St John’s Wort for ADHD: Who Cares?
This past week, a study was released in the prestigious Journal of the American Medical Association, which documented that St. John’s Wort has no benefit in ADHD or ADD.
You can access the original article here.
While I’m glad to see a natural treatment receive such rigorous research, and publication in such a leading journal, the question is: who cares?
The main concern that I have with this study is: Who even thought that St. John’s Wort worked for ADHD?
In the introduction of the research paper, the authors assert that St. John’s Wort is one of the top 3 botanical/herbal remedies used for ADHD. This statistic is referenced from a survey published in 2003 (you can read the abstract of this study here). There is a problem with taking this as a conclusion from this survey. This study surveyed pediatric patients treated for depression and ADHD, and reported on the most common herbal treatments used in the past year. The top 3 herbal preparations used included: gingko biloba, echinacea, and St. John’s Wort. However, the authors did not correlate the herbal medicine’s use with the condition - in other words, if an ADHD patient had taken echinacea, this study does not tell us that he/she took it for ADHD or for the common cold. In other words, the St. John’s Wort could have been taken for the depression (which was also tracked in the study) and not for the ADHD. Furthermore, there were very few patients who had taken herbal preparations in the past year (i.e. 18), bringing into question if this study was representative of the wider use of herbal preparations in ADHD.
As a physician in the field of ADHD - talking to my patients who try alternatives, and reading about it as well - I have never heard of using St. John’s Wort for ADHD. Referencing the book:ADHD Alternatives: A Natural Approach To Treating ADHD, By: Aviva Romm and Tracy Romm - they document that St. John’s Wort is effective for depression, but they do not even consider it a treatment for ADHD.
The American Herbal Products Association (AHPA) responded to the study, documenting two main concerns:
- That the survey documenting that St. John’s Wort’s use for ADHD was flawed
- That the strength of the St. John’s Wort in this clinical trial was degraded by the end of the study. They document that the authors even admit this.
Click here to read the AHPA’s response to this study.
In summary, I like seeing a major clinical trial on an alternative treatment for ADHD. I believe that we need a lot more of those. In future, my hope is that the researchers will choose compounds which are both widely used and considered to be effective before running the whole trial.
Please share your comments below - and if you do have any experience with St. John’s Wort - or more importantly - an herbal treatment which actually worked for ADHD - please share it below (in the comments).
All the best,
Dr. Kenny
p.s. to read more on St. John’s Wort - here is the wikipedia article.
Technorati Tags: St. John’s Wort, ADHD, Herbal Medicine, ADD
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Written by Dr. Kenny Handelman - The ADHD Doctor
To find get a FREE special report on ADD/ADHD Medication, visit: Medication Mastery
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June 13th, 2008 at 11:07 am
I have never experienced any of my patients having success using herbal treatment. I think there is a lot of false statements concerning their effect but I have not seen any positive results. I am not against herbal treatment, if it can be jproven it is effective in the treatment of ADHD.
Stan Carder, MS, LPCC
June 13th, 2008 at 11:12 am
DHLPA helps. Doesn’t cure, but if I go off it a handful of days, I’m very, very scatterbrained. 500mg/day.
Ginko helps some.
June 13th, 2008 at 12:16 pm
I’m very in favour of studies on natural therapies for ADHD, as the side effects of the meds can be very difficult for parents to deal with. More studies are needed on other alternative treatments e.g. amino acids, antioxidants, zinc, etc. The role that heavy metals may play in ADHD should also be discussed in medical arenas…..
cathy
June 13th, 2008 at 1:25 pm
Behavior modification through coaching and therapy are the only real ways to change the brain permanently. Of course this takes a lot of work , which is difficult, but once the brain connections are made they do not go away. Taking drugs prescription or herbal is like turning a light switch on and off. Drugs only work when you take them, and the brain returns to the normal ADD state when you don’t.
June 13th, 2008 at 3:11 pm
I would like to see proof that any sort of ‘talk therapy’ could physically change an organic neurological disorder. In the example of chronic depression, results are worse than doing nothing at all.
As to medications, we are still at the ‘hit the side of the tv’ stage. We are beginning to understand some of the neurological characteristics, such as have been found with PET scans, but being able to treat the cause, and not some of the symptoms, at a remove, is beyond us as of yet.
June 13th, 2008 at 4:21 pm
Dear Dr. Handelman,
I’m glad that you noticed that the study was seriously flawed. Unfortunately, the major news networks were not as thorough. Some of the headlines were:
St. John’s wort fails to help kids with ADHD
The Associated Press
St. John’s Wort Doesn’t Work for ADHD
Washington Post
St. John’s Wort No Help in ADHD
ABC News
St. John’s wort no better than placebo for ADHD, Bastyr study finds
Seattle Times
St. John’s Wort No Help for ADHD
TIME Magazine
Herb does not ease ADHD
ZDNet
St. John’s wort doesn’t help ADHD, study finds
Reuters
_____________
It makes me wonder if the big news organizations have a bias against alternative medicine (After all, the drug companies advertise heavily in the mainstream news media. )
Or, perhaps reporters are just to overworked to take the time to dig for the truth anymore.
