Writing in the Journal of Lipids, the article suggests that the supplementation of these fatty acids may lead to lowered doses of psychopharmacologic medications for the condition, improving compliance in the process.
The author Dr Emma Derbyshire identifies a dose ratio of 9: 3: 1 consisting of Eicosapentaenoic acid (EPA) (558 milligrams (mg)), docosahexaenoic acid (DHA) (174 mg) and gamma linolenic acid (GLA) (60 mg) as a regimen that could generate measurable effects.
“[The ratio] was associated with improved hyperactivity and impulsivity subscores and reduced ADHD symptoms, especially in the inattentive ADHD subtype and those with comorbid neurodevelopment disorders,” said Dr Derbyshire.
“The ratio of omega-6 to omega-3 in studies and especially the arachidonic acid (ARA)/DHA ratio may also have impacted on study outcomes, as this is regarded as being important for membrane fluidity.”
High concentration in brain
Omega-3 fatty acids’ have long been thought of as a therapeutic supplement both for the brain and the heart, providing possible protection from a heightened cardiovascular disease and stroke risk.
The long-chain polyunsaturated fatty acids are also highly concentrated in the brain, exhibiting antioxidative, anti-inflammatory, and antiapoptotic effects contributing to neuron protection.
It is these health-enhancing properties that are the subject of the review in which 16 randomised controlled trials (RCTs) were put forward for general assessment.
Of these 13 reported beneficial effects, though the levels of effect appeared to depend on the dose of the intervention, ratio of the fatty acids, quality of the RCT, and ADHD subtype under investigation.
One notable study found that children (aged 6-12) receiving omega-3/6 fatty acids providing 558 mg EPA, 174 mg DHA, and 60 mg GLA in a 9:3:1 ratio over a year did not need such a high dose of the pharmaceutical methylphenidate (MPH), to manage and reduce their ADHD symptoms (0.8 mg/kg/day versus 1.0 mg/kg/day).
The completion rate was also higher in this group, whilst the withdrawal rate and the incidence of adverse events were significantly lower. These findings indicate that omega-3/6 fatty acids may act as a useful adjunctive therapy to MPH, helping to improve tolerability, dosing, and adherence.
GOED thoughts
Commenting on past research looking at the link between Omega 3/6 fatty acids and ADHD, Harry Rice, vice president of regulatory and scientific affairs at the Global Organisation for EPA and DHA Omega-3s (GOED) said the evidence was more compelling now than it was a couple of years ago.
“Like we see with a number of conditions where EPA/DHA helps, the benefit seems to be most dramatic in individuals who have low EPA/DHA levels.
“Given the almost non-existent side effect profile of omega-3s versus the drugs of choice to treat ADHD, it makes sense to first increase intake of EPA/DHA before starting a pharmaceutical treatment.
“Even if drug treatment is necessary, increasing EPA/DHA may allow the dose of a drug to be reduced.”
Source: Journal of Lipids
Published online ahead of print: doi.org/10.1155/2017/6285218
“Do Omega-3/6 Fatty Acids Have a Therapeutic Role in Children and Young People with ADHD?”
Authors: E. Derbyshire