Attention Deficit Hyperactivity Disorder (ADHD)

Last Updated: August 16, 2022

Attention deficit/hyperactivity disorder (ADHD) is characterized by impulsivity, inattention, and hyperactivity. Although often diagnosed in children, it’s nearly as common in adults.

Attention Deficit Hyperactivity Disorder (ADHD) falls under thePregnancy & ChildrenandBrain Healthcategories.

What is ADHD?

Attention deficit/hyperactivity disorder (ADHD) is a behavioral condition characterized by inattention, impulsivity, and hyperactivity. Most people experience these behaviors from time to time, but in ADHD, they are more severe, happen more often, and interfere with a person’s ability to function socially, at school, or in the workplace.[1] ADHD is divided into three subtypes by predominant symptomatology: Inattentive (ADHD-I), Hyperactive-Impulsive (ADHD-HI), and Combined (ADHD-C). Symptom clusters can change as individuals mature and develop.[2]

What are the main signs and symptoms of ADHD?

People with ADHD can show signs of inattention, hyperactivity, impulsivity, or both.[3] This can manifest as difficulty paying attention to details, getting sidetracked from schoolwork, troubles with organization, and being easily distracted. Other behaviors include fidgeting or squirming, inability to remain seated when expected, inappropriate running or climbing, and talking excessively. ADHD in adults is often internalized and may present as restlessness, scattered thoughts, and poor time management.[4]

How is ADHD diagnosed?

In children, at least six of the symptoms mentioned need to be present to qualify for a diagnosis; in adults, only five. In both cases, these symptoms need to be present for more than 6 months and interfere with academic, occupational, or social functioning.[5]

What are some of the main medical treatments for ADHD?

Except in children under age 5, medications are considered the first-line treatment for ADHD.[6][7] Short- and long-acting forms of amphetamines and methylphenidate — stimulants that increase levels of dopamine and norepinephrine in the brain — are most commonly prescribed and considered highly effective for treating ADHD.[8][9]

Other nonstimulant medications used for ADHD include atomoxetine,[10] bupropion,[11] and tricyclic antidepressants.[12]There is some preliminary research suggesting that modafinil may improve ADHD, but much more research is needed.[13]

Have any supplements been studied for ADHD?

Fish oil contains the omega-3 fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), which have well-supported anti-inflammatory properties and can regulate neurotransmitter and immune function, and as a result, may improve ADHD.[14]

Ginkgo biloba increases blood flow in the human brain and the signaling of serotonin and norepinephrine in rats, which may contribute to its mild, positive effect on ADHD.[15][16]

Both L-carnitine and acetyl-L-carnitine are present in brain cells and play an important role in energy production — it’s possible that by increasing mitochondrial activity in neurons and promoting dopamine signaling, carnitine could improve symptoms of ADHD.[17]

Supplementing with phosphatidylserine (a phosphorus-containing lipid) seems to positively affect ADHD,[18] which is likely due to its important role in adjusting receptor, enzyme, and ion channel activity, and consequently, affecting the signaling of most neurotransmitters in the brain.

How could diet affect ADHD?

A number of dietary interventions for ADHD have been studied, including the elimination of artificial food colorings, diets high in polyunsaturated fatty acids (PUFAs), and the few-foods diet (a type of elimination diet that gradually reintroduces foods based on how a person’s symptoms change).[19] High-PUFA diets aren’t likely to improve ADHD symptoms, but the few-foods diet is promising. More research on dietary artificial food coloring intake is necessary before it can be recommended for treating ADHD.

Are there any other treatments for ADHD?

Behavioral strategies can be used to manage ADHD symptoms, and include:[20]

  • Keeping a consistent schedule
  • Minimizing external distractions
  • Setting small, reachable goals
  • Identifying unintentional reinforcement of negative behaviors
  • Using charts and checklists
  • Limiting choices
  • Using calm discipline in children (e.g., time out)

Psychotherapy and cognitive behavioral therapy can be helpful for children and adults with ADHD, although it’s not recommended as a substitute for medication.[21]

What causes ADHD?

