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Besides chemical medications that are prescribed that can increase the level of dopamine, and other important neurotransmitters in the brain. What is the most effective natural treatment method for ADD, and ADHD?

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    $\begingroup$ have you done any googling? what have you found and what you still want to understand better? $\endgroup$ Commented Dec 17, 2017 at 23:36

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Not much seems to work; psychotherapy appears questionable when the patients are re-evaluated by someone else. The only thing with a minor but generally applicable effect is free fatty acid supplementation, although the effect may be so minor as to have no clinical value.

Of course, most of these findings come from a meta-analysis (Sonuga-Barke 2013) published in a psychiatry journal...

Two different analyses were performed. When the outcome measure was based on ADHD assessments by raters closest to the therapeutic setting, all dietary (standardized mean differences=0.21-0.48) and psychological (standardized mean differences=0.40-0.64) treatments produced statistically significant effects. However, when the best probably blinded assessment was employed, effects remained significant for free fatty acid supplementation (standardized mean difference=0.16) and artificial food color exclusion (standardized mean difference=0.42) but were substantially attenuated to nonsignificant levels for other treatments.

CONCLUSIONS: Free fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessments, although the clinical significance of these effects remains to be determined. Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities. Better evidence for efficacy from blinded assessments is required for behavioral interventions, neurofeedback, cognitive training, and restricted elimination diets before they can be supported as treatments for core ADHD symptoms.

The editorial that accompanied this paper had this pull-out:

Behavioral treatments have been demonstrated to be helpful for children with co-occurring disorders and symptoms, although this blinded analysis did not show efficacy for core ADHD symptoms.

And it's worded that way because a prior meta-analysis (Fabiano 2009) using less stringent criteria (no blinging required) found (of course) that behavioral interventions work.

Regarding food colorants, only about 8% of ADHD children are estimated by a different meta-analysis (Nigg 2012) to be affected/sensitive.

And a meta-analysis of diet interventions Pelsser 2017 was quite skeptical of most stuff:

Considering the small average ESs [effect size] PUFA [poly-unsaturated fatty acid] supplementation is unlikely to provide a tangible contribution to ADHD treatment, while further research is required for AFC [artificial food color] elimination before advising this intervention as ADHD treatment. The average FFD [Few Foods Diets] ES is substantial, offering treatment opportunities in subgroups of children with ADHD not responding to or too young for medication.

So the cool new thing is FFD now. Since the last paper is freely available... I won't say much more, except that it may take a year to permute food choices until the right few foods are determined. They do say in the (body of the) paper that (owing to this time-scale issue):

large-scale implementation of the few-foods approach would not be a realistic recommendation.

I have to wonder why that didn't make it into the abstract.

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It seems that things like aerobic exercise and mindfulness meditation can help alleviate some of the symptoms of ADHD. Aerobic exercise, in particular, helps increases many of the neurotransmitters involved in ADHD such as dopamine. Mindfulness meditation helps strengthen executive function and can be a good strategy for regulating emotions and behaviors.

Source: http://www.russellbarkley.org/factsheets/ADHD_EF_and_SR.pdf

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  • $\begingroup$ Exercise has seen more attention ncbi.nlm.nih.gov/pmc/articles/PMC3724411 "Taken together, these five pilot studies – although each limited by small sample size, unblind status of the researchers and raters of behavior, and/or either lack of or poorly designed control conditions – provide preliminary evidence of the potential for exercise interventions to improve both the behavioral symptoms and neuropsychological functioning of school-aged children with ADHD." Exercise is beneficial anyway, but I would not pin too much hope on it alone given the quality of the research. $\endgroup$ Commented Dec 20, 2017 at 3:11
  • $\begingroup$ And a newer review by different authors concluded pretty much the same thing: "The preliminary state of the evidence supports PA as an adjunctive treatment for ADHD at this time, but the body and sophistication of the research to date is insufficient at present to support PA as a stand-alone treatment." $\endgroup$ Commented Dec 20, 2017 at 3:15
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    $\begingroup$ And regarding meditation, another recent review says "Results indicated that risk of bias was high across studies. At this stage, no definitive conclusions can be offered regarding the utility of meditation-based interventions for children with ADHD and/or their parents, since the methodological quality of the studies reviewed is low." And this pretty much the same finding from a different review some years ago. $\endgroup$ Commented Dec 20, 2017 at 3:17
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Not an expert on the field, but neuro feedback seems to be even more effective than drugs, in particular regarding the long term benefits. Here I cite an additude article which summarized four studies. Clearly, none of the studies is bullet proof, but I think this is pretty good evidence.

Monastra, et al. (2002): 100 six- to 19-year-olds with ADHD were treated for one year with a combination of Ritalin, behavior therapy, and school accommodations. Half of parents also opted to include neurofeedback in the treatment plan. The youth receiving neurofeedback did better than did the other subjects on parent and teacher reports, and computerized attention tests. EEG scans showed that their brainwaves had normalized. After discontinuing medication, only the patients who received neurofeedback saw persistent results. This study is criticized because its participants were not randomly assigned to treatment groups.

Levesque, et al. (2006): 20 eight- to 12-year-old children with ADHD were randomly assigned to receive 40 weekly neurofeedback treatment sessions, or to a waitlist control condition with no treatment. At the end of 40 weeks, the children who had received neurofeedback showed noteworthy improvement, as captured by parent ratings and laboratory measures. fMRI scans showed significant change in brainwave patterns for the treated children, but no change for control children. This study was limited by its small sample size.

Gevensleben, et al. (2009): 102 eight- to 12-year-olds with ADHD were randomly chosen to receive neurofeedback or computerized attention training. Both groups received 36 active treatment sessions over 18 weeks. Researchers tried to keep parents and teachers from knowing which treatment the children received. This study sought to remedy shortcomings of previous research with a randomized control group, along with a larger sample size. At the end of the study, the children in the neurofeedback group showed 0.6 greater reductions in parent and teacher ratings of ADHD symptoms when compared to the computer-training group. Six months later, the differences remained, and parents of the children treated with neurofeedback reported fewer homework difficulties.

Meisel et al. (2013): 23 seven- to 14-year-olds were randomly assigned treatment with methylphenidate or 40 neurofeedback sessions. Both groups showed significant and equivalent reductions in parent and teacher ratings of ADHD symptoms immediately after training ended, two months afterward — and the improvements persisted through a six-month follow-up. Teachers reported significant academic improvements in reading and writing skills for only the neurofeedback group, but it is not clear if teachers were blind to which group received which treatment.

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