Management of ADHD symptoms in children : iron supplementation versus conventional therapy

Abstract

Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric condition characterized by hyperactivity, impulsivity and inattentiveness. Current first-line pharmacotherapeutic treatments have undesirable side-effects; to try to avoid these, iron supplementation as an alternative therapy was explored. Thus, this evidence-based dissertation explored the research question: ‘How does iron supplementation compare to conventional therapy in the management of ADHD symptoms in 3-15 year old children with ADHD?’ of which the PICO elements were P–3–15 year old children with ADHD, IIron supplementation, C-Conventional therapy, O-Improved ADHD symptoms. The articles required to be: available in full-text, focusing on a population of children with ADHD aged 3-15 years, published within the past 10 years and studying solely ADHD. Articles in abstract form, conducted on adults or animals, published before 2004 and which included comorbidities were excluded from the study. Academic Search Complete, MEDLINE (ProQuest), CINAHL Plus with Full Text (EBSCO) database, Cochrane Database of Systematic Reviews (EBSCO), Cochrane Central Register of Controlled Trials (EBSCO), PubMed, PsycINFO (EBSCO) and Advanced Google Scholar were searched up to August 30th, 2014, for literature regarding ADHD and its possible treatment, particularly iron supplementation. Using inclusion and exclusion criteria, eight articles were chosen for further analysis. AMSTAR, CASP tools, and the Cochrane Effective Practice and Organisation of Care risk of bias form and a critical appraisal tool prepared by the Centre for Evidence-Based Management were used to appraise the selected articles according to their suitability. The lack of statistically significant evidence in the literature due to set study limitations resulted in an indefinite answer to the PICO question. Scientific evidence supports the use of conventional therapy in the treatment of ADHD, but the results in this dissertation reveal the possibility of iron supplementation being also effective in reducing the symptoms of ADHD. This conclusion is conditional on further high quality research being conducted in order to confirm the results of the eight selected studies, which suffered from a small sample size. Furthermore, more awareness and education is needed with regards to ADHD, the current treatments and the availability of potential alternate therapies.