The exact etiology of ADHD is unknown but is thought to involve structural and neurochemical alterations in brain regions responsible for executive function, memory, and information processing.[22][23] Norepinephrine and dopamine signaling play a major role in the function of these brain regions, and individuals with ADHD tend to have lower levels of both of these neurotransmitters than individuals without ADHD.[22]

ADHD has a strong genetic component. The risk of ADHD is increased by 2–8 times in individuals who have a parent or sibling with ADHD, and pooled twin studies suggest that the heritability of ADHD is nearly 80%.[24]

Supplements Demystified: Get Our Unbiased, Evidence-Based Guide

Examine Database: Attention Deficit Hyperactivity Disorder (ADHD)
What works and what doesn't?

Unlock the full potential of Examine

Get started

Don't miss out on the latest research

  1. ^National Institute of Mental HealthAttention-Deficit/Hyperactivity Disorder(2019-09)
  2. ^Benjamin B Lahey, William E Pelham, Jan Loney, Steve S Lee, Erik WillcuttInstability of the DSM-IV Subtypes of ADHD from preschool through elementary schoolArch Gen Psychiatry.(2005 Aug)
  3. ^Jonathan Posner, Guilherme V Polanczyk, Edmund Sonuga-BarkeAttention-deficit hyperactivity disorderLancet.(2020 Feb 8)
  4. ^Sandra J J Kooij, Susanne Bejerot, Andrew Blackwell, Herve Caci, Miquel Casas-Brugué, Pieter J Carpentier, Dan Edvinsson, John Fayyad, Karin Foeken, Michael Fitzgerald, Veronique Gaillac, Ylva Ginsberg, Chantal Henry, Johanna Krause, Michael B Lensing, Iris Manor, Helmut Niederhofer, Carlos Nunes-Filipe, Martin D Ohlmeier, Pierre Oswald, Stefano Pallanti, Artemios Pehlivanidis, Josep A Ramos-Quiroga, Maria Rastam, Doris Ryffel-Rawak, Steven Stes, Philip AshersonEuropean consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHDBMC Psychiatry.(2010 Sep 3)
  5. ^World Health Organization(2021-05)
  6. ^Joel L Young, David W GoodmanAdult Attention-Deficit/Hyperactivity Disorder Diagnosis, Management, and Treatment in the DSM-5 EraPrim Care Companion CNS Disord.(2016 Nov 17)
  7. ^National Institute for Health and Care ExcellenceAttention deficit hyperactivity disorder: diagnosis and management(2014-03-14)
  8. ^Timothy E Wilens, Nicholas R Morrison, Jefferson PrinceAn update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adultsExpert Rev Neurother.(2011 Oct)
  9. ^Agnes Mészáros, Pál Czobor, Sára Bálint, Sarolta Komlósi, Viktória Simon, István BitterPharmacotherapy of adult attention deficit hyperactivity disorder (ADHD): a meta-analysisInt J Neuropsychopharmacol.(2009 Sep)
  10. ^Ruth Cunill, Xavier Castells, Aurelio Tobias, Dolors CapellàAtomoxetine for attention deficit hyperactivity disorder in the adulthood: a meta-analysis and meta-regressionPharmacoepidemiol Drug Saf.(2013 Sep)
  11. ^Narong Maneeton, Benchalak Maneeton, Manit Srisurapanont, Stephen D MartinBupropion for adults with attention-deficit hyperactivity disorder: meta-analysis of randomized, placebo-controlled trialsPsychiatry Clin Neurosci.(2011 Dec)
