Effect of vitamin D supplementation as adjunctive therapy to methylphenidate on ADHD symptoms: A randomized, double blind, placebo-controlled trial

Nutr Neurosci. 2018 Apr;21(3):202-209. doi: 10.1080/1028415X.2016.1262097. Epub 2016 Dec 7.

Abstract

Objectives: Previous studies have shown that serum levels of vitamin D were lower in attention deficit hyperactivity disorder (ADHD) children compared to healthy controls. The aim of the study was to determine the effect of vitamin D supplementation as adjunctive therapy to methylphenidate on symptoms of children with ADHD.

Methods: Sixty-two children aged 5-12 years with a diagnosis of ADHD based on DSM-IV criteria were randomly assigned into two groups to receive either 2000IU vitamin D or placebo in addition to methylphenidate for 8 weeks. Symptoms severity was assessed by Conner's Parent Rating Scale-Revised[S] (CPRS), ADHD rating scale-IV (ADHD-RS), and Weekly Parent Ratings of Evening and Morning Behavior (WPREMB) at weeks 0, 4, and 8. Serum levels of 25(OH)D were measured at baseline and after 8 weeks. Anthropometric variables, dietary intake, physical activity, sun exposure, and side effects were assessed.

Results: Fifty-four participants completed the trial. After 8 weeks of supplementation, serum levels of 25(OH)D significantly increased in the vitamin D group. ADHD symptoms decreased significantly in both groups (P < 0.05). Evening symptoms and total score of WPREMB scale were significantly different at weeks 4 and 8 between the two groups (P = 0.013, 0.016, respectively), but no differences were found in symptoms by CPRS and ADHD-RS scales.

Discussion: Vitamin D supplementation as adjunctive therapy to methylphenidate improved ADHD evening symptoms. Future research is needed to clarify vitamin D effects as monotherapy in ADHD and its mechanism. The trial was registered in www.irct.ir is (IRCT201404222394N10).

Keywords: Attention deficit hyperactivity disorder; Conners’ Parent Rating Scale-Revised; Supplementation; Symptoms; Vitamin D.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living
  • Attention Deficit Disorder with Hyperactivity / complications
  • Attention Deficit Disorder with Hyperactivity / diet therapy*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / physiopathology
  • Calcifediol / blood
  • Child
  • Child Nutritional Physiological Phenomena* / drug effects
  • Child, Preschool
  • Combined Modality Therapy / adverse effects
  • Diagnostic and Statistical Manual of Mental Disorders
  • Dietary Supplements* / adverse effects
  • Dopamine Uptake Inhibitors / adverse effects
  • Dopamine Uptake Inhibitors / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Iran
  • Male
  • Methylphenidate / adverse effects
  • Methylphenidate / therapeutic use*
  • Parents
  • Severity of Illness Index
  • Symptom Assessment
  • Vitamin D / adverse effects
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / diet therapy
  • Vitamin D Deficiency / physiopathology

Substances

  • Dopamine Uptake Inhibitors
  • Vitamin D
  • Methylphenidate
  • Calcifediol