Children and teens with attention-deficit/hyperactivity disorder (ADHD)
who were treated with the herb St. John’s wort did not have any greater
improvement in ADHD symptoms compared to those who received placebo.
ADHD affects 3 to 12 percent of children in the United States. Up to
30 percent of these children do not respond to pharmaceutical
medications or have adverse effects such as nausea, insomnia, or weight
loss from the medications, according to background information in the
article. "For these reasons, many parents seek complementary or
alternative medicine for their children with ADHD. Complementary or
alternative medicine treatments used for pediatric ADHD include
massage, dietary changes, dietary supplements, and herbal treatments.
In the United States, the most common herbal treatments used by
children with ADHD are St John’s wort, Echinacea species, and Ginkgo
biloba," the authors write.
Wendy Weber, N.D., Ph.D., M.P.H., of Bastyr University, Kenmore,
Wash., and colleagues conducted a clinical trial of St. John’s wort
(Hypericum perforatum) with 54 children and adolescents with ADHD, age
6 to 17 years, to determine whether this agent was effective in
lessening the severity of ADHD symptoms. Twenty-seven participants were
randomly assigned to receive 300 mg of H perforatum standardized to 0.3
percent hypericin (a compound derived from H perforatum) and 27
participants received a matched placebo, three times daily for eight
weeks. Other medications for ADHD were not allowed during the trial.
The researchers found that there were no significant differences
between the two groups in the change in ADHD rating scale scores from
the start of the trial to week 8 and in change in scores rating
inattentiveness and hyperactivity. There was also no difference in the
proportion of participants who were rated as much or very much improved
regarding ADHD symptoms on another measurement scale. No statistically
significant difference was found between the two groups in the
proportion of participants who experienced 1 or more rash,
nausea/vomiting, headache, or sunburn during the trial.
"To our knowledge, this is the first placebo-controlled trial of H
perforatum in children and adolescents. The results of this study
suggest that administration of H perforatum has no additional benefit
beyond that of placebo for treating symptoms of child and adolescent
ADHD," the authors write.
Editorial: Quality of Efficacy Research in Complementary and Alternative Therapies
In an accompanying editorial, Eugenia Chan, M.D., M.P.H., of
Children’s Hospital Boston and Harvard Medical School, writes that
conducting randomized controlled trials of complementary and
alternative therapies can pose challenges.
"… randomizing participants may be difficult or impossible when
the therapy to be evaluated relies on participants’ belief in the
treatment or relationship with the practitioner. Use of placebo and
blinding may be difficult in therapies such as acupuncture, yoga,
psychotherapy, or surgery, although techniques such as placebo needles
that do not actually enter the skin have been developed. Even when a
plausible placebo can be used, placebo and expectation effects can be
very large in both complementary and alternative medicine and
conventional interventions and may be part of the mechanism of
Source : JAMA and Archives Journals