  12. ^T E Wilens, J Biederman, J Prince, T J Spencer, S V Faraone, R Warburton, D Schleifer, M Harding, C Linehan, D GellerSix-week, double-blind, placebo-controlled study of desipramine for adult attention deficit hyperactivity disorderAm J Psychiatry.(1996 Sep)
  13. ^Biederman J, Swanson JM, Wigal SB, Kratochvil CJ, Boellner SW, Earl CQ, Jiang J, Greenhill LEfficacy and safety of modafinil film-coated tablets in children and adolescents with attention-deficit/hyperactivity disorder: results of a randomized, double-blind, placebo-controlled, flexible-dose studyPediatrics.(2005 Dec)
  14. ^Jane Pei-Chen Chang, Kuan-Pin Su, Valeria Mondelli, Carmine M ParianteOmega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological StudiesNeuropsychopharmacology.(2018 Feb)
  15. ^Laura L Boles Ponto, Susan K SchultzGinkgo biloba extract: review of CNS effectsAnn Clin Psychiatry.(2003 Jun)
  16. ^F Huguet, T TarradeAlpha 2-adrenoceptor changes during cerebral ageing. The effect of Ginkgo biloba extractJ Pharm Pharmacol.(1992 Jan)
  17. ^L Eugene Arnold, Antonino Amato, Hernan Bozzolo, Jill Hollway, Amy Cook, Yaser Ramadan, Lindsay Crowl, Dan Zhang, Susan Thompson, Giussepe Testa, Vernon Kliewer, Timothy Wigal, Keith McBurnett, Michael ManosAcetyl-L-carnitine (ALC) in attention-deficit/hyperactivity disorder: a multi-site, placebo-controlled pilot trialJ Child Adolesc Psychopharmacol.(2007 Dec)
  18. ^Hirayama S, Terasawa K, Rabeler R, Hirayama T, Inoue T, Tatsumi Y, Purpura M, Jäger RThe effect of phosphatidylserine administration on memory and symptoms of attention-deficit hyperactivity disorder: a randomised, double-blind, placebo-controlled clinical trialJ Hum Nutr Diet.(2013 Mar 17)
  19. ^Lidy M Pelsser, Klaas Frankena, Jan Toorman, Rob Rodrigues PereiraDiet and ADHD, Reviewing the Evidence: A Systematic Review of Meta-Analyses of Double-Blind Placebo-Controlled Trials Evaluating the Efficacy of Diet Interventions on the Behavior of Children with ADHDPLoS One.(2017 Jan 25)
  20. ^American Academy of PediatricsUnderstanding ADHD: Information for Parents
  21. ^Stephen V Faraone, Tobias Banaschewski, David Coghill, Yi Zheng, Joseph Biederman, Mark A Bellgrove, Jeffrey H Newcorn, Martin Gignac, Nouf M Al Saud, Iris Manor, Luis Augusto Rohde, Li Yang, Samuele Cortese, Doron Almagor, Mark A Stein, Turki H Albatti, Haya F Aljoudi, Mohammed M J Alqahtani, Philip Asherson, Lukoye Atwoli, Sven Bölte, Jan K Buitelaar, Cleo L Crunelle, David Daley, Søren Dalsgaard, Manfred Döpfner, Stacey Espinet, Michael Fitzgerald, Barbara Franke, Manfred Gerlach, Jan Haavik, Catharina A Hartman, Cynthia M Hartung, Stephen P Hinshaw, Pieter J Hoekstra, Chris Hollis, Scott H Kollins, J J Sandra Kooij, Jonna Kuntsi, Henrik Larsson, Tingyu Li, Jing Liu, Eugene Merzon, Gregory Mattingly, Paulo Mattos, Suzanne McCarthy, Amori Yee Mikami, Brooke S G Molina, Joel T Nigg, Diane Purper-Ouakil, Olayinka O Omigbodun, Guilherme V Polanczyk, Yehuda Pollak, Alison S Poulton, Ravi Philip Rajkumar, Andrew Reding, Andreas Reif, Katya Rubia, Julia Rucklidge, Marcel Romanos, J AntoThe World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorderNeurosci Biobehav Rev.(2021 Sep)
  22. ^Amy F T ArnstenFundamentals of attention-deficit/hyperactivity disorder: circuits and pathwaysJ Clin Psychiatry.(2006)