Keep up the good fight towards figuring out what really works.
- Mike
June 13th, 2008 at 8:38 pm
Hi; Our 9 year old son is ADHD and we have researched the mainstream herbal medications in order to try to ensure that the medicine he uses can be kept at the lowest dosage possible. We have never heard of St. John’s Wort used for this condition so thank you Dr. Kenny for commenting on it. We have used the Omega 3’s with limited success although when we first started using them a number of years ago we did feel there was an improvement in his emotional stability in that it didn’t seem to be quite the same roller coaster of emotions. If I may add to the above comment about behaviour modification being more important than the medications either herbal or otherwise. I couldn’t agree more. Unfortunately, it is not effective if the person’s ADHD will not allow the brain to grasp the lessons being taught. Our feeling is that the combination allows our son to grasp the lesson before failure to fit his behaviour to society’s narrow confines causes his personality/charm & exuberance to wither.
]What we have used that has been very effective for him is Melatonin. He has great sleep hygiene however struggles significantly to get to sleep, lying in the dark for upwards of 2 hours without successfully falling asleep. Our pediatrician suggested some medications but we were reluctant to persue the drug cocktail solution, for obvious reasons. After some research and unsuccessful attempts at yoga for sleep etc. we decided to give Melatonin a try. It has been very successful for our son in quite low dosages allowing him to fall asleep appropriately and impacting his behaviour accordingly. There are a couple of studies I’ve found about sleep/Melatonin/ADHD but I believe this is an area that would benefit from further concentration.
June 14th, 2008 at 2:18 pm
I hope questions are ok.
I’d like to know if herbal / vitamen preparations such as Clarocet are helpful. What about the vitamin advice given by Dr. Frank Lawliss (Dr. Phil’s mentor!) in his book on ADHD? Also, should women who only discover they have ADHD at menopause because their estrogen tanks and they have been adaptive enough to cover it up since childhood, try estrogen creams or patches? Do you favour website brain programs for helping with ADHD in adults?
June 14th, 2008 at 4:05 pm
Thanks for the information on ADHD.
We recently wrote an article on if having ADHD affects children in school at Brain Blogger. Having a child with ADHD is hard work, especially when having ADHD affects their school life. There was a study that followed 370 adolescents who have ADHD as well as 740 controls (There were two controls for each adolescent with ADHD.) and showed that ADHD students are absent more, have lower standardized reading scores, dropout of school at higher levels, and are held back more often.
We would like to read your comments on our article. Thank you.
Sincerely,
Kelly
June 14th, 2008 at 8:44 pm
Dr. Kenny, I recently purchased something at the grocery store called Nervita (for lack of concentration), containing anacardium orientale, cina, coffea cruda, gelsemium, kalium bromatum, and kalium phosphoricum. Our 7-year-old son has ADHD, and is currently on 25 mg of Strattera - it is helping a little for hyperactivity but not for inattention. We tried the Nervita once and didn’t notice any difference. Can you tell me anything about the substances in Nervita and their effectiveness in treating ADHD?
June 15th, 2008 at 10:38 pm
I am all for natural treatment & remedies. Keep up with the research though any kind of education is good education.
June 19th, 2008 at 2:30 pm
HI , JUST THOUGHT ID SHARE WITH YOU SOME INFO.MY SON WHO IS NOW 14 SAW A NUTRITIONALIST FROM HARLEY ST IN LONDON AND HE RECOMMENDED A LOCAL CHEMISTS PREPARATION OF ZINC DROPS. APPARENTLY ZINC WORKS AS A TRAFFIC POLICEMAN TO THE BRAIN AND HELPS SEND THE CORRECT MESSAGES AT THE RIGHT TIME. THESE DROPS HAVE WORKED WONDERS AND MY SON CAN CONCENTRATE AND THINK MUCH QUICKER WHEN HE IS TAKING THEM. PS ZINC TABLETS ARE NOT THE SAME.
June 20th, 2008 at 2:12 am
I live in the Philiipines…they only have 2 meds for ADHD…we tried both them but they make my 9 yr. old more agitated and hyper. So I researched the herbal route. I read in a book about what to try..its written by a Dr. in Calif.– I forgot the name right now. Its been helpful! I see a difference in his behavior and mood. Because of my child’s specific symptoms, we tried a combination of an amino acid (L-tyrosine) combined with St. John’s wort. The book said not to take the amino acid without the St. John’s wort, for the ones with anger and negativity, because some previous patients had experienced nightmares and destructive thoughts. The amino acid helps the brain regarding hyperactivity and impulsivity and the St. Johns wort helps the mood. He has always been hyperactive and impulsive, but happy. Then at 8 years old, and a school year with a teacher and principal that were uninformed about ADHD (always scolding and punishing him), my child became quite negative, including complaining, whining, and also angry. My child takes 3 times daily…..I can see when it starts to wear off. The herbs dont work immediately, but have to get into the system…..also if takes a couple days to see a big difference if stopped.