acid supplementation may lead to small behavior gains for children and teens with ADHD, and that if these supplements are used they should be used only in conjunction with other interventions, like ADHD medications and behavioral treatments, and not as a stand-alone treatment. If you are considering adding omega-3 fatty acids to your child or teen’s ADHD treatment plan, consult with your pediatrician to discuss the proper supplement dose and possible side effects.
1Chang J.P.C., et al. (2019). “High-dose eicosapentaenoic acid (EPA) improves attention and vigilance in children and adolescents with attention deficit hyperactivity disorder (ADHD).” Translational Psychiatry, 9, Article number: 303.
2Banaschewski, T. et al. (2018). Supplementation with polyunsaturated fatty acids (PUFAs) in the management of attention deficit hyperactivity disorder (ADHD). Nutrition and Health, 24(4), 279-284.
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
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