  23. ^Erik G Willcutt, Alysa E Doyle, Joel T Nigg, Stephen V Faraone, Bruce F PenningtonValidity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic reviewBiol Psychiatry.(2005 Jun 1)
  24. ^Alicia K Smith, Eric Mick, Stephen V FaraoneAdvances in genetic studies of attention-deficit/hyperactivity disorderCurr Psychiatry Rep.(2009 Apr)
  25. ^B Kadesjö, C GillbergThe comorbidity of ADHD in the general population of Swedish school-age childrenJ Child Psychol Psychiatry.(2001 May)
  26. ^C Gillberg, E BillstedtAutism and Asperger syndrome: coexistence with other clinical disordersActa Psychiatr Scand.(2000 Nov)
  27. ^J L Bradshaw, D M SheppardThe neurodevelopmental frontostriatal disorders: evolutionary adaptiveness and anomalous lateralizationBrain Lang.(2000 Jun 15)
  28. ^Belinda A Gargaro, Nicole J Rinehart, John L Bradshaw, Bruce J Tonge, Dianne M SheppardAutism and ADHD: how far have we come in the comorbidity debate?Neurosci Biobehav Rev.(2011 Apr)
  29. ^Song P, Zha M, Yang Q, Zhang Y, Li X, Rudan IThe prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis.J Glob Health.(2021-Feb-11)
  30. ^S Weibel, O Menard, A Ionita, M Boumendjel, C Cabelguen, C Kraemer, J-A Micoulaud-Franchi, S Bioulac, N Perroud, A Sauvaget, L Carton, M Gachet, R LopezPractical considerations for the evaluation and management of Attention Deficit Hyperactivity Disorder (ADHD) in adultsEncephale.(2020 Feb)
  31. ^Ashkan Beheshti, Mira-Lynn Chavanon, Hanna ChristiansenEmotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysisBMC Psychiatry.(2020 Mar 12)
  32. ^Faraone SV, Larsson HGenetics of attention deficit hyperactivity disorder.Mol Psychiatry.(2019-04)
  33. ^Daniel PreiatoExploring the Link Between ADHD and Exercise
  34. ^Silva AP, Prado SO, Scardovelli TA, Boschi SR, Campos LC, Frère AFMeasurement of the effect of physical exercise on the concentration of individuals with ADHD.PLoS One.(2015)
  35. ^Mehren A, Reichert M, Coghill D, Müller HHO, Braun N, Philipsen APhysical exercise in attention deficit hyperactivity disorder - evidence and implications for the treatment of borderline personality disorder.Borderline Personal Disord Emot Dysregul.(2020)
  36. ^CHADDADHD & Recreational Marijuana: What’s the Attraction?
Examine Database References
  1. ADHD Symptoms - Torrioli MG, Vernacotola S, Peruzzi L, Tabolacci E, Mila M, Militerni R, Musumeci S, Ramos FJ, Frontera M, Sorge G, Marzullo E, Romeo G, Vallee L, Veneselli E, Cocchi E, Garbarino E, Moscato U, Chiurazzi P, D'Iddio S, Calvani M, Neri GA double-blind, parallel, multicenter comparison of L-acetylcarnitine with placebo on the attention deficit hyperactivity disorder in fragile X syndrome boysAm J Med Genet A.(2008 Apr 1)
  2. ADHD Symptoms - L Eugene Arnold, Antonino Amato, Hernan Bozzolo, Jill Hollway, Amy Cook, Yaser Ramadan, Lindsay Crowl, Dan Zhang, Susan Thompson, Giussepe Testa, Vernon Kliewer, Timothy Wigal, Keith McBurnett, Michael ManosAcetyl-L-carnitine (ALC) in attention-deficit/hyperactivity disorder: a multi-site, placebo-controlled pilot trialJ Child Adolesc Psychopharmacol.(2007 Dec)
