Food and Behaviour Research

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Vitamin-mineral treatment improves aggression and emotional regulation in children with ADHD: a fully blinded, randomized, placebo-controlled trial

Rucklidge JJ, Eggleston MJF, Johnstone JM, Darling K, Frampton CM (2018) J Child Psychol Psychiatry  59(3) 232-246. doi: 10.1111/jcpp.12817. Epub 2017 Oct 2. 

Web URL: Read this and related articles via PubMed here. Free full text of this article is available online

Abstract:

Background: Evaluation of broad-spectrum micronutrient (vitamins and minerals) treatment for childhood ADHD has been limited to open-label studies that highlight beneficial effects across many aspects of psychological functioning.

Method: This is the first fully blinded randomized controlled trial of medication-free children (n = 93) with ADHD (7-12 years) assigned to either micronutrients (n = 47) or placebo (n = 46) in a 1:1 ratio, for 10 weeks. All children received standardized ADHD assessments. Data were collected from clinicians, parents, participants and teachers across a range of measures assessing ADHD symptoms, general functioning and impairment, mood, aggression and emotional regulation.

Results: Intent-to-treat analyses showed significant between-group differences favouring micronutrient treatment on the Clinical Global Impression-Improvement (ES = 0.46), with 47% of those on micronutrients identified as 'much' to 'very much' improved versus 28% on placebo. No group differences were identified on clinician, parent and teacher ratings of overall ADHD symptoms (ES ranged 0.03-0.17). However, according to clinicians, 32% of those on micronutrients versus 9% of those on placebo showed a clinically meaningful improvement on inattentive (OR = 4.9; 95% CI: 1.5-16.3), but no group differences on improvement in hyperactive-impulsive symptoms (OR = 1.0; 95% CI: 0.4-2.5). Based on clinician, parent and teacher report, those on micronutrients showed greater improvements in emotional regulation, aggression and general functioning compared to placebo (ES ranged 0.35-0.66). There were two dropouts per group, no group differences in adverse events and no serious adverse events identified. Blinding was successful with guessing no better than chance.

Conclusions: Micronutrients improved overall function, reduced impairment and improved inattention, emotional regulation and aggression, but not hyperactive/impulsive symptoms, in this sample of children with ADHD. Although direct benefit for core ADHD symptoms was modest, with mixed findings across raters, the low rate of adverse effects and the benefits reported across multiple areas of functioning indicate micronutrients may be a favourable option for some children, particularly those with both ADHD and emotional dysregulation. Trial registered with the Australian New Zealand Clinical Trials Registry ACTRN12613000896774.

Keywords: ADHD; Mood; Treatment; aggression; micronutrient; mineral; vitamin.

FAB RESEARCH COMMENT:

Supplementation with a broad range of vitamins and minerals showed benefts for children with ADHD in this randmised, double-blind placebo-controlled trial - supporting findings from previous open studies in this area.

Significant reductions were found for core symptoms of inattention, and also for emotional regulation and aggressive behaviour following supplementation, while changes in hyperactivity did not reach significance over placebo treatment.

The multi-vtamin and mineral (MVM) supplementation only provided levels of micronutrients comparable to recommended daily intakes, and no adverse effects were reported. 

Similar broad-spectrum vitamin and mineral supplementation has already been shown in controlled trials to reduce mood and behaviour problems in other populations, including adults with ADHD.

Given the safety and acceptability of this kind of supplementation, and the limitations of existing treatments for ADHD and related conditions, these findings add to the case for using this kind of approach as an adjunctive treatment.  


In this related news article, the first author and another leading researcher in this field explain the rationale for this study, and provide more details on both its findings and their implications for policy and practice:


For more information on clinical trials of nutritional and dietary interventions in the management of ADHD, see also: