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St. John's Wort Does Not Help Kids With ADHD, Says Study

Parents of children and teens with attention deficit hyperactivity disorder (ADHD) often just want their kids to feel "normal" — to be able to handle the day-to-day routines and duties better and enjoy life much more, without their brains and bodies feeling so out of control. So, it's no surprise that concerned Moms and Dads often consider different kinds of remedies — both traditional and alternative — that just might help.

But, according to a new study, one alternative ADHD treatment that does not work is St. John's wort — one of the top three over-the-counter herbal supplements parents turn to for a prescription-free remedy for their kids' ADHD. The natural remedy (also called Hypericumperforatum, or H perforatum) affects certain brain chemicals (dopamine, norepinephrine, and serotonin) that may influence conditions like depression.

So to see what effect, if any, St. John's wort had on kids' ADHD, researchers gave 54 6- to 17-year-olds with the condition either the herbal supplement or placebos (pills containing no medication or herb) over a couple of months.

It turned out that St. John's wort had no effect at all on any of the children with ADHD. There was no difference whatsoever between the kids who got the herbal supplement and those who took the placebo.

Although certain drugs (which may include stimulants, nonstimulants, and sometimes antidepressants) work for up to 70% of kids and teens with ADHD, says the study, many Moms and Dads of kids with the condition are reluctant to put their children on prescribed medications (because they don't work for some and others experience side effects). Many hope that non-drug options will help their kids instead.

And that's understandable, especially considering the American Heart Association's (AHA) recent recommendation that doctors now order an electrocardiogram (ECG or EKG) for any kids prescribed stimulants (like Ritalin) to make sure that they aren't at risk for heart problems related to taking commonly recommended ADHD drugs. Although stimulant drugs' side effects (like increased heart rate and blood pressure) are "usually insignificant," AHA says kids diagnosed with ADHD should get an ECG before starting or continuing stimulants — just to be on the safe side.

More About ADHD

ADHD can affect how kids interact and function socially, academically, and at home. And children and teens with the condition also may have other problems (like depression, anxiety, or learning disorders) that require treatment, too. Plus, they may be at greater risk for smoking and drug use, especially if the ADHD isn't treated consistently — or at all. That's why catching the condition and treating it as soon as possible is so crucial.

Because ADHD is a broad category covering different types of symptoms — attention, activity, and impulsivity — it can show up in different ways in different people (both children and adults).

Some kids with ADHD have trouble:

paying attention or staying focused on a task or activity
engaging in activities quietly
finishing assignments at school or home
focusing on instructions and following through
paying close attention to details or making careless mistakes
organizing tasks and activities
waiting their turn

Children with ADHD may also:

jump from one activity to another
lose or forget things (such as homework)
become easily distracted, even when doing something fun
interrupt or intrude on other people
blurt out answers before questions have been completed
fidget with their hands or feet or squirm around when sitting
feel restless
talk excessively
Of course, all kids (especially younger ones) act like this sometimes, especially when they're tired, anxious, or excited. But the difference is that ADHD symptoms are present over a longer period of time and regularly happen in different settings.

What This Means to You

Supplements and herbal remedies, like St. John's wort, aren't regulated by the U.S. Food and Drug Administration (FDA) as drugs; they're classified as foods. That means they aren't tested and monitored like other medications for safety and effectiveness (especially in kids).

Make sure to talk to your doctor before giving your child any type of alternative medicine. And don't delay or stop any traditional medical treatment in favor of an alternative therapy. Relying entirely on alternative therapies for any serious short- or long-term conditions can jeopardize kids' health.

If you think your child might have ADHD, schedule an evaluation with your doctor, who can try to get to the root of the problem, rule out other conditions, and possibly refer you to a mental health professional.

If ADHD is diagnosed, the doctor will work closely with you to create a treatment plan tailored specifically to your child's symptoms, circumstances, and medical history.

To help control ADHD symptoms and allow kids and teens with ADHD to concentrate, focus, and function better, an ADHD treatment plan may include not just medications but also behavioral therapy and making adjustments such as:

reorganizing the home and school environment
giving clear directions and commands
responding appropriately to kids' most trying behaviors
using calm discipline techniques
helping kids develop problem-solving skills and learn how to cope with frustrations
setting up a system of consistent rewards for appropriate behaviors and negative consequences for inappropriate ones

A recent study also suggested that — because sleep problems among kids with ADHD are so common and affect them (and their parents) so much — a primary part of the ADHD treatment plan should be modifying sleep habits, which can even lessen the need for drugs in some kids.

ADHD can't be cured with any kind of treatment, but it can be successfully managed. Getting kids with ADHD the help they need can help them learn to control their behavior and lead much more manageable, happy lives.

Reviewed by: Steven Dowshen, MD
Date reviewed: June 2008

Source: "Hypericum perforatum (St John's Wort) for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents," Journal of the American Medical Association (JAMA), June 11, 2008.