  3. ADHD Symptoms - Van Oudheusden LJ, Scholte HREfficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorderProstaglandins Leukot Essent Fatty Acids.(2002 Jul)
  4. ADHD Symptoms - Seyed-Hesameddin Abbasi, Shahram Heidari, Mohammad-Reza Mohammadi, Mina Tabrizi, Ali Ghaleiha, Shahin AkhondzadehAcetyl-L-carnitine as an adjunctive therapy in the treatment of attention-deficit/hyperactivity disorder in children and adolescents: a placebo-controlled trialChild Psychiatry Hum Dev.(2011 Jun)
  5. ADHD Symptoms - Hirayama S, Terasawa K, Rabeler R, Hirayama T, Inoue T, Tatsumi Y, Purpura M, Jäger RThe effect of phosphatidylserine administration on memory and symptoms of attention-deficit hyperactivity disorder: a randomised, double-blind, placebo-controlled clinical trialJ Hum Nutr Diet.(2013 Mar 17)
  6. ADHD Symptoms - Alisha Bruton, Joy Nauman, Douglas Hanes, Melissa Gard, Angela SendersPhosphatidylserine for the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-AnalysisJ Altern Complement Med.(2021 Feb 4)
  7. ADHD Symptoms - Manor I, Magen A, Keidar D, Rosen S, Tasker H, Cohen T, Richter Y, Zaaroor-Regev D, Manor Y, Weizman AThe effect of phosphatidylserine containing Omega3 fatty-acids on attention-deficit hyperactivity disorder symptoms in children: a double-blind placebo-controlled trial, followed by an open-label extensionEur Psychiatry.(2012 Jul)
  8. ADHD Symptoms - Jane Pei-Chen Chang, Kuan-Pin Su, Valeria Mondelli, Senthil Kumaran Satyanarayanan, Hui-Ting Yang, Yi-Ju Chiang, Hui-Ting Chen, Carmine M ParianteHigh-dose eicosapentaenoic acid (EPA) improves attention and vigilance in children and adolescents with attention deficit hyperactivity disorder (ADHD) and low endogenous EPA levelsTransl Psychiatry.(2019 Nov 20)
  9. ADHD Symptoms - Richardson AJ, Puri BKA randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficultiesProg Neuropsychopharmacol Biol Psychiatry.(2002 Feb)
  10. ADHD Symptoms - Bos DJ, Oranje B, Veerhoek ES, Van Diepen RM, Weusten JM, Demmelmair H, Koletzko B, de Sain-van der Velden MG, Eilander A, Hoeksma M, Durston SReduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity DisorderNeuropsychopharmacology.(2015 Sep)
  11. ADHD Symptoms - Voigt RG, Llorente AM, Jensen CL, Fraley JK, Berretta MC, Heird WCA randomized, double-blind, placebo-controlled trial of docosahexaenoic acid supplementation in children with attention-deficit/hyperactivity disorderJ Pediatr.(2001 Aug)
  12. ADHD Symptoms - Gustafsson PA, Birberg-Thornberg U, Duchén K, Landgren M, Malmberg K, Pelling H, Strandvik B, Karlsson TEPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHDActa Paediatr.(2010 Oct)
  13. ADHD Symptoms - Stevens L, Zhang W, Peck L, Kuczek T, Grevstad N, Mahon A, Zentall SS, Arnold LE, Burgess JREFA supplementation in children with inattention, hyperactivity, and other disruptive behaviorsLipids.(2003 Oct)
  14. ADHD Symptoms - Widenhorn-Müller K, Schwanda S, Scholz E, Spitzer M, Bode HEffect of supplementation with long-chain ω-3 polyunsaturated fatty acids on behavior and cognition in children with attention deficit/hyperactivity disorder (ADHD): a randomized placebo-controlled intervention trialProstaglandins Leukot Essent Fatty Acids.(2014 Jul-Aug)
