SUDBURY, MASSACHUSETTS. Attention-deficit hyperactivity disorder (ADHD) manifests itself by the inability to concentrate in a sustained manner, control impulsive actions, and pay attention to tasks. Hyperactivity and oppositional/defiant behavior are other ADHD symptoms, which affects as many as 7% of children in the United States, mostly boys. About 70% if children with ADHD continue to experience ADHD-related problems as adults. Several clinical studies have noted that ADHD patients have a deficiency of omega-3 long chain fatty acids, specifically EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid, respectfully), the main components of fish oil. It is also clear that ADHD patients have a very high ratio of arachidonic acid (AA) to EPA.
Depression often accompanies ADHD and an increased AA:EPA ratio correlates positively with severity of depression. The prevalence of depression is very low in Japan and so is the average AA:EPA ratio which ranges from about 1.3 to 3. In comparison, US boys with ADHD usually have AA:EPA ratios of 30 or higher. Researchers at the Inflammation Research Foundation and the Hallowell Center reasoned that it might be possible to reduce ADHD symptoms by fish oil supplementation using dosages sufficient to bring the AA:EPA ratio down to the Japanese level and carried out a pilot study to investigate this possibility.
The study involved 6 boys and 3 girls who had been diagnosed with ADHD and were under the care of a psychiatrist. The median AA:EPA ratio in isolated plasma phospholipids was 20 at the start of the study. All study participants were instructed to take 2 tablespoons (30 mL) of a liquid concentrate of EPA and DHA supplying a total of 10.8 grams EPA and 5.4 grams of DHA a day. After 4 weeks, the AA:EPA ratio was measured again and the EPA and DHA dosage adjusted to ensure an AA:EPA ratio of no less than about 1.5. At the end of the 8-week trial the median AA:EPA ratio was 1.7 as compared to 20 at baseline. Also over the 8-week period, EPA concentration in phospholipids increased by a factor of 10, while DHA concentration tripled. AA concentration did not change significantly. Commensurate with the decrease in AA:EPA ratio, a highly significant reduction in ADHD symptoms was observed by both the psychiatrist and parents. Inattention score fell from 18 to 10, hyperactivity score from 11 to 5, oppositional/defiant score from 10 to 5, and conduct disorder score from 5 to 1. The researchers conclude that high-dose EPA and DHA supplementation (which can be found in fish oil capsules) is effective in reducing the AA:EPA ratio, and markedly reduces the most common symptoms of ADHD.
Sorgi, PJ, et al. Effects of an open-label pilot study with high-dose EPA and DHA concentrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder. Nutrition Journal, Vol. 6, 2007, pp. 16-23