There is no ‘cure’ for ADHD, but a variety of treatment options can help manage symptoms and improve quality of life for some people. Treatments range from medications and behavioural therapies to lifestyle interventions (and alternative approaches). Research supports the efficacy of many treatments for ADHD, but individual responses can vary, highlighting the importance of a tailored approach (National Institute for Health and Care Excellence, 2018).
1. Medication Types for ADHD
Medications are one of the most common treatments for ADHD and are often effective in reducing symptoms such as inattention, impulsivity, and hyperactivity. ADHD medications fall into two main categories: stimulants and non-stimulants.
a) Stimulants
Stimulant medications, such as methylphenidate (e.g., Ritalin, Concerta) and amphetamines (e.g., Adderall, Vyvanse), are the most widely prescribed for ADHD. They work by increasing levels of dopamine and norepinephrine in the brain, which helps improve focus and impulse control. Stimulants have a well-documented efficacy rate, with approximately 70-80% of people with ADHD showing significant improvement in symptoms (Faraone & Buitelaar, 2010). However, stimulants can cause side effects, including appetite suppression, sleep disturbances, increased heart rate, and more.
b) Non-Stimulants
Non-stimulant medications, such as atomoxetine (Strattera) and guanfacine (Intuniv), are alternatives for individuals who do not respond well to stimulants or experience side effects they cannot tolerate. Atomoxetine, for example, works by selectively inhibiting norepinephrine reuptake, which can improve focus and reduce impulsivity. Non-stimulants typically have a slower onset of action but can be effective in managing ADHD symptoms without the stimulating effects, making them suitable for those prone to anxiety or sleep issues (Michelson et al., 2002).
2. Cognitive Behavioural Therapy (CBT)
CBT is a structured, evidence-based psychological treatment that helps individuals with ADHD develop coping strategies to manage symptoms. CBT focuses on changing patterns of thinking and behaviour that may exacerbate ADHD symptoms, such as procrastination, disorganisation, and impulsive decision-making (Knouse & Safren, 2010). CBT has been shown to be particularly beneficial for adults with ADHD, who often struggle with task completion, time management, and emotional regulation. While CBT does not directly reduce core ADHD symptoms, it helps individuals build strategies to handle everyday challenges, improving overall functioning and quality of life.
3. ADHD Coaching
ADHD coaching is a supportive, goal-oriented process that helps individuals develop practical strategies for managing specific challenges associated with ADHD, such as organisation, time management, and productivity. ADHD coaches work collaboratively with clients to create personalised strategies for handling tasks and staying motivated. Coaching has gained popularity as an effective supplement to other treatments, especially among adults and adolescents (Parker et al., 2013). Studies show that it can helps individuals with ADHD set and achieve personal and professional goals (Prevatt & Levrini, 2015).
4. Diet and Exercise
Lifestyle interventions, particularly diet and exercise, can have beneficial effects on ADHD symptoms. Regular physical exercise is linked to improvements in attention, executive function, and mood in individuals with ADHD. Physical activity increases dopamine and norepinephrine levels, similar to the effects of stimulant medications, and helps reduce hyperactivity and improve focus (Hoza et al., 2015).
Diet also plays a role, with some research indicating that certain dietary adjustments may benefit individuals with ADHD. For example, reducing sugar (which ADHD brains crave more-so than others due to the dopamine hit) is known to combat ‘sugar crashes’ causing sleepiness in adults, and contributes to improved behavioural outcomes in children with ADHD (Sonuga-Barke et al., 2013).
It is important to note that exercise and dietary interventions alone are generally not sufficient as a primary treatment, but can be useful as part of an overall management plan. Also the research on this has limitations, and there is currently no consensus on how impactful these lifestyle changes are on ADHD. However, given the more general benefits of good diet and exercise on all people, ADHD aside, it is recommended and recognised as likely to improve life quality overall.
5. Alternative and Complementary Treatments
A variety of alternative treatments are often considered for ADHD, though their efficacy varies, and many lack robust evidence compared to mainstream treatments. Some popular alternatives include:
a) Mindfulness and Meditation
Mindfulness practices, such as meditation, help increase awareness and attention control, which can be beneficial for managing ADHD symptoms. Studies indicate that mindfulness training can improve attention, emotional regulation, and executive functioning in both children and adults with ADHD (Zylowska et al., 2008). Although mindfulness is not a standalone treatment for ADHD, it can be an effective complementary approach. The benefits of mindfulness and medication are fairly well established in general, and likely to have some positive effect on the lives of people with ADHD.
b) Neurofeedback
Neurofeedback is a type of biofeedback that aims to train individuals to regulate their brain wave activity. Some studies suggest that neurofeedback can improve ADHD symptoms by encouraging patterns of brain activity associated with focus and impulse control. However, while promising, neurofeedback remains controversial due to limited evidence and inconsistent results across studies (Arns et al., 2014).
c) Herbal and Nutritional Supplements
Certain supplements, such as zinc, magnesium, and vitamin B6, have been suggested to help manage ADHD symptoms. Omega-3 fatty acids, in particular, have shown modest improvements in symptoms like inattention and hyperactivity (Bloch & Qawasmi, 2011). But the evidence is minimal and inconsistent, so while some supplements may provide additional support, they are not substitutes for standard treatments.
Proven Efficacy of Treatments
Research supports the efficacy of medication as the main primary ADHD treatment. Medication, particularly stimulants, is often the most effective option for symptom management, but combining medication with behavioural therapies such as CBT and/or coaching generally provides the best outcomes (NICE, 2018). Exercise and dietary adjustments, while not primary treatments, can enhance treatment effects and improve overall well-being.
Alternative treatments like mindfulness, neurofeedback, and supplements may provide additional benefits for some individuals, but these approaches are best used in conjunction with mainstream treatments due to limited evidence. Each treatment should be tailored to the individual’s needs, as ADHD manifests differently for each person, and combining therapies often yields the most successful results.
References
Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2014). Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clinical EEG and Neuroscience, 40(3), 180-189.
Bloch, M. H., & Qawasmi, A. (2011). Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 50(10), 991-1000.
Faraone, S. V., & Buitelaar, J. K. (2010). Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. European Child & Adolescent Psychiatry, 19(4), 353-364.
Hoza, B., Martin, C. P., Pirog, A., & Shoulberg, E. K. (2015). Using physical activity to manage ADHD symptoms: The state of the evidence. Current Psychiatry Reports, 18(5), 18-26.
Knouse, L. E., & Safren, S. A. (2010). Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder. Psychiatric Clinics of North America, 33(3), 497-509.
Michelson, D., Adler, L., Spencer, T., Reimherr, F. W., West, S. A., Allen, A. J., … & Dietrich, A. (2002). Atomoxetine in adults with ADHD: two randomized, placebo-controlled studies. Biological Psychiatry, 53(2), 112-120.
National Institute for Health and Care Excellence (NICE). (2018). Attention deficit hyperactivity disorder: Diagnosis and management.
Parker, D. R., Hoffman, S. F., Sawilowsky, S., & Rolands, L. (2013). Self-control in postsecondary settings: Students’ perceptions of ADHD coaching. Journal of Attention Disorders, 17(1), 48-58.
Prevatt, F., & Levrini, A. (2015). ADHD coaching: A guide for mental health professionals. American Psychological Association.
Sonuga-Barke, E. J., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., … & Sergeant, J. (2013). Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170(3), 275-289.
Zylowska, L., Ackerman, D. L., Yang, M. H., Futrell, J. L., Horton, N. L., Hale, T. S., & Smalley, S. L. (2008). Mindfulness meditation