Practices

Natural is not a regulated word: anyone can print it next to a picture of a leaf, on anything at all. Organic in the USDA sense does have a legal definition sitting behind it.

The same goes for the reassuring line about following good manufacturing practices, which describes what a company aims at rather than what an…

Kava, valerian, St John's wort, ginkgo, ginseng and the proprietary blends have not shown benefit for ADHD in trials that matched the amount in every capsule and kept both the person handing them out and the person rating behaviour unaware of who got what.

Those two design details are most of the story. Ordinary use has dose wobble and expectation running through it, and expectation is powerful,…

If a stimulant that was working suddenly is not, ask what else the person has started taking before deciding the dose needs to go up.

One woman's Adderall went flat while she was on a herbal supplement and came back to its usual self once she stopped it. Herbs can shift stomach…

If a little helps then a lot must help more is not really a supplement thought. It is an addiction shaped thought that has wandered into the vitamin aisle.

Moderation tends not to be a natural strength with ADHD, and this is one place where that costs something. Name it early, before a safe dose has…

People with ADHD tend to have lower omega-3 in their blood, and bringing low levels up has been linked with some improvement in symptoms. No convincing difference has shown up between DHA and EPA for this.

Omega-3 comes mostly from oily fish and krill, and fish is exactly what many people with texture sensitivity will not eat. Whether the shortfall…

In one trial, children were given omegas with a multivitamin, omegas alone, or neither, and after fifteen weeks everybody got both. The omega groups gained on set shifting and attention, and the children who started with nothing caught up once they crossed over.

Two features of that design are worth understanding. Everyone receiving the treatment eventually shows that the improvement follows the treatment…

Sixty two children took methylphenidate with either vitamin D or a placebo, and both groups improved. The two ADHD rating scales showed no difference between them, which leaves the positive headline resting on the clinician's judgement rather than on what parents reported.

That shape repeats all over this literature, so it is worth learning to spot. When a study reports an effect on one measure and not another, the…

People with ADHD are reported to run low on both tryptophan and homocysteine. Low homocysteine is a good thing to have, since it is the high version that damages hearts.

The reflex to correct any number under the reference range is worth resisting. Levels can be tested where there is a reason to test them. Eating a…

More clinicians now raise supplements themselves, and more of them will suggest something like omegas. The shift matters less for what gets recommended and more for what it does to disclosure.

People hide what they expect to be laughed at. Someone braced for an eye roll simply does not mention the four bottles in the kitchen cupboard, and…

Omega supplementation for ADHD began with encouraging results, including a Swedish study where about a quarter of inattentive children seemed to improve. Blinded, placebo controlled work did not reproduce it, and a Cochrane meta-analysis found no effect.

The manufacturers themselves largely moved on to other conditions, which tells you something. None of this makes omegas worthless, and levels do run…

Cutting sugar does not improve ADHD, and nor does stripping out additives. Both have been tested repeatedly, including under conditions where nobody knew which child had eaten what.

The belief survives because parties are where children eat sweets, and parties are also loud, crowded and thrilling. The sugar takes the blame for…

Megavitamins, antioxidant products such as pycnogenol and assorted trace minerals have not beaten placebo for ADHD. They stay popular on the strength of a good story about how they ought to work.

The gap between a mechanism and an outcome is the thing worth teaching, because it will still be useful when the next product appears. Ask what…

Chiropractic neurologic organisation training, the kind involving manipulation of the skull, has no credible theory behind it for ADHD. The main harm is not the treatment itself but the months and the money that go into it.

Families meet this because it is marketed at them at the exact moment they are most willing to try anything. Naming it plainly, once, is usually…

A child can learn a self control routine beautifully in the therapy room and not use it once all week at school. Knowing the steps and performing them under pressure are two different skills.

This is why supports that sit in the moment tend to beat supports that sit in the mind. A prompt at the point of need, a changed seat, a rule the…

With EEG neurofeedback, the weaker the study, the better the results look. Six large trials using sham feedback, with parents and teachers kept unaware of who received what, found nothing beyond placebo.

That shrinking with rigour is itself the finding. Blinding matters especially here because the outcome is a rating made by adults who have watched…

Brain training makes you better at the game, and at things that resemble the game. It does not seem to reach the parts of life you bought it for.

Cogmed, the several hundred apps, the balance based programmes: they all hit the same wall when someone independent tests them with a proper control…

Ask for photographs of every bottle rather than a list from memory, then pass that list to the prescriber. Recall is patchy about names and hopeless about doses.

Intake forms catch some of it and a photo of the shelf catches the rest, including the two things nobody mentions because they seem too minor to…

Play therapy and insight based psychotherapy do not treat ADHD. There is no buried, unexpressed feeling driving it that talking will let out.

The difficulty sits in executive control and how it develops, not in hidden conflict. That said, a child with ADHD can also be anxious, grieving or…

Benzodiazepines turn the volume down. They do not change the setting the volume keeps returning to, and it is worth saying that plainly before someone starts one.

They work by strengthening the braking system the brain already runs, which is why they act quickly and why they need that braking chemistry to be…

When loss hits, remember it was named in advance as a test, and that good news was promised to those who hold.

The pain is real and expected, not a sign that something has gone uniquely wrong with you.