April 8, 2004 -- Behavioral problems in children with attention deficit hyperactivity disorder (ADHD) frequently don't resolve with Ritalin, the medication most commonly used to treat the condition. But new research suggests that combining a daily zinc supplement with Ritalin can boost the efficacy of Ritalin.
A new study shows that children who took 55 mg of zinc daily along with their Ritalin had better symptom control than children given Ritalin and a dummy pill, says Shahin Akhondzadeh, PhD, associate professor of clinical neuropharmacology at the Tehran University of Medical Sciences in Tehran, Iran.
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Akhondzadeh tells WebMD that studies have suggested that vitamin deficiency -- in particular, zinc deficiency -- may play a role in ADHD. "The efficacy of zinc sulfate to obtain a better improvement in children with ADHD seems to support the role of zinc deficiency," he says.
The study appears in this week's issue of BMC Psychiatry.
The six week study involved 44 children, mostly boys ages 5 to 11. Before the study, these children had not been treated for ADHD. Half were given Ritalin plus a daily zinc supplement, and half received Ritalin plus a dummy pill. During the study, teachers and parents provided information to the researchers on behavioral and learning patterns in the children.
Although both treatment groups showed improvements in behavioral problems and symptoms, teachers and parents both reported significantly better improvement in the group receiving Ritalin and zinc, he says.
Children taking zinc were also much more likely to complain about a metallic aftertaste.
More Study Needed
Andrew Adesman, MD, director of the division of developmental and behavioral pediatrics at Schneider Children's Hospital in New Hyde Park, N.Y., tells WebMD that the new study is intriguing, "but the reality is that there are still many unanswered questions, and it would be premature to recommend zinc supplementation."
Adesman, who wasn't involved in the study, says that even if the zinc-Ritalin combination is proven to be more effective than Ritalin alone, that would not suggest that zinc could also improve the efficacy of Stattera, a new nonstimulant treatment for ADHD.
Adesman explains that zinc and Ritalin both affect a chemical in the brain called dopamine, which controls a number of brain functions and relays messages. Studies have shown that children with ADHD have problems with chemical messages to the brain.
Strattera, on the other hand, is a nonstimulant medication that targets norepinephrine, another brain chemical that affects impulsivity and control. "So it is far from clear that there would be an adjunctive role for zinc with Stattera," Adesman says.
While the results of his study seem promising, Akhondzadeh agrees that it is too soon to make general recommendations about zinc. He says his study had only a small number of participants and was conducted for a short time. Nonetheless, he says the findings are promising and "a larger study could answer these questions."