<h4>Context</h4>Nonpharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) encompass a range of care approaches from structured behavioral interventions to complementary medicines.<h4>Objectives</h4>To assess the comparative effectiveness of nonpharmacologic treatments for ADHD among individuals 17 years of age and younger.<h4>Data sources</h4>PubMed, Embase, PsycINFO, and Cochrane Database of Systematic Reviews for relevant English-language studies published from January 1, 2009 through November 7, 2016.<h4>Study selection</h4>We included studies that compared any ADHD nonpharmacologic treatment strategy with placebo, pharmacologic, or another nonpharmacologic treatment.<h4>Data extraction</h4>Study design, patient characteristics, intervention approaches, follow-up times, and outcomes were abstracted. For comparisons with at least 3 similar studies, random-effects meta-analysis was used to generate pooled estimates.<h4>Results</h4>We identified 54 studies of nonpharmacologic treatments, including neurofeedback, cognitive training, cognitive behavioral therapy, child or parent training, dietary omega fatty acid supplementation, and herbal and/or dietary approaches. No new guidance was identified regarding the comparative effectiveness of nonpharmacologic treatments. Pooled results for omega fatty acids found no significant effects for parent rating of ADHD total symptoms (<i>n</i> = 411; standardized mean difference -0.32; 95% confidence interval -0.80 to 0.15; I² = 52.4%; <i>P</i> = .10) or teacher-rated total ADHD symptoms (<i>n</i> = 287; standardized mean difference -0.08; 95% confidence interval -0.47 to 0.32; I² = 0.0%; <i>P</i> = .56).<h4>Limitations</h4>Studies often did not reflect the primary care setting and had short follow-up periods, small sample sizes, variations in outcomes, and inconsistent reporting of comparative statistical analyses.<h4>Conclusions</h4>Despite wide use, there are significant gaps in knowledge regarding the effectiveness of ADHD nonpharmacologic treatments.

The treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents can be challenging and involve a combination of pharmacologic and non-pharmacological approaches. Using recent literature, we aim to identify the effectiveness of cognitive behavioral therapy (CBT) and methylphenidate (MPH) in reducing the symptoms and improving the quality of life. The investigators conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Investigators independently conducted a routine search on PubMed and Google Scholar for articles published within the last five years through July 30, 2022. Fourteen studies were identified as generally good quality but with some limitations. The final analysis included 2098 patients with an age range of three to eighteen. Nine studies reporting the efficacy of MPH in children, adolescents, or both had different formulations and doses. Six studies documenting the effectiveness of CBT had varying sessions, duration per therapy, modality of administration, and participants. The diagnostic assessment measures showed that the parent symptom rating was the highest and appeared in 11 studies, reflecting the burden on the family. In addition, a structured-self-rated questionnaire rating appeared in eight studies, and two diagnostic assessment measures, teacher symptom rating and investigators, appeared in six. The studies demonstrated significant reductions in the primary symptoms of ADHD at assessment, which led to improved behavioral and functional status with a reduced impact on family and society. Further trials are needed to understand the benefits of CBT and MPH when combined to reduce psychiatry co-morbidities and improve learning and overall quality of life in the long term.

