Can You Treat ADHD without Drugs?

Ask a Doctor

My daughter has been diagnosed with attention deficit hyperactivity disorder and now our doctor wants to prescribe her Adderall, which in my understanding, is basically amphetamines. I really don’t want my little girl on those kind of drugs. What are other interventions I can explore instead? Can You Treat ADHD without Drugs?

Doctor’s Response

While some people have suggested that certain diets, teaching or parenting methods, or other approaches may keep ADHD from developing, unfortunately, none of these approaches has stood up to rigorous scientific testing so far. On the other hand, once the symptoms have begun and careful assessment has produced an ADHD diagnosis, various specific behavioral and learning techniques can be used by teachers and family to help get symptoms under better control. These should be discussed with the treating doctor so that the right interventions can be applied for the specific person.

Regular physical activity has been shown to play an important role in some of the common related conditions (for example, depression, anxiety) and to improve concentration. Regular exercise may be beneficial in people with ADHD. Several studies on children with ADHD not taking medication have shown an improvement in concentration and reduction in inattentive and hyperactive behaviors if one hour of vigorous after-school play occurs before starting homework.

No specific food or diet has been clearly shown to have a significant positive or negative effect on the symptoms or course of ADHD. People with ADHD should eat a healthy diet and probably avoid caffeine. That having been said, if the family's experience with a person having ADHD is that some sort of dietary change, such as decreased refined sugar intake, helps, then if the person is not deprived of necessary nutrients, there is certainly no harm in trying to follow such a plan. A good rule of thumb is to discuss the plan with the family doctor or whoever is providing the primary treatment for the ADHD symptoms.

CAM (complementary and alternative medicine) therapies are considered and/or tried in over half of patients with ADHD. Many times these modalities are used covertly and it is important for the treating physician to inquire about CAM to encourage open communication and review the risks versus benefits of such an approach. CAM treatment modalities incorporating vision training, special diets and megavitamin therapy, herbal and mineral supplements, EEG biofeedback, and applied kinesiology have all been advocated. The benefits of these approaches, however, have not been confirmed in double-blinded controlled studies. Families should be aware that such programs might require a long-term financial commitment that may not have insurance reimbursement as an option. Recent research on the benefits of specific polyunsaturated fatty acid (EPA and DHA) supplementation has demonstrated a therapeutic benefit in several well-designed studies. Further research in this area will hopefully shed light on how these supplements work.

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ADHD Practice Guideline for the Diagnosis, Evaluation and Treatment of Attention Deficit Hyperactivity Disorder in Childhood and Adolescence. Subcommittee of the American Academy of Pediatrics: Steering Committee on Quality Improvement and Management. Pediatrics 128 (2011): 1007.

Biederman, J., et al. "Do Stimulants Protect Against Psychiatric Disorders in Youth With ADHD? A 10-Year Follow-up Study." Pediatrics 124.1 July 2009: 71-78.