Non-stimulant interventions in ADHD

Abstract

Aim: The overall aim of the thesis was to study alternative non-stimulant treatments for Attention Deficit Hyperactivity Disorder (ADHD) in children, adolescents and adults. Method: The thesis includes four studies referring to three different treatment trials. Study 1: Randomized double-blind placebo-controlled trial of Omega 3/6 fatty acids (Equazen eyeq) treatment of ADHD in children and adolescents. Study 2: Changes in plasma fatty acid profiles in the Omega 3/6 trial, and comparison with treatment response. Study 3: One year trial of efficacy and safety of the non-stimulant medication atomoxetine in adults with ADHD. Study 4: Study of the effectiveness of the cognitive-behavioural model “Collaborative Problem Solving” (CPS) in children with ADHD and Oppositional Defiant Disorder (ODD). Results: The overall group results of Study 1 were negative, but clinical response was seen in subgroups such as those with ADHD inattentive subtype, Developmental Coordination Disorder (DCD), and reading-writing disorder. Study 2 findings suggested that clinical response to Omega 3/6 was associated with plasma fatty acid changes, especially with reduction of the n-6/n-3 ratio. Study 3 showed a moderate effectiveness of atomoxetine after 10 weeks in adults with ADHD, but the longer-term compliance to treatment was poor. In study 4 CPS showed promise in reducing problem behaviours in children with ADHD and ODD, and children with severe ADHD symptoms may be improved by combining CPS and ADHD medication. Conclusions: The trials of non-stimulant treatments included in this thesis showed some promising results and suggested directions for future research and study designs.