  15. ADHD Symptoms - Bloch MH, Qawasmi AOmega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysisJ Am Acad Child Adolesc Psychiatry.(2011 Oct)
  16. ADHD Symptoms - Sinn N, Bryan JEffect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child ADHDJ Dev Behav Pediatr.(2007 Apr)
  17. ADHD Symptoms - Bélanger SA, Vanasse M, Spahis S, Sylvestre MP, Lippé S, L'heureux F, Ghadirian P, Vanasse CM, Levy EOmega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: A randomized, double-blind, placebo-controlled studyPaediatr Child Health.(2009 Feb)
  18. ADHD Symptoms - Arnold LE, Disilvestro RA, Bozzolo D, Bozzolo H, Crowl L, Fernandez S, Ramadan Y, Thompson S, Mo X, Abdel-Rasoul M, Joseph EZinc for attention-deficit/hyperactivity disorder: placebo-controlled double-blind pilot trial alone and combined with amphetamineJ Child Adolesc Psychopharmacol.(2011 Feb)
  19. ADHD Symptoms - Talebi S, Miraghajani M, Ghavami A, Mohammadi HThe effect of zinc supplementation in children with attention deficit hyperactivity disorder: A systematic review and dose-response meta‑analysis of randomized clinical trials.Crit Rev Food Sci Nutr.(2022)
  20. ADHD Symptoms - Ruth E Cooper, Emma Williams, Seth Seegobin, Charlotte Tye, Jonna Kuntsi, Philip AshersonCannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trialEur Neuropsychopharmacol.(2017 Aug)
  21. ADHD Symptoms - Sara Baziar, Ali Aqamolaei, Ebrahim Khadem, Seyyed Hosein Mortazavi, Sina Naderi, Erfan Sahebolzamani, Amirhosein Mortezaei, Shakiba Jalilevand, Mohammad-Reza Mohammadi, Mahsa Shahmirzadi, Shahin AkhondzadehCrocus sativus L. Versus Methylphenidate in Treatment of Children with Attention-Deficit/Hyperactivity Disorder: A Randomized, Double-Blind Pilot StudyJ Child Adolesc Psychopharmacol.(2019 Apr)
  22. ADHD Symptoms - Hae-Jin Ko, Inbo Kim, Jong-Bae Kim, Yong Moon, Min-Cheol Whang, Keun-Mi Lee, Seung-Pil JungEffects of Korean red ginseng extract on behavior in children with symptoms of inattention and hyperactivity/impulsivity: a double-blind randomized placebo-controlled trialJ Child Adolesc Psychopharmacol.(2014 Nov)
  23. ADHD Symptoms - Salehi B, Imani R, Mohammadi MR, Fallah J, Mohammadi M, Ghanizadeh A, Tasviechi AA, Vossoughi A, Rezazadeh SA, Akhondzadeh SGinkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trialProg Neuropsychopharmacol Biol Psychiatry.(2010 Feb 1)
  24. ADHD Symptoms - Surman C, Vaudreuil C, Boland H, Rhodewalt L, DiSalvo M, Biederman JL-Threonic Acid Magnesium Salt Supplementation in ADHD: An Open-Label Pilot Study.J Diet Suppl.(2021)
  25. Attention - Susan Kennel, Ann Gill Taylor, Debra Lyon, Cheryl BourguignonPilot feasibility study of binaural auditory beats for reducing symptoms of inattention in children and adolescents with attention-deficit/hyperactivity disorderJ Pediatr Nurs.(2010 Feb)
  26. Sleep Quality - Lyon MR, Kapoor MP, Juneja LRThe effects of L-theanine (Suntheanine®) on objective sleep quality in boys with attention deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled clinical trialAltern Med Rev.(2011 Dec)