Attention-deficit/hyperactivity disorder (ADHD) is a neurobiological disorder. Common symptoms are inattention, hyperactivity, impulsivity, and executive functions deficit, often with comorbidities. Main treatment involves pharmacological and non-pharmacological therapies (cognitive-behavioral therapy, psycho-pedagogical programs). Emerging non-pharmacological treatments include manual therapies (MTs) in mental health. Several MT techniques have shown effectiveness in ADHD. The objectives of this study are as follows: (a) to assess short-term effects and persistence of an MT program on neuropsychological (hyperactivity index through the Conners’ Global Index [CGI]) and neurophysiological (time–frequency domain parameters of heart rate variability [HRV]) variables in ADHD children, and (b) to test the feasibility of the design. This study was approved by the Parc Tauli Corporation Clinical Research Ethics Board (#2017311). Pilot, controlled, multidisciplinary study of eight children with ADHD randomly assigned to control group (CG; n = 4) and intervention group (IG; n = 4). Both followed multimodal treatment, and IG also received an MT program per week for 4 weeks. A physiotherapist and a psychologist analyzed short-term effects (1-week post-program) and persistence (36 weeks). Eight children (boys, 62.5%; girls, 37.5%) with an average age of 10.375 ± 0.74 years were included. Baseline HRV parameters showed basal sympathetic predominance. The MT program increased the parasympathetic activity, which was significantly maintained at 1 to 36 weeks; there were no changes in CG. One-week post-program IG showed significant CGI reduction (–7 points, p = .016*), CG without changes (p = .41), with significant differences CG – IG (p = .0097*), and very large effect size (d = 2.235); 36 weeks post-program showed no effects (IG, p = .293; CG, p = .247), without differences CG – IG (p = .369). The MT program reduced the hyperactivity index with a 1-week persistence and increased the parasympathetic activity with a 36-week persistence. More investigations are needed to generalize the outcomes. Additional research is planned to further explore the possibilities of MT in psychiatric disorders with autonomic imbalances.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition that affects attention, impulse control, and the ability to remain still. These challenges can make it harder for individuals with ADHD to succeed at school, work, and in social situations. Stimulant medications, such as methylphenidate and amphetamines, are commonly used as first-line treatments and are effective at reducing symptoms. However, their use can be limited by side effects, such as insomnia, appetite loss, cardiovascular risks, potential for misuse, and variability in individual response. Since current treatments have drawbacks, many people are exploring nonstimulant options, such as behavioral therapy, dietary changes, and neurofeedback. These approaches may be safer and easier to maintain, but research on their effectiveness remains uncertain. This systematic review and meta-analysis aim to compare the effectiveness of pharmacological and nonpharmacological therapies for ADHD. Method: We systematically searched PubMed, PsycINFO, Cochrane Library, ClinicalTrials.gov, and IEEE Xplore for randomized controlled trials (2008–2023) evaluating pharmacological (e.g., stimulant medications), non-pharmacological (e.g., behavioral therapy, cognitive training), or combined interventions in children and adolescents with ADHD. The search yielded 318 records. After screening titles and abstracts, 249 were excluded. Sixty-nine full-text articles were assessed, and 18 RCTs met th

ADHD is one of the most common neurodevelopmental disorders in children that persist into adulthood. Commonly used medications, like stimulants, have serious side effects and short-lived effects, which limit their usage to a small group of children. This predicament leaves room for the exploration of various Complementary Alternative Medicines (CAM) and their efficacy in the place of pharmacological treatment or as an add-on treatment to reduce the dosage of stimulant medication. The absence of side effects draws parents to CAM. Some of the standard CAM therapies discussed in this article are dietary changes, behavioral changes, academic or school-based interventions, homeopathy, Traditional Chinese Medicine, Chinese Herbal Medicine, Cognitive training, Cognitive Behavior Therapy, Neurofeedback, Meditation, and yoga. Though the efficacy of the non-pharmacological treatments is still conflicting, parents continue to try out these Complementary and Alternative Medicines and Therapies and report improvements in ADHD symptoms and behavioral and academic gains.

