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Review: ω-3 fatty acids produce a small improvement in ADHD symptoms in children compared with placebo

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Is ω-3 fatty acid supplementation effective in treating attention deficit hyperactivity disorder (ADHD) symptoms in children?


Primary outcome: change in ADHD severity (standardised mean difference in change between intervention and placebo). Secondary outcome: relationship between dose of different ω-3 fatty acids in supplements and effectiveness.



Systematic review and meta-analysis.

Data sources

PUBMED was searched from 1965 up to December 2010. Unpublished or ongoing trials were searched for using the website. Hand searches of the reference lists of relevant meta-analyses or reviews were also conducted.

Study selection and analysis

Randomised placebo-controlled trials which examined the efficacy of ω-3 fatty acid supplementation in children with ADHD or targeting ADHD symptoms in undiagnosed children or those with comorbidities were included. Studies were required to have used a validated rating scale to measure ADHD symptom severity. Trials where other psychoactive substances were started at the same time as ω-3 fatty acid supplementation were excluded but supplementation was allowed to augment existing pharmacotherapy. RevMan 5 was used to carry out fixed effects meta-analysis of the results, with SPSS 19.0 to carry out meta-regression.

Main results

Ten randomised controlled trials (RCTs) in 699 …

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  • Sources of funding The authors acknowledged the National Institute of Mental Health, Yale Child Study Center, National Institutes of Health (NIH), the American Psychiatric Institute for Research and Education/Eli Lilly and Co, the American Academy of Child and Adolescent Psychiatry/Eli Lilly and Co, the Trichotilomania Learning Center, the National Alliance for Research on Schizophrenia and Depression, and the National Center for Research Resources.


  • Competing interests AJR is currently the co-holder of a corporate research grant (via Oxford University) for clinical trials of ω-3 supplementation for child behaviour and learning. She also acts as an occasional paid consultant (lectures and advisory work) for other companies and organisations involved in producing, selling or promoting foods or supplements containing ω-3.

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