Attention deficit hyperactivity disorder (ADHD) is the most common behavioural disorder in children. The mainstay of treatment is stimulant drugs. There is significant interest in the role of omega 3 fatty acids in ameliorating ADHD symptoms. We reviewed the evidence from available randomized controlled trials.

Clinical question In a child with ADHD (patient), will supplementation with LCPUFA (omega3) (intervention) improve symptoms (outcome)?

Sources Pubmed, Sumsearch, Ovid and Cochraine library. 7 randomised control trials were analysed.

Summary There was no uniformity in terms of the dose or duration of fatty acids. The criteria used for measuring outcome varied significantly. In the largest study, Sinn etal compared omega3 with omega3 and multivitamins and placebo. This study involved the longest treatment period. There was significant improvement in ability to switch and control attention. But, there was no improvement in any other cognitive measures. Richardson et al and Belanger et al reported statistically significant improvements in symptoms with higher doses of omega 3. However both used small sample size. The former study lacked robust inclusion criteria. Of the studies that used low dose regime, Gustafson et al demonstrated significant improvement in cognition, inattention and opposition while Voigt et al failed to show any. Interestingly, Hirayama et al showed improvement in the placebo group.

The current available evidence is not sufficient to support the use of omega 3 fatty acid in the treatment of ADHD. More studies need to be conducted in the future using objective outcome criteria and good sample size.