Background; Dietary interventions for attention-deficit/hyperactivity disorder (ADHD) have attracted increasing interest as potentially modifiable adjuncts to standard care. However, the evidence base remains fragmented, methodologically heterogeneous, and clinically difficult to interpret. Existing narrative evidence suggests that unhealthy dietary patterns may be associated with worse ADHD outcomes, whereas selected nutritional approaches, including supplementation and restrictive diets, may offer benefit in some patients. At the same time, restrictive approaches may carry meaningful harms, including nutritional deficiency and poor growth, and available evidence indicates that such interventions do not work uniformly across all patients. The literature therefore points toward a subgroup-sensitive, precision-oriented approach rather than broad claims of benefit for all individuals with ADHD. Yet no systematic review has specifically synthesized treatment effects according to baseline nutrient deficiency, gastrointestinal symptoms, and medication status. Objective; To systematically evaluate whether the effectiveness and safety of dietary interventions in children, adolescents, and adults with ADHD differ according to baseline nutrient deficiency, gastrointestinal symptom status, and medication status. Methods; This review will be conducted as a systematic review of intervention effectiveness with planned subgroup synthesis. Randomized controlled trials will form the core evidence base, and comparative nonrandomized studies of interventions will also be considered where they contribute clinically relevant evidence on effectiveness, subgroup response, or harms not adequately captured by randomized designs. Eligible interventions will include nutrient supplementation, restrictive or elimination diets, whole-diet interventions, and microbiome-targeted nutritional interventions. Primary outcomes will be change in core ADHD symptoms and functional impairment. Secondary outcomes will include executive function, emotional and behavioral symptoms, sleep outcomes, gastrointestinal symptoms, biomarkers relevant to nutrient status or inflammation, adverse events, nutritional deficiencies, growth outcomes, and treatment adherence or acceptability. Searches will be conducted in MEDLINE via PubMed, Embase via Elsevier, PsycINFO via EBSCOhost, Cochrane CENTRAL via the Cochrane Library, Web of Science Core Collection via Clarivate, and Scopus via Elsevier, supplemented by trial registries, backward and forward citation searching, reference list screening, and contact with corresponding authors when needed. Search reporting will follow PRISMA-S. Two reviewers will independently screen studies, assess full texts, conduct risk-of-bias appraisal, and oversee data extraction. RoB 2 will be used for randomized trials and ROBINS-I for comparative nonrandomized studies. Structured narrative synthesis will be the primary synthesis method, with random-effects meta-analysis undertaken only where clinical and methodological homogeneity permits. Certainty of evidence will be assessed using GRADE. Registration; The protocol will be registered prospectively in PROSPERO before full-text screening begins.

behavioral. Traditionally medications have been the cornerstone of treating ADHD, non-pharmacological treatments are also showing some promise ( 6 - 8 ). The American Academy of Pediatrics (AAP) has recently updated guidelines in 2019 which has formed the basis of management of ADHD ( 1 ): Preschool age group (4–5 years): first line treatment is evidence based parent training in behavior management (PTBM) and/or behavioral classroom interventions, methylphenidate may be considered if no improvement; Elementary school-aged children (6–11 years): medications approved by Food and Drug Administration (FDA) along with PTBM and/or behavioral classroom interventions (preferably both); Adolescents (12–18 years): FDA approved medications is preferred treatment. Evidence based training interventions and/or behavioral interventions should be encouraged. The American Psychological Association (APA) Working Group on psychoactive medications for children and adolescents recommend psychosocial therapy first followed by medications if insufficient ( 9 ). However, the Multimodal Treatment of ADHD (MTA) Cooperative Group found that starting with medication was better than behavioral treatment ( 10 ). Pelham et al. did a multi-randomization study of treatment sequencing in ADHD and concluded that starting treatment with behavioral intervention showed better results than beginning with medications, while starting with medication and later adding behavioral therapy was found to be less effective option ( 11 ). This article focuses on the non-pharmacologic management of ADHD and will be discussed under two broad headings: Psychosocial treatments and Integrative medicine. Psychosocial treatments Since 1998, there has been strong body of evidence that support using psychosocial treatments for ADHD in children and adolescents ( 6 - 8 ). There are 3 types of psychosocial treatments that can be recommended: Behavior management interventions (parent training, classroom interventions, peer-bas

