Today, we wanted to take you into a conversation with one of America’s leading experts on natural therapies for ADHD. We trust this interview will be helpful:
Stimulants or Natural Therapies: Thoughts from the Expert
We are discussing natural therapies for ADD with one of our Nation’s top psychiatrists, Dr. Andrew Farah. To begin with, Dr. Farah, you have been critical of the use of stimulants in kids, and adults also—
Well, critical of them as first-line therapy. I think there are so many risks, and potential side effects with stimulants that it really is just best for the patient to start with the omega-threes, the natural therapies first.
What are the risks you are concerned about?
The most serious ones include hallucinations. One possible issue is children on stimulants may see things, often they see snakes. I recall one adult patient on Adderall who saw worms coming out of her skin. It’s very frightening for them, and this can occur with standard doses. Tics are also a possibility, as anytime we manipulate the dopamine system, as we do with stimulants, you can induce abnormal movements. Suppression of appetite, suppression of growth. That’s why we often see clinicians recommend a discontinuation of stimulants during summer if possible.
What about stimulant abuse?
Certainly we see this in college and in adults. Now, the good news is that stimulant use in childhood ADD is actually associated with a reduction in the risk for subsequent drug and alcohol use disorders later in life, we used to worry that it predisposed ADD kids to abuse of substances later, but these rates are lower.
So there is a role for stimulants?
There are some kids who will need stimulant therapy, but we should start with the safest option first in every case. And even if partially successful, the omega-three is the platform that can lower the required dose of a stimulant, making its use safer.
So a combination- right?
Yes, they are safe together.
Natural Therapies for ADHD: Omega-Threes
Now let’s focus on the omega-threes; you have argued that they are healthier as far as brain development, right?
Yes, the brain is about 60% lipids. Specifically it’s the phospholipids that comprise the cell membranes. Omega-threes are the building blocks for brain cell membranes, but also regulate the membrane’s fluidity and play a role in cell-to-cell communication. We’ve known since the late 80’s that reduced levels of omega-three fatty acids are associated with ADD and ADHD. But dietary changes in recent decades mean kids may not get adequate omega-threes for brain maturation.
OK, so which omega-three- how much, how often?
The literature is all over the place, and patients and doctors alike seek some clarity. We go with the Fastbraiin brand of DHA and phosphatidylserine. They have internal data that shows a robust response for ADD kids as far as concentration, attention span, improved memory, and it’s the most cost-effective brand, for about $20 a month. The dose is DHA at 700 mg a day, and they will also send the phosphatidylserine (PS) to take with it.
Is the PS necessary?
Yes, it makes the omega “brain-ready.” Some brands charge more to have the PS already attached to the DAH, but your GI system disassembles it and your body has to reassemble it, so it’s cheaper to save a step and give them separate.
Dr. Farah, Thank you!