Attention-Deficit / Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder with significant functional impact. It is characterized by inattention, hyperactivity, and impulsivity. Its diagnosis remains challenging due to informant discrepancies, developmental variations, and gender- or culture-related biases. Disparities in healthcare access and stigma further contribute to under- and over-diagnosis, particularly in marginalized populations. This narrative review synthesizes recent literature on advances in ADHD assessment and management. Structured diagnostic tools, digital health innovations, and equity-aware algorithm design are emerging as promising solutions to improve accuracy and reduce bias. In Europe, methylphenidate remains the most commonly prescribed first-line treatment, supported by robust evidence for symptom reduction. Non-stimulant options, such as atomoxetine, guanfacine, and clonidine, provide alternatives for patients with contraindications or poor tolerance to stimulants. Beyond pharmacology, evidence-based psychosocial interventions; including Parent Management Training (PMT) and Cognitive Behavioral Therapy (CBT), play a critical role in promoting long-term functional outcomes. Lifestyle modifications, particularly structured physical activity and dietary interventions, e.g., balanced nutrition, omega-3 supplementation, show benefits in symptom management. The expansion of telemedicine and digital platforms has enhanced care delivery, enab

Introduction and objective: The treatment of ADHD remains a topic of global discussion among researchers and clinicians. Stimulant medications are the primary therapy, but concerns about side effects, addiction, and misuse have led to growing interest in alternative methods, such as behavioral therapy, cognitive training, neurofeedback, and dietary interventions. This review aims to compile data on ADHD treatment and assess whether alternative therapies can replace stimulants. Brief description of the state of knowledge: Numerous studies describe individual therapeutic methods, but a lack of definitive conclusions persists due to uncertainties and isolated evaluations. More comparative research and studies on combined treatments are needed to determine the most effective approaches. Particularly, there is a shortage of studies on integrating pharmacological and alternative therapies, highlighting the need for future research. Methods: A literature review was conducted using PubMed and Google Scholar with search terms like “ADHD - diagnostic criteria and symptoms”, “Stimulant medications in the treatment of ADHD”, “Alternative treatment methods for ADHD”, “Dietary treatment and supplementation in ADHD”. Articles published within the last five years were prioritized. Conclusions: Stimulants remain the most effective ADHD treatment but are associated with side effects such as sleep disturbances, appetite loss, and addiction concerns. In response, alternative therapies are gainin

adolescents For children ages 6 years and older, AAP recommends combining medication treatment with behavior therapy. Several types of behavior therapies are considered effective, including: Parent training in behavior management; Behavioral interventions in the classroom; Peer interventions that focus on behavior; and Organizational skills training. These approaches are often most effective if they are used together, depending on the needs of the individual child and the family. Parents, healthcare providers, and the school can work together on developing the right treatment plan. Good treatment plans will include close monitoring of whether and how much the treatment helps the child's behavior, as well as making changes as needed along the way. ADHD care and treatment recommendations Learn more about AAP recommendations for the care and treatment of children and adolescents with ADHD. Clinical Care of ADHD in Children Medications used to treat ADHD Medication can help children manage their ADHD symptoms in their everyday life and can help them control the behaviors that cause difficulties with family, friends, and at school. Medications can affect children differently and can have side effects such as decreased appetite or sleep problems. One child may respond well to one medication, but not to another. Several different types of medications are FDA-approved to treat ADHD in children as young as 6 years of age: Stimulants are the best-known and most widely used ADHD medications. Between 70-80% of children with ADHD have fewer ADHD symptoms when taking these fast-acting medications. Nonstimulants were approved for the treatment of ADHD in 2003. They do not work as quickly as stimulants, but their effect can last up to 24 hours. Keep in mind Healthcare providers who prescribe medication may need to try different medications and doses. The AAP recommends that healthcare providers observe and adjust the dose of medication to find the right balance between benefits an

state-of-the-art behavioral therapy in treating ADHD (NIH Consensus Statement on ADHD, 2000). Specifically … ‘‘medication for ADHD,’ the reader can assume that the medication referred to for ADHD is at least 95% … diagnosis of ADHD, the lifetime pre- valence of stimulant medication for students diagnosed with